Week 3 Content Review PDF - Pediatric Diseases

Pediatric Circulatory System Alterations Indicators of cardiac dysfunction are noted in the patient history and physical assessment. Tachycardia Poor feeding Tachypnea FTT Developmental delays Prenatal risk factors Family history of cardiac disease Congenital Heart Disease and Cardiac Anomalies Comm...

Pediatric Circulatory System Alterations Indicators of cardiac dysfunction are noted in the patient history and physical assessment. Tachycardia Poor feeding Tachypnea FTT Developmental delays Prenatal risk factors Family history of cardiac disease Congenital Heart Disease and Cardiac Anomalies Common cardiac defects: Patent ductus arteriosus (PDA) Atrial septal defect (ASD) Ventricular septal defect (VSD) Defects can result in congestive heart failure (CHF) or hypoxemia Obstructive Blood Flow Defects where blood flow is stenosed or restricted Common cardiac conditions: Aortic stenosis Pulmonary stenosis Coarctation of the aorta Mixed Blood Flow: Mixing of blood from the pulmonary and systemic circulations Common cardiac conditions: Transposition of the great arteries/vessels Truncus arteriosus Hypoplastic left heart Pediatric Hematologic or Immunologic Alterations Hemophilia Anemia Reduction in RBCs Causes: Decreased production Increased destruction Excessive loss Sequestration Symptoms Dizziness Fatigue Tachycardia Pallor Therapeutic Management Tx of underlying cause Hemophilia A Deficiency of factor VIII X-linked recessive disorder Hemophilia B Deficiency of factor IX X-linked recessive disorder Von Willebrand Inherited lack of Von Willebrand factor protein Inability of platelets to aggregate Therapeutic Management Stop bleeding Administer clotting factor (if bleeding occurs) Avoid trauma Sickle Cell Anemia Congenital hemolytic disease resulting from a defective hemoglobin molecule (Hgb S) Risk Factors: Autosomal recessive condition requiring genes from both parents Manifestations: SOB Fatigue Acute pain Complications Brain- stroke, headache Eyes – retinopathy, blindness, hemorrhage Heart – heart failure Chest/lungs – pain, chest syndrome, pneumonia, pulmonary hypertension, atelectasis Abdomen – pain Spleen – splenomegaly, splenic sequestration, autosplenectomy Liver – jaundice, hepatic coma Gall Bladder – gallstones Kidneys – hematuria, impaired function Genitourinary – painful erection (priapism), hematuria, hyposthenuria (dilate urine) Sickle Cell Crisis AKA vaso-occlusive crisis Blood stasis causes ischemia and infarction Acute vaso-occlusive crisis Related to dehydration and decreased oxygen Sequestration Potentially life-threatening crisis Pooling of blood in the spleen and sometimes the liver Aplastic crisis Extreme drop/reduction in RBCs Triggered by a viral infection Therapeutic Management Pain management Blood products Hydration Oxygen Comfort and mobility Infection prevention Sickle Cell Anemia: Family Education Kaw asaki Disease Multisystem disorder AKA mucocutaneous lymph node syndrome Affects children under 5 years old Involves widespread inflammation of the small and medium-sized blood vessels Leading cause of acquired heart disease in children Does not spread person-to-person After treatment symptoms subside in approximately 6 to 8 weeks Kaw asaki Disease: Clinical Manifestations 3 stages of disease process Acute Stage (1-2 weeks) Conjunctivitis (w/out discharge) Strawberry tongue Red, oral mucous membranes Edema of the hands and feet Subacute (2-4 weeks) Fever Irritability Desquamation of hands and feet Temporary arthritis and arthralgia Convalescent (6-8 weeks) Symptoms resolved Lab values abnormal Kawasaki Disease: Diagnosis, Management, & Education Diagnosis Echocardiogram Lab test (CBC, ESR, liver enzymes, albumin levels) Therapeutic Management High dose gamma globulin (IVIG) Salicylate (Aspirin) Nursing Care Monitor (vitals, intake and output, signs of HF) Administer medication (IVIG, aspirin) Passive ROM Comfort care Complications Anuerysms Side effects of aspirin therapy Side effects of IVIG Education Understand disease progression Maintain follow-up appointments Irritability may last 2 months Avoid hard soaps Passive ROM exercises Avoid live immunizations for 11 months after IVIG administration Monitor temperature Monitor for aspirin toxicity Multisystem Inflammatory Syndrome (MIS -C) Multiple body systems and tissue become inflamed Heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs Considered a syndrome, not a disease Manifestations: Persistent fever Vomiting Diarrhea Abdominal pain Kawasaki disease-like features: Therapeutic Management Treatment tailored to specific clinical manifestations IV fluids, respiratory support, medication Care focused on symptomatic relief Monitor for complications Aneurysms Side effects of aspirin therapy Aspirin toxicity Side effects of IVIG