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Pediatric Cardiovascular System

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After a cardiac catheterization, what is it important to monitor the patient for in order to recognize potential complications?
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Hypotension, bleeding from the insertion site, loss of circulation to the extremities, dysrhythmias, development of a hematoma, nausea or vomiting
Why is nausea and vomiting a concern after a cardiac catheterization?
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Vomiting can trigger bleeding from the insertion site, very problematic if it was arterial
You are assessing a patient after a cardiac catheterization. You note that the patient is bleeding from the venous insertion site. What should you do?
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Apply pressure for 5 minutes BELOW the insertion site
You are assessing a patient after a cardiac catheterization. You note that the patient is bleeding from the arterial insertion site. What should you do?
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Apply pressure for 15 minutes ABOVE the insertion site.
What is it important to educate the patient about with respect to what to expect post cardiac catheterization?
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They will be on bedrest and will be expected to drink lots of fluids to assist in eliminating the dye from their body
A patient is being discharged home after a cardiac catheterization. What are important education points to cover before they leave?
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Keep the insertion site covered with a band-aid for several days, no baths for 3-4 days, report signs of infection, if bleeding begins, call EMS and hold pressure at the site, can return to school but avoid strenuous activity, take Tylenol or Ibuprofen for pain
What procedures can be performed during a cardiac catheterization? (6)
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Balloon Septostomy Balloon Valvuloplasty Coil Occlusion Device Closure Stent Placement Radiofrequency Ablation (RFA)
Captopril (Capoten, Enalapril (Vasotec) and Lisinopril (Prinivil)are all examples of what class of drug?
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ACE-I inhibitors
How do drugs like Captopril (Capoten, Enalapril (Vasotec) and Lisinopril (Prinivil)work to treat cardiac problems?
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They block the production of angiotensin II which reduces afterload (stroke volume resistance) and decreases workload. They increase excretion of sodium and water by acting on the kidneys.
What heart conditions are drugs like Captopril (Capoten, Enalapril (Vasotec) and Lisinopril (Prinivil)usually used to treat?
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Heart failure and hypertension
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What are the nursing implications related to medications like Captopril (Capoten, Enalapril (Vasotec) and Lisinopril (Prinivil)?
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Monitor for hypotension. A dry, hacking cough is a common side effect. Potassium levels, BUN and creatinine must be monitored closely. Angioedema is a serious complication characterized by swelling of the tongue and pharynx.
Angioedema is characterized by swelling of the tongue and pharynx and is a very serious complication associated with what medications?
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Captopril (Capoten) Enalapril (Vasotec) Lisinopril (Prinivil)
Furosemide (Lasix),Chlorothiazide (Diuril),and Spirononlactone (Aldactone)are all what class of medications used to treat cardiac problems?
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Diuretics
What are the major nursing implications related to drugs like Furosemide(Lasix),and Chlorothiazide (Diuril)?
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Must not initiate if the patient isn't on a potassium supplement, monitor potassium closely, can cause hypotension. Monitor I&O, lung sounds, assess for edema. Patient should be encouraged to eat potassium rich foods.
Which of the following, Furosemide(Lasix),Chlorothiazide (Diuril),and Spirononlactone (Aldactone) is a potassium sparing diuretic and therefore doesn't require potassium supplementation?
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Spirononlactone (Aldactone)
What cardiac conditions are Furosemide(Lasix),Chlorothiazide (Diuril),and Spirononlactone (Aldactone)typically used to treat?
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Heart failure and HTN
What class of medication are Carvedilol (Coreg)and Propanolol (Inderal)?
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Beta Blockers
How do medications like Carvedilol (Coreg)and Propanolol (Inderal)treat cardiac conditions?
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They decrease HR, BP, which decreases cardiac output & workload.
What are the nursing implications related to medications like Carvedilol (Coreg)and Propanolol (Inderal)?
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Known for causing bradycardia, so check their radial pulse and hold if their HR is too low. Watch for hypotension, dizziness and fainting. Close monitoring is especially required if the child has asthma.
What type of medications are typically withheld for several days prior to a cardiac catheterization to prevent the development of problems?
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Any anticoagulants (like aspirin)
________ after a cardiac catheterization may indicate hemorrhage due to perforation of the heart muscle or bleeding from the insertion site.
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Hypotension
  
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