 CARDIOVASCULAR DISORDERS

 PRESCHOOLERS: imaginative, conscience

develops  PDA (Patent Ductus Arteriosus)
 mixing of blood
 COMMON FEARS:  acyanotic
 Fear of the dark
 Fear of being left alone, esp at bed time  s/sx:
 Fear of animals (large dogs)  Machinery like murmur-(PATHOGNOMONIC
 Fear of ghosts SIGN/ hallmark)
 Fear of mutilation and pain  S/sx of heart failure
 Poor feeding- For them to suck they need
 FAMILY TEACHING: enormous amount of oxygen
 night light = fear of the dark  Fatigue
 play out fears on dolls or toys (therapeutic  Poor weight gain
use of play)  Irritability (cerebral hypoxia)  dec
 desensitization (gradual exposure to the LOC[levels of consciousness]
feared object)
 Management:
 SCHOOLERS/ SCHOOL AGE  DOC: Indomethacin  closure of PDA

 Motor Skills: engagement with sports, -cursive  Septal Defects

writing (8 years)  Acyanotic
 Cognitive: read time, know months of the year,  Mixing of blood
collect and sort objects
 Language: knows figurative of speech,  2 types
 Socialization: same sex pairs and groups, 1. ASD – atrial septal defect
competition (Sports / academics) 2. VSD – ventricular septal defect

 Ss/x:
 ADOLESCENCE  Fatigue
 Dyspnea on exertion – DOB when in activity
 Early Adolescence [10-13 yrs old]  Failure to thrive (delayed milestones)
 Development of secondary sexual  Ss/x of heart failure
characteristics
 Rapid growth  Management:
 Sexual aspect: Interest > activity  Dacron Patch
 Self-concept: Self-consciousness - Tissue -decreased rejection rate
 Family: Increase independence - Plastic -increased rejection rate
 Peers: Same sex
 Coarctation of Aorta – narrowing of aorta
 Middle Adolescence [14-16 yrs old] (descending aorta)
 Peak of growth  acyanotic
 Body shape and composition  Increase pressure; decrease output
 Acne, odor, menarche, spermarche(sperm
cell production)  Ss/x:
 Sexual: Sexual drive, experimentations, and
questions of sexual orientations
Upper Lower
 Abstract thought
extremities Extremities
 Self-concept: Concern with attractiveness
BP increase decrease
 Family: Increased independence
Pulse Bounding Weak/
 Peers: Dating
absent
 Late Adolescence [17-20 years old]
 slower growth  Management:
 sexual: consolidation of sexual identity  Surgery:
 idealism  Balloon Angioplasty with coronary stenting-->
 self-concept: stable body image Repairing of Aorta using balloon with support
 family: practical independence of coronary stent
 intimacy
* Stent --> mesh, support, scaffold
 TOF (Tetralogy of Fallot) – 4 problems  Rheumatic Heart Fever – infectious heart
 Cyanotic disease

 Problems:  CAUSE: GABHS [Group A Beta Hemolytic

1 Pulmonary stenosis Streptococcus] –-> sore throat/ AGN [acute
2 Right ventricular hypertrophy glomeruli nephritis]
3 Overriding of aorta
4 VSD  Jones Criteria:

 2 MAJOR symptoms + History of GABHS

Or
 Ss/x:  1 Major + 2 minor + History of GABHS

 Cyanosis (ineffective tissue perfusion)--> “Blue Major symptoms Minor Symptoms

Babies” Carditis – inflammation of Low grade fever
 Squatting--> Compensation the heart
-Dec venous return--> relax the heart Polyarthritis – Arthralgia – joint pains
-Conservation of oxygen in the vital organs inflammation of various without swelling
 Tet Spells (PATHOGNOMONIC SSIGN/ joints
hallmark)--> Group of s/sx that manifest low Chorea – st vitus dance Aso titer – [antistreptolysin
oxygen, irritability, pallor, black outs, convulsions (worm like movements) o titer]
 Cardiomegaly Subcutaneous nodules – c-reactive protein
 Clubbing of nails (spoon shaped fingernails) – on knees, knuckles, inflammatory markers
represents chronic hypoxia elbows
Erythema marginatum – Esr [erythrocyte
 Diagnostics: rashes in trunk area sedimentation rate]
 2D echo – boot shaped heart inflammatory markers
 Management:
 Allow client to squat
 Management:
 Surgery  DOC: Penicillin [5-10 days] – finish the
duration of the drug to prevent drug
 Palliative surgery – only relieves the resistance
s/sx - If allergic to penicillin: Clindamycin /
Erythromycin
 BLALOCK TAUSSIG SHUNT =
anastomosis of Pulmonary artery  Exacerbation and Remission: t/x will be continued
and aorta using subclavian artery-- up to 10 years
> to increase oxygen than carbon
dioxide--> Relieved s/ssx + Additional drugs
 Salicylates (Aspirin)– Pain and swelling

- 4 A’s of Aspirin:
1. Antiplatelet
2. Antipyretic
3. analgesic;
4. anti-inflammatory
*These two effects are the only effects needed in
Rheumatic heart fever
 Curative surgery – cures and treats  Corticosteroids – relieve carditis
the condition –
 Pathophysiology:
 Intracardiac Surgery / Brocks: 2
surgeries  Tooth surgeries, mouth sores  GABHS affects
 Balloon Angioplasty heart (RHF) and kidneys (AGN), Throat (sore
*Solved pulmonary stenosis, right throat)
ventricular hypertrophy
 Dacron Patch
*Solved VSD & overriding of Aorta
 RESPIRATORY DISORDER –

 CROUP / Laryngotracheobronchitis –
narrowing of airway due to viral infection

 Ss/x:

 Barking seal-like cough (PATHOGNOMONIC

SIGN/ HALLMARK)
 Inspiratory stridor (passage of air in a narrowed
airway)
 Dyspnea
 Cyanosis
 No fever/ low grade fever

 Management:

 Increase humidity in the room  cool mist

 Inhale cool night air (comfort)/ warm bathroom air
(bronchodilation)
 Tracheostomy set on the bedside

 Medical Management:
 Antiviral agents
 Antibiotics
 Bronchodilators  s/e: tachycardia