Cardiac Peds PDF

Cardiac Revein Bloodflow Cardiacoutput is volume of Blood pumpedbyheart in 1min strokevolume is volume ofBlood in 1 beat Cardiac output is HR strokevolume Adults can changetheir stroke volume kids can not butcan HR Blood Flow Inferior Superior...

Cardiac Revein Bloodflow Cardiacoutput is volume of Blood pumpedbyheart in 1min strokevolume is volume ofBlood in 1 beat Cardiac output is HR strokevolume Adults can changetheir stroke volume kids can not butcan HR Blood Flow Inferior Superior venaCava RightAtrium Rventricle Pulmonaryartery lungs Pulmonaryveins L atrium L ventricle Aorta Body Fetal Circulation Blood is mixed w Oc nonOr dH openings in heart Pressure is Same on L B in Adults Lside thanRight Foramen ovale Ductusarteriosus startto close Whenclosed becomes aligament Congenital Heart Disease Majorcause of death in 1styear oflife Causes Drugexposure chromosomal Abnormalities  infection Rubella AMA Altered Hemodynamics Blood Flowsfrom Pressure to Low Pressure Abnormal Connections changepressure result in Leftto Rightshunt Right to let Shunt Hematology NeoplasticDysfunction Anemias sickleCell Hemophilia Leukemia ASSESSMENT is key Energy easyBruising Bleeding sickeasily Anemia in of RBC's HGB concentration normal causes RBCproduction iron deficiency anemia RBLdestruction sickle celldisease RBCloss Hemophilia Interventions Tx underlying cause 1 IVF to Intravascular  y g Transfuse PRN volume Nutritional intervention iron 2 02 3 Bed rest don'twant to Exertthemselves to maximize Oz Educate about labwork havechild aware play pretend Use JTip or Topicalforpain Try to limitActivits Preventinfection IRON Anemia cause inadequate supply of dietary iron body has no iron toproduce Hgb to prevent iron fortified cereals formulas for infants Babies 1st 5 6months haveironstoresfrom Mom but Preemies DO NOT 6 24months Risk Adolescents dlt Rapidgrowth i poor Eating what happens to body if not managed delayed growth cognitive delays  Behavioral changes interventions iron child receives Ferrous Yf absorption ofiron D Iron fortified formula Cereal or Fedrops 5months if BreastFed ironsupplementation Oral may stain teeth usestraw or medication dropper Put it behindtheteeth Black Green stools Tarry constipation I M use 2 track method massage Irma It Sickle Cell Anemia Hereditary Bothparents Autosomal recessive 25 chance kid will get it mostly seen in AfricanMiddleEastern Indian PATHO Obstruction Destruction of BBC partial Complete replacement of HGB w abnormal HGB Susicate  BBCtakes shape as Sickle D BBC won't Func properly Sickle cell will obstruct capillary blood flow causing obstruction shapeofRBC DH Hypoxia Stasis of blood infarction w ischemia Replacement w Fibrous tissue scarring PROGNOSIS TOCURE But Bonemarrow or stemcelltransplant Freq Bacterial infections DA immunocompromised ACUTE CHEST SYN leading causeof death forkids stasisof Blood in Pulmonarysys W Sickle Cell STROKES Sickle Cell Crisis cause anything Folffty's need for Oz or alters transport of 02 Trauma infection physical Emotional Stress dehydration will viscosity of Blood Hypoxia XtremeTemps changein Elevation 2 Types vaso occlusive Crisis most Common Stasis of Blood very painful when clumping of Cells in microcirculation ischemia infarction leads to manifestations Fever pain tissue engorgement Splenic sequestration Life  p q crausespleentoruptured Blood pools in Liver Spleencould shock manifestations anemia weakness hypovolemia Diagnosis Newbornscreening Cord Blood Genetic testing to identify Carriers Isickledex or sicklecellprep it Hgb Electrophoresis Prevention of SC Crisis risk of infection tx infection aggresively monitor reticulocyte Blood transfusionearly in crisis reduceischemia iron in tissues tx w iron chelation med Feroxamine Hydroxyurea medis cytotoxic toxictocells but Fetal HGB TREATMENT FluidsPOorIVF Painmeds rest OrPRN BloodTransfusion Electrolyte balance ABX if infection Immunizations interventions monitor childs growth tells ushow severe sicklecell is Assess pain infection dehydration inflammation  signs of shock BLEEDING Disorders HEMOPHILIA group of Hereditory bleeding disorders d t lack of specific Clotting Fx's Mother Son specificFx will lead to definitive tx Hemophilia A Classic lackof VIII manifestations Bruising nosebleed hematuria Start to see 5 Sx 6months dH mobility Hemarthrosis in Joints impairedmobility Bleeding Diagnostics genetics of family amniocentesis Hx presentation of PT Labs Fx VIII for A or IX for B Pt's Fibrinogen benormal  I HGB Hct dt severeor prolonged Bleeding X complications hemorrhage shock transfusions Reaction death Desmopressin DDAVP IV or Nasalspray Fx V11 Replace FxV11 Corticosteriods joint Swelling Blood trans Interventions electric razor 15minPressure ICE forcut Supervision w play Dentalprocedure in controlled Environment for Hemiarthrosis obesepressure on joints painmeds ICE Elevate PT BOM post Bleed Leukemia abnormal WBC immature MainTypes 1 ACUTE lymphoblastic leukemia ALL mostCommon 2 10 0 Boys Caucasians 90 cure rate y 2 ACUTE myelogenous leukemia AML  y g 2nd mostcommon adolescents 50 survival PATHO cause unknown Stem cells in Bonemarrow produce immature WBC's normal WBC's BBC PLt's which then take over in Circulation Cellularimmunity Through cloningl prone to infection anemia bruising bleeding manifestations Joint bone pain Petechine Lymphadenopathy enlargedlymphnod Fever pallorlethargic Hepatosplenomegaly n enlarged liver spleen Bruising bleeding HAvomitpapillaedema CNS envolument Testesenlargment Diagnosis Labs BC anemia thrombocytopenia neutropenia MP at 1st phosphorus if abnormal Bonemarrow biopsy immature Lymphoblast Tx radiation chemo HSCT Stem CellTransplant for AML Round 2 forALL interventions Signs of Bleeding Nutrition Fluids paincontrol monitorRenal Func I 0 specificgravity DW Behavior oralulcers EI.it