Pediatric HESI CHD for NCLEX REVIEW , VERIFIED 2025,Complete Guide

Transition from fetal to pulmonary circulation How does the circulation during fetal life differ from that of the neonate? What leads to this transition? How do the changes of pressures and resistance within ...

Transition from fetal to pulmonary circulation How does the circulation during fetal life differ from that of the neonate? What leads to this transition? How do the changes of pressures and resistance within the heart effect the foramen ovale, ductus venosus, and ductus arteriosus? Differences for the child in cardiovascular functioning  Why is the child at greater risk of CHF?  Why does the child’s heart beat faster?  Hct, Hgb and pulse ox concentrations appropriate for age needed for adequate oxygen transport  Cyanosis indicates hypoxemia to bone marrow producing RBC’s to Hgb (polycythemia)  Polycythemia: Hgb  20 g/dL & Hct  55%-60%  What is the danger of Severe Hypoxemia? Leads to bradycardia cardiac arrest BASIC PHYSIOLOGY  WHAT IS THE HEART: Heart is a pump sending blood throughout the body  WHAT IS CARDIAC OUTPUT?Heart must maintain adequate CARDIAC OUTPUT: volume of blood ejected by the heart in a 1 minute  Cardiac output determined by multiplying the heart rate by the stroke volume  WHAT IS STROKE VOLUME: amount of blood ejected by the heart in any one contraction PHYSIOLOGY CONTINUED  WHAT IS STROKE VOLUME INFLUENCED BY: 1. Preload: volume of blood returning to the heart or the circulating blood volume; measured by CVP 2. Afterload: resistance against which the ventricles must pump when ejecting blood (ventricular ejection); measured by hemodynamic monitoring via arterial blood pressure 3. Contractility: ability of the cardiac muscle to act an efficient pump; difficult to measure clinically WHAT KIND OF TESTING IS DONE TO DIAGNOSE? Cardiac Catherization  Imaging study using radiopague catheters  placed in a peripheral blood vessel  advanced into the heart 1. To measure pressures and oxygen levels in heart chambers 2. To visualize heart structures 3. To see blood flow patterns PREOP NURSING CARE CARDIAC CATHERIZATION WHY NEED Accurate hgt and wgt WHY IS History of allergies to iodine important? WHAT HAPPENS IF THE CHILD HAS Severe diaper rash WHY Mark pulses: dorsalis pedis, posterior t ibial WHY Baseline pulse ox PREOP CARDIAC CATH HOW TO Prepare child: schoolage/adolescent Preop receive what drugs? WHAT DIET PREOP AND WHY?