Nclex 준비 - Peds Heart

안녕하세요 예비 미국 간호사 선생님들
이번에는 Peds Heart 에 대해 공부해봅시다.
이 문제는 보통 passing level입니다

 

 

 

Tetralogy of Fallot

- Cyanotic congenital heart deficit (Normal)

- Finger clubbing is common

- S&S HF

• Cool extremeties
  • Reduced perfusion
• Puffiness around eyes
  • Edema
• Reduction in number of wet diapers
  • Urinary retention
• Weight gain

Teaching

- knee-chest position 

Aterial Septal Defect (ASD)

 

 

** "Septal Defect" =  Left to right = Acynotic

 

Ruel #1 Murmur is common

 

Rule #2. Acyanotic congenital heart defect

Ventricular septal defect

 

** "Septal Defect" =  Left to right = Acynotic

 

Rule #1. Priority

 

- Left to right shunting

• risk for congestive HF and Pulmonary hypertension
• pulmonary congestion; high pressure on left side and low pressure on right side

- Cortication of the aorta (COA) is an abnormal aortic narrowing that result in increased cardiac output

- Diaphoresis (땀 많이) during feeding

• Sympathetic stimulation

- Poor weight gain

• Increased metabolic rate

 

- Patent ductus arteriosus (PDA) with systolic murmur

• commonly resolved within 48 hr

 

Rule #2. Acyanotic congenital heart defect

 

 

Rule #3. Harsh systolic murmur

 

 

 

 

Patent dectus arteriosus

 

- Loud machine-like murmur (expected)

Pulmonary Stenosis

 

- Systolic ejection murmur (expected)

 

- Slight cyanosis of the nail beds (expected)

- Severe diaper rash ?

• Yeast or bacteria may present on rash and could be into blood stream