Nursing Care of a Family When a Child Has a Cardiovascular Disorder

ASSESSMENT:

Assessment of a child with a cardiovascular disorder includes

 History
 Physical assessment
 general appearance
 History: Heart disease in the newborn may or may not be recognized before birth (during
prenatal testing) or even during the newborn period while the baby is still in the hospital.
Because the newborn with cardiac problems will be tachycardia and tachypnea.
 Questions to ask the parents during the newborn period include those related to the baby’s
feeding patterns and those related to the mother’s pregnancy history (maternal infections,
medication use during pregnancy, and any radiation exposure).
 The physical assessment begins with measuring height and weight, comparing it to the standard
growth chart (looking for signs of failure to thrive).
 The general appearance assessment then focuses on the body systems that would be affected
by a heart disorder.
 Vital signs are assessed. The presence of any heart murmur is also discussed with the parents.
“Innocent” murmurs are murmurs of no significance and are sometimes referred to as
“functional” murmurs.
 A murmur associated with a congenital heart defect is termed an “organic” murmur. Children
with innocent heart murmurs are not restricted in activity and does not require any further
diagnostic testing or treatment (innocent murmurs are not a prelude to heart disease). Organic
murmurs will require monitoring by a physician.

NURSING DIAGNOSIS:

Nursing diagnoses associated with heart disease in children

Examples include:
 Congestive Heart Failure
 Heart failure
 Congenital Heart Disease
 Decreased cardiac output related to congenital structural disorder
 Ineffective tissue perfusion related to inadequate cardiac output
 Deficient knowledge related to care of the child pre and postoperatively
 Fear related to lack of knowledge about child’s illness
 Interrupted family processes related to stresses of diagnosis and care responsibilities
 Impaired parenting related to inability to bond with critically ill newborn
IMPLEMENTATION

 the care of children with a cardiovascular disorder include teaching, providing an opportunity
for children and their families to express fears about a child’s illness and treatment plan,
providing physiologic and psychological support such as comfort measures after surgery, and
caring for a child in cardiac failure.
 An equally important role is teaching prevention of heart disease such as promoting nonsmoking
and exercise, maintaining appropriate weight, and eating a low-fat diet.
 Inform of activity or exercise restrictions and to set own limits for exercise and activity. Prevents
fatigue while engaging in activities as nearly normal as possible. Explain to parents need to
conserve energy and encourage rest.

OUTCOME EVALUATION

Outcome evaluation should include both immediate and future outcomes for the child and family
because cardiac disorders may be long term. Important short term outcomes involve receiving adequate
support during procedures and treatment

Examples suggesting achievement of outcomes are:

 The child’s heart rate remains within accepted parameters for age.
 The child demonstrates age-appropriate coping skills related to diagnosis and possible surgery.
 The parents demonstrate competence with procedures required for care of their child.
 the parents exhibit positive coping skills related to their child’s diagnosis and required care to
foster optimal growth and development in their child.
 The parents verbalize positive aspects about their child.