NURSING CARE OF THE CHILD WITH A CARDIOVASCULAR DISEASE

Clinical Aspect of Maternal and Child NursingNUR 363Lecture 9

ASSESSMENT OF HEART DISORDERS IN CHILDREN

• History

• Physical assessment– general

appearance– pulse, blood

pressure, & respirations

ASSESSMENT OF HEART DISORDERS IN CHILDREN

• Diagnostic tests– Electrocardiogram– Radiography– Echocardiography– Magnetic resonance imaging– Exercise testing– Laboratory tests

CLASIFICATION OF CHD

A Cyanotic Heart Defect Move blood from arterial …to…venous system

A Cyanotic

Increased in pulmonary blood flow1. ASD2. VSD3. AVC4. PDA

Obstruction of blood flow from ventricle

1. Pulmonary stenosis2. Aortic stenosis

3.Coarctation of the Aorta

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CONGENITAL HEART DISEASE

• Defects with increased pulmonary blood flow– Ventricular Septal

Defect• Opening between

ventricles• S/S

– 4-8 weeks, fatigue and harsh murmur

• Therapeutic management– Most close spontaneously

(small ones). Other larger VSDs may require open heart surgery

• Defects with increased pulmonary blood flow– Atrial Septal Defect

• Opening between the atria

• S/S– Murmur

• Management– Surgery

A trial Sepal Defect (ASD)

**Obstruction of blood flow from ventricle

1.Pulmonary stenosis

2.Aortic stenosis

3.Coarctation of the Aorta

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– Pulmonic Stenosis• Narrowing of the

pulmonary valve or artery causing the right ventricle to hypertrophy

• S/S– Mild right sided

heart failure

• Therapeutic Management

– Balloon angioplasty to relieve the stenosis

-Aortic Stenosis• Stenosis of the aortic

valve prevents blood from passing from the left ventricle into the aorta, leading to hypertrophy of the left ventricle

• S/S– Usually asymptomatic but

with murmur– May have chest pain and

even sudden death

• Therapeutic Management

– Stabilization with a Beta Blocker or Calcium Channel Blocker

– Balloon valvuloplasty– Valve replacement

– Coarctation of the Aorta

• Narrowing of the lumen of the aorta

• S/S– Absence of

palpable femoral &/or brachial pulses; headache, vertigo, nosebleeds, leg pain

• Therapeutic Management

– Surgery or angiography

Coarctation of the Aorta

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Cyanotic Heart Defect

Cyanotic

Decreased pulmonary blood flow Mixed blood flow

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**Defect with Decreased pulmonary blood flow

1. Tricuspid Artesia

2. Tetrology of Fallot

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– Tricuspid Atresia• The tricuspid valve is

completely closed, allowing no blood to flow from the right atrium to the right ventricle.

• When these structures close, cyanosis, tachycardia, and dyspnea occur.

• Treatment consists of an IV infusion of PGE (prostaglandin) to keep the ductus open until surgery can be performed.

Tetrology of Fallot (TOF)

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– Tetralogy of Fallot

• Four anomalies

– Pulmonary stenosis

– VSD

– Dextroposition of the aorta

– Hypertrophy of right ventricle

• S/S

– Cyanosis

– Polycythemia (increase in number of RBC)

– Dyspnea, growth restriction, clubbing of fingers

• Therapeutic Management

– Surgery