100% satisfaction guarantee Immediately available after payment Both online and in PDF No strings attached
logo-home
Summary NRSG 328 Exam 2 Study Guide $11.99   Add to cart

Summary

Summary NRSG 328 Exam 2 Study Guide

 7 views  0 purchase

Exam 2 Study Guide for Bio 328. *Essential!! * For you,at a price that's fair enough!!

Preview 3 out of 19  pages

  • August 30, 2024
  • 19
  • 2021/2022
  • Summary
All documents for this subject (11)
avatar-seller
anyiamgeorge19
Exam 2 Blueprint

Chapter 29
1. Review nursing care of a child undergoing cardiac catheterization including precatheterization,
postcatheterization, and home care.
**Catheterization Notes
 Purpose: Can be diagnostic or therapeutic
 To assess oxygen saturation and pressure in chambers, cardiac output, blood flow, anatomic
abnormalities
 Interventional
o Closures
o Balloon catheters open narrow vessels/valves
o Insertion of valves
o Insertion of stents
 Procedure:
o Radiopaque catheter inserted through a peripheral blood vessel into the heart
o Catheter is introduced through the vein in which a catheter is threaded over a guide wire
inserted through a large-born needle

**Pre-catheterization
 Child will be NPO
 IV fluid
 Assess pedal pulses
 Document allergy to radiopaque dye or shellfish
 Sedation
 Educate mother and child


**post-catheterization/home care
 Child must lay still supine, with affected leg straight for 4-6 hours
 Vital signs, insertion site observed
 distal pulses checked q15 minutes x 1st hour, then q30 minutes
 Observe for bleeding at site, pallor, loss of pulses, coolness in extremity distal to site
 If bleeding occurs at insertion site, apply continuous pressure 1 inch above insertion
 Push fluids to help flush dye out of the body
 Observe for reactions to dye (vomiting, rash, increased creatinine, decreased urinary output)
 Avoid baths for 3 days after catheterization

, 2. Identify clinical manifestations and management of heart failure in an infant and child.
CLASSIFICATION OF CONGENITAL HEART DISEASE


A c y a n o tic C y a n o tic


In c re a s e d O b s t r u c t io n o f D e c re a s e d M i x e d B l o o d F lo w
P u lm o n a r y B lo o d B l o o d F lo w P u l m o n a r y B lo o d
F lo w F lo w

Atrial Septal Defect Coarctation of the
Aorta Tetrologyof Fallot Transposition of
the Great Arteries
Ventricular Septal Pulmonic Stenosis
Defect Tricuspid atresia Hypoplastic Left
Heart Syndrome
Patent Ductus Aortic Stenosis
Arteriosus

 Clinical manifestations: four types
o Impaired myocardial function
 Tachycardia; fatigue; weakness; restlessness; pale, cool extremities; decreased
BP; decreased urine output
o Pulmonary congestion
 Tachypnea, dyspnea, respiratory distress, exercise intolerance, cyanosis
o Systemic venous congestion
 Peripheral and periorbital edema, weight gain, ascites, hepatomegaly, neck vein
distention

 Management/Medication Management
o Improve cardiac function: Digoxin (improves contractility)
 Measure apical pulse (for 1 minute!) prior to administrating digoxin
 Drug order usually specifies at what heart rate the drug is withheld
 Narrow therapeutic index
 Do not repeat a dose if the child vomits after administering drug
 Signs of toxicity
 Bradycardia
 Anorexia
 Nausea and vomiting
 Visual disturbances
o Decrease preload:
 Diuretics- Furosemide (Lasix)
 Low sodium diet
o Decrease afterload
 ACE Inhibitors-Vasodilation
 Captopril, Vasotec

3. Review the following cardiac defects in terms of pathophysiology, clinical manifestations, treatment,
and nursing care: atrial septal defect, ventricular septal defect, patent ductus arteriosus, coarctation of the
aorta, Tetralogy of Fallot, and Hypoplastic Left Heart Syndrome.
4.
Clinical
Pathophysiology Treatment Nursing Care
Manifestations
Atrial Septal  Asymptomatic  Asymptomatic  May close 
Defect  Undiagnosed spontaneously (<3
 Left to right shunt; ASD: mm)

, right atrial and o Heart failure  If large (>8 mm),
ventricular dilation and in 3rd and 4th close in cardiac
enlargement; right decade of life cath lab or open
ventricular volume o Atrial heart surgery
enlargement
overload; increased
o Atrial
pulmonary blood flow Arrhythmias
 Increased PVR o Emboli
 Decreased systemic
blood flow = decreased
CO

Ventricular  Abnormal opening  Most  Surgical-Dacron 
Septal between the left and asymptomatic patch
Defect right ventricle  Murmur may not  Closure during
 Most common CHD be heard until 2-8 cardiac
 occurs anywhere along weeks of life catherization
ventricular septum  Loud harsh
 Blood flows through murmur left
the defect to the sternal border
pulmonary artery  Large defects
 Increased PVR result in dyspnea,
 Common in preterm poor feeding,
infants poor growth

Patent  normal opening  Machinery-like  Medical 
Ductus between the (machine hum) management:
Arteriosus pulmonary artery and murmur o Administration
aorta in the developing  Bounding pulses of
fetus Indomethacin
 Allows most of the IV:
blood from the right prostaglandin
ventricle to bypass the inhibitor
fluid-filled non- o (first 10-14 days
functioning lungs and of life)
flow into the aorta.  Surgical
 functionally closes at 12- management”
72 hours o PDA ligation
 Common in preterm o Coils
infants
 Left to right shunt
(Aorta to Pulmonary
Artery)
 Increased pulmonary
blood flow
 Decreased systemic
blood flow

The benefits of buying summaries with Stuvia:

Guaranteed quality through customer reviews

Guaranteed quality through customer reviews

Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.

Quick and easy check-out

Quick and easy check-out

You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.

Focus on what matters

Focus on what matters

Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!

Frequently asked questions

What do I get when I buy this document?

You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.

Satisfaction guarantee: how does it work?

Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.

Who am I buying these notes from?

Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.

Will I be stuck with a subscription?

No, you only buy these notes for $11.99. You're not tied to anything after your purchase.

Can Stuvia be trusted?

4.6 stars on Google & Trustpilot (+1000 reviews)

67096 documents were sold in the last 30 days

Founded in 2010, the go-to place to buy study notes for 14 years now

Start selling
$11.99
  • (0)
  Add to cart