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NCLEX-RN (8) Pediatrics > Cardiovascular > Flashcards

Flashcards in Cardiovascular Deck (21)
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What do all of these pediatric cardiac conditions generally have in common?

  • atrial septal defect
  • atrioventricular canal defect
  • patent ductus arteriosus
  • ventricular septal defect
  • aortic stenosis
  • coarctation of the aorta
  • pulmonary stenosis

In general, these are all cardiac defects that occur at birth that can cause low oxygen and the infant to become hypercyanotic.

Immediate complication

What are the steps if an infant is hypercyanotic due to a heart defect?

  1. place infant in knee-chest position
  2. give 100% oxygen
  3. give morphine sulfate to ease breathing
  4. start IV fluids
  5. document


How are cardiac defects treated?

Surgery to repair the vessels or cardiac tissue


Tetralogy of Fallot

Tetralogy of Fallot includes 4 heart defects.

Immediate complication

What are the characteristic signs and symptoms of tetralogy of fallot and most other cardiac defects?

  • cyanosis called blue spells or tet spells
  • hypoxia


When is digoxin given to an infant?

Give digoxin 1 hour before or 2 hours after feedings.

Needs to be given on an empty stomach for absorption.


What is the intervention if the digoxin dose for a child has been missed?

If a digoxin dose has been missed and it's been more than 4 hours, skip the dose.

If it's less than 4 hours, give the dose.


After how many missed doses of digoxin should the parent notify the HCP?

Call the HCP after 2 missed doses of digoxin.


What is the diet for a child after cardiac surgery?

  1. no added-salt diet
  2. do not introduce new foods in case of allergy
    • allergy may be mistaken as a complication


What is the activity for a child after cardiac surgery?

  • do not play outside for 2 weeks due to injuries and possible infections
  • avoid activities that could cause injuries for 2 - 4 weeks such as bike riding
  • do not attend physical education class for at least 2 months


When can a child go back to school after cardiac surgery?

Child can go back to school on the 3rd week starting with half days.


What medical procedures are avoided for 2 months following cardiac surgery for a child?

  • immunizations
  • dental visits
  • invasive procedures

All increase risk of infection.


Rheumatic fever

Rheumatic fever is an inflammatory autoimmune disorder that affects all parts of the body, especially the heart, joints, skin, and brain.

It is caused by an untreated strep infection.


What is the most serious complication of rheumatic fever? 

The most serious complication of rheumatic fever is rheumatic heart disease which affects the heart valves.


How long after a strep infection can rheumatic fever begin?

Rheumatic fever can start 2 to 6 weeks after a strep infection.

Diagnostic tests:

Rheumatic fever

  • ↑ anti-streptolysin O titer
  • ↑ ESR (erythrocyte sedimentation rate)
  • ↑ C-reactive protein
  • Aschoff bodies (lesions): found in the body


Rheumatic fever and rheumatic heart disease

  • antiinflammatory meds such as NSAIDs
  • seizure precautions if brain is affected
  • antibiotics to treat any infections


What is the teaching to the parents if the heart valves have been affected by rheumatic heart disease?

antibiotic prophylaxis for dental work and invasive procedures


How is joint pain managed with rheumatic fever?

Massage and alternating hot/cold therapy


Kawasaki Disease (mucocutaneous lymph node syndrome)

Kawasaki disease is an acute systemic inflammation that can cause serious cardiac complications such as aneurysms.

The cause is unknown.


Kawasaki disease

  • aspirin to prevent blood clots
  • immunoglobulin IV to boost immune system

Do not give aspirin to children < 18 years old unless prescribed by the HCP.