Pediatric Cardiac Conditions

Cardiac Conditions in Pediatrics

• Disease processes in scope include tricuspid atresia, Kawasaki's disease, and digoxin use.
• Classify heart defects, and understand the importance of proper feeding interventions and activity levels.
• Understand cardiac catheterization procedures, Tetralogy of Fallot, and Tet spells.
• Address infective endocarditis, rheumatic fever, coarctation of the aorta, and bilirubinemia.
• Comprehend congenital heart defects that either increase or decrease pulmonary blood flow.
• Prioritize reviewing Tetralogy of Fallot and Tet spells.
• Recognize clinical signs of congenital heart disease and discuss appropriate nursing interventions.
• Understand why children with congenital heart conditions require special play considerations and learn how to educate parents.
• Know the role of digoxin (Lanoxin) in pediatric heart failure and how to assess for toxicity.
• Learn about Kawasaki Disease, including signs, prioritized interventions, and treatment.
• Understand abnormal lab values related to cardiac conditions.
• Be aware of screening for coarctation of the aorta
• Aspirin is not generally given to pediatric patients due to risk.
• Identify the two disease processes that are exceptions to the rule in this chapter.
• Know what to teach parents to protect a child if aspirin is administered.

Gastrointestinal Disorders

• Disease processes include: Omphalocele, Hirschsprung's, and Diaphragmatic hernia.

• Other conditions to consider are imperforate anus, IBS, Gastroschisis, Transesophageal fistula, and atresia.

• Encopresis, Gastroenteritis, appendicitis, Meckel's diverticulum, hyperbilirubinemia, and lead poisoning are also important.

• Review common congenital GI malformations, including their presentation in neonates and required immediate surgical interventions.

• Study the classic signs of appendicitis and how they differ from other GI conditions.

• Understand pediatric feeding concerns, reflux, and aspiration prevention.

• Differentiate between various causes of bloody stools in infants and children.

• Be familiar with nutritional considerations for children with inflammatory bowel disease.

• What are the signs of kernicterus?

• Understand what a low-residue diet is and the patient conditions for which it should be recommended.

• Know the nursing priorities for inflammatory bowel diseases.

Hematologic Disorders

• Identify common lab findings in pediatric bleeding disorders, and how treatment impacts them.
• Understand clotting disorders and their priority interventions.
• Comprehend the pathophysiology of pediatric leukemias and key nursing responsibilities.
• Study how to prevent and manage complications in sickle cell disease.
• Review medications used to treat blood disorders, including Factor VIII replacement for hemophilia.
• Review DIC and understand the pathophysiology, recognition, diagnostics, and interventions.

Immune and Autoimmune Disorders

• Recognize signs of immune system dysfunction in newborns and children.
• Understand why children with primary immunodeficiencies require extra infection precautions.
• Review systemic lupus erythematosus (SLE) complications and when certain medications may be contraindicated.
• Learn about Severe Combined Immunodeficiency (SCID) and what parents need to know.
• Be familiar with rheumatic fever, its prevention, and associated cardiac complications.
• Juvenile arthritis: Review signs and symptoms of juvenile idiopathic arthritis (JIA) and appropriate interventions.
• Identify conditions that cause joint swelling and pain in children and when they are medical emergencies.
• Understand how to manage pain and mobility in children with chronic musculoskeletal conditions.
• Review graft-versus-host disease, including recognition and interventions.

Respiratory and Infectious Diseases

• Identify the warning signs of neonatal respiratory distress and congenital abnormalities that impact lung function.
• Understand the importance of strict infection control in neutropenic patients.
• Review why newborns with jaundice undergo phototherapy and how to care for them; be aware of necessary precautions.
• Study sepsis indicators in pediatric patients and how to recognize when a condition is worsening.

Oncology

• Leukemia: Understand the pathophysiology of acute lymphocytic leukemia (ALL) and its impact on bone marrow.
• Review common symptoms such as fatigue, frequent infections, and bruising.
• Know the basics of chemotherapy treatment and its side effects, including stomatitis and immunosuppression.
• Neuroblastoma: Understand how this cancer presents in infants and young children, including abdominal mass and catecholamine-related symptoms,.
• Understand Wilms Tumor (Nephroblastoma): DO NOT palpate the abdomen, as it is the key nursing intervention to prevent tumor rupture.
• Hodgkin's vs. Non-Hodgkin's Lymphoma: Understand the differences in lymph node involvement, symptoms, and treatment approaches.
• Osteosarcoma & Ewing's Sarcoma: Review common presentations (bone pain, swelling) and treatment modalities (surgery, chemotherapy, radiation).
• Chemotherapy & Immunosuppression: Know common side effects of chemotherapy, including neutropenia, anemia, thrombocytopenia, and mucositis.
• Understand neutropenic precautions and infection control measures for immunocompromised patients.
• Stem Cell Transplants in Pediatric Oncology: Review indications for hematopoietic stem cell transplantation (HSCT) and post-transplant nursing considerations.

Pediatric Pharmacology & Pain Management

• Know the safe administration of NSAIDs, opioids, and non-opioid analgesics.
• Review when to question a medication order based on lab values.
• Learn about topical anesthetics like EMLA cream and proper application techniques.
• Understand patient-controlled analgesia (PCA) use in older children and appropriate monitoring.
• Review pediatric dosage calculations, including weight-based IV and oral medication administration.
• Select appropriate methods of pain assessment by age group.

Fluid Balance & Medication Administration

• Calculate safe pediatric medication dosages and assess whether a prescribed medication amount is safe.
• Understand why IV fluids are needed in dehydration and how to assess for improvement.

Additional Review Considerations

• Developmentally appropriate communication and play interventions for hospitalized children.
• Parental education and home care instructions for chronic pediatric conditions.