NSG CARE of CHILD

w/ CARDIOVASCULAR DSE
CARDIOVASCULAR SYSTEM
 Cardiac output- volume of blood pumped
by the ventricles each minute
= SV x HR
 Stroke volume- volume of blood a ventricle
ejects during systole
3 FACTORS AFFECTING CO
• Preload- volume of blood in the ventricles
at the end of diastole
• Afterload- resistance against which the
ventricles must pump
• Contractility-ability of ventricles to stretch
ASSESSMENT
 Begins with HISTORY + PHYSICAL
ASSESSMENT
 Specific dx studies are ordered as
indicated
 Developmental testing-incorporated since
increased risk of poor tissue perfusion may
effect G & D
 HISTORY
 Chief Concern:
a. Fatigue
b. Cyanosis
c. Frequent upper respiratory infections
d. Feeding difficulty
e. Poor weigh gain, growth failure
HISTORY
 Past medical history
a. Infection during pregnancy
b. Difficulty with resuscitation at birth
 Family history
• Other members with heart disorders
PHYSICAL EXAMINATION
 Decreased height and weight
 Easily fatigued
 Cyanosis of mucus membrane
 Polycythemia
 Frequent nose bleeds
 Tachypnea, tachycardia
 Displaced apex beat
PHYSICAL EXAMINATION
 Heart murmur
 Enlarged liver
 Absent femoral pulses
 Faint peripheral pulses
 Clubbing of fingers
 Pain in legs
MURMURS
 INNOCENT HEART MURMUR- of no
significance
 Reflects a normal variation of vibration in
the heart o pulmonary artery
 ORGANIC HEART MURMUR- occurs as a
result of heart disease or a congenital
defect
 MURMURS
CHARACTERISTIC INNOCENT ORGANIC

Timing Systolic Systolic or

diastolic
Duration Short Longer

Quality Soft, musical Harsh, blowing

Intensity Soft Loud

Position in which Usu. supine Heard I all

heard positions positions
Affected by exercise Yes No
ELECTROCARDIOGRAM
 Written record of the electrical voltages
generated by the contracting heart
 Provides information about heart rate,
rhythm, state of the myocardium, (+) or (-)
of hypertrophy, ischemia or necrosis,
abnormalities in conduction