Congenital Heart Disease Case study – Flashcards
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Which clinical manifestations would the nurse expect to assess in an infant diagnosed with a ventricular septal defect?
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Tachypnea and grunting with intercostal retractions
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Ventricular Septal Defect (VSD) Clinical manifestations:
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Left to right shunting tachypnea, dyspnea Poor growth Palpable thrill Systolic murmur at left lower sternal border
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Initial sign of CHF:
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Never seems to get full and feedings are taking a long time
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Teachings about post procedure care for cardiac catheterization:
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Explain they will need to hold them in the prone position after the procedure
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Nursing plan of care for patient diagnosed with "Decreased Cardiac Output":
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Assess infants's peripheral pulses and capillary refill time
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What type of feedings does a infant with CHF need to have?
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Small concentrated feedings
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Why do you need to use a soft nipple with a large hole to feed?
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Will be able to such more easily and not get tired from eating
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Which measure will be most valuable to assess the infants response to each feeding?
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SaO2 changes during feeding
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What should you expect to see as manifestations of Heart Failure in an child?
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Cool Extremities Peripheral Edema Nasal Flaring
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Which manifestations would you expect to find in a child with Rheumatic Fever?
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Erythema Marginatum Elevated C-reactive protein Uncoordinated movements of extremities Two or more major Jones criteria
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What intervention would you implement prior to administering first dose of Lanoxin?
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Obtain apical pulse to determine within the guidelines of written order (Don't give if > 90)
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When should you give a dose of Digoxin how many hours before a routine lab test?
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give a regular dose of medication at least 6 hours prior to the test
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If patient starts to choke, turn blue, and goes limp what is the first intervention you would do?
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Attempt to stimulate patients breathing by rubbing the sole of his foot
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What to say when asked to respond about alternative therapy?
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should consult doctor before allowing him to take any herbal treatments
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What does digoxin do for the heart?
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Improves myocardial contractility
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What is the hallmark sign of digitoxicity?
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Vomiting
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Which intervention should you include when teaching parents about administration of Digoxin?
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Advise parents to administer meds about 20 - 30 minutes before the infant is fed
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Why is glucose important to the heart?
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It is important for cardiac contractability
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Rids body of excess fluid and sodium:
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Lasix
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Increases tissue oxygenation:
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Oxygen
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Improves myocardial contractility:
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Digoxin
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Reduces Afterload:
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Captopril
