ALTERATIONS OF CARDIAC FUNCTION CONGENITAL HEART DEFECTS VALVULAR

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ALTERATIONS OF CARDIAC FUNCTION CONGENITAL HEART DEFECTS VALVULAR PROBLEMS ENDOCARDITIS ABDOMINAL AORTIC ANEURYSM 2009

ALTERATIONS OF CARDIAC FUNCTION CONGENITAL HEART DEFECTS VALVULAR PROBLEMS ENDOCARDITIS ABDOMINAL AORTIC ANEURYSM 2009

Transition from fetal to pulmonary circulation R How does the circulation during fetal life

Transition from fetal to pulmonary circulation R How does the circulation during fetal life differ from that of the neonate? R What leads to this transition? R 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 R Why is the child at greater

Differences for the child in cardiovascular functioning R Why is the child at greater risk of CHF? R Why does the child’s heart beat faster? R What are the Hct, Hgb and pulse ox concentrations appropriate for age needed for adequate oxygen transport R What does cyanosis indicate? hypoxemia What is polycythemia? R What labs indicate Polycythemia: R What is the danger of Severe Hypoxemia?

BASIC PHYSIOLOGY R WHAT IS THE HEART: R WHAT IS CARDIAC OUTPUT? R How

BASIC PHYSIOLOGY R WHAT IS THE HEART: R WHAT IS CARDIAC OUTPUT? R How is cardiac output determined? R WHAT IS STROKE VOLUME?

PHYSIOLOGY CONTINUED R WHAT 3 things influence STROKE VOLUME? 1. Define Preload: 2. Define

PHYSIOLOGY CONTINUED R WHAT 3 things influence STROKE VOLUME? 1. Define Preload: 2. Define Afterload: 1. Define Contractility:

WHAT KIND OF TESTING IS DONE TO DIAGNOSE? RCardiac Catherization R What is used

WHAT KIND OF TESTING IS DONE TO DIAGNOSE? RCardiac Catherization R What is used during the test? R Where are the catheters placed? R What measurements are taken? R What is visualized?

PREOP NURSING CARE CARDIAC CATHERIZATION RWHY NEED Accurate hgt and wgt RWHY IS History

PREOP NURSING CARE CARDIAC CATHERIZATION RWHY NEED Accurate hgt and wgt RWHY IS History of allergies to iodine important? RWHAT HAPPENS IF THE CHILD HAS Severe diaper rash RWHY Mark pulses: dorsalis pedis, posterior tibial RWHY Baseline pulse ox

PREOP CARDIAC CATH RHOW TO Prepare child: schoolage/adolescent RPreop receive what drugs? RWHAT DIET

PREOP CARDIAC CATH RHOW TO Prepare child: schoolage/adolescent RPreop receive what drugs? RWHAT DIET PREOP AND WHY?

POSTOP NURSING CARE CARDIAC CATHERIZATION R What would you expect to find when assessing

POSTOP NURSING CARE CARDIAC CATHERIZATION R What would you expect to find when assessing the pulses? R What is normal and what is abnormal? R R What rhythm and rate change would you expect?

POSTOP NURSING CARE CARDIAC CATHERIZATION R WHY CHECK BP R WHY Check dressing R

POSTOP NURSING CARE CARDIAC CATHERIZATION R WHY CHECK BP R WHY Check dressing R What assessment would you need to do regarding hydration and why? R What do you do with the effected? R How do you adapt care to a toddler? R What do you do to prevent bleeding?

POSTOP HOME CARDIAC CATH RPressure dressing INSTRUCTIONS RWhat is done to Cover site? RBathing

POSTOP HOME CARDIAC CATH RPressure dressing INSTRUCTIONS RWhat is done to Cover site? RBathing instructions? RWhat observations are made for complications? RWhat activity instructions? RWhat is used for pain?

POSTOP CARDIAC CATH SITUATION R Tommy, a 4 year old with Tetralogy of Fallot

POSTOP CARDIAC CATH SITUATION R Tommy, a 4 year old with Tetralogy of Fallot returns from catherization laboratory. He has vomited, his mother calls you to the bedside to tell you that he is bleeding. You arrive to find Tommy crying and sitting up in a puddle of blood. The first thing you do is:

ANSWERS TO POSTOP CATH SITUATION R 1. Increase the rate of his IV fluids

ANSWERS TO POSTOP CATH SITUATION R 1. Increase the rate of his IV fluids R 2. Give an antiemetic and keep Tommy NPO R 3. Call the cardiologist R 4. Lie Tommy down, remove the dressing and apply direct pressure above the catherization site

ANSWERS TO SITUATION

ANSWERS TO SITUATION

GENERAL S & S of CHD in INFANTS AND CHILDREN R R R R

GENERAL S & S of CHD in INFANTS AND CHILDREN R R R R R INFANTS: Dyspnea Difficulty feeding Stridor, choking spells Pulse rate over 200 FTT Heart murmurs Frequent URI’s Anoxic attacks CVA R R R R R CHILDREN: Exercise intolerance Increased BP Poor physical development Heart murmurs Cyanosis Recurrent URI Clubbing fingers/toes squatting

CLASSIFICATION OF CHD R 1. 2. eg: Based on how the blood flows: obstructed,

CLASSIFICATION OF CHD R 1. 2. eg: Based on how the blood flows: obstructed, delayed, abnormally shunted: Blood flow can be obstructed or delayed which CHD (what anomalies are examples? ) If Blood is abnormally shunted from one side of the heart to the other what happens to pulmonary blood flow with a left to right shunt? right to left shunt What kind of blood is abnormally shunted? What happens to the lungs

REMEMBER THIS ABOUT SHUNTS! RHow does Blood flows occur in the heart? RWhat can

REMEMBER THIS ABOUT SHUNTS! RHow does Blood flows occur in the heart? RWhat can you say about the pressure on the RIGHT SIDE of the heart as compared to the pressure on the LEFT SIDE of the heart?

SECONDARY CLASSIFICATION OF CHD R Define happens with ACYANOTIC DEFECTS? R Give examples of

SECONDARY CLASSIFICATION OF CHD R Define happens with ACYANOTIC DEFECTS? R Give examples of Acyanotic defects? R Define what happens with CYANOTIC DEFECTS: R Give examples of Cyanotic defects? R What kind of shunt occurs?

OBSTRUCTIVE DEFECTS R Explain what happens to blood flow with an anatomic narrowing (stenosis)?

OBSTRUCTIVE DEFECTS R Explain what happens to blood flow with an anatomic narrowing (stenosis)? R Explain what happens to the Pressure in the ventricle and in the great artery before the obstruction? R Where is the most common Location of narrowing? R Give some EXAMPLES of obstructive defects:

COARCTATION OF AORTA R Where is the narrowing located? R Where is the increased

COARCTATION OF AORTA R Where is the narrowing located? R Where is the increased pressure and what does it cause? R Where is decreased pressure and what does it cause?

RESULTS OF COARCTATION RBecause of the large volume of blood going to the head

RESULTS OF COARCTATION RBecause of the large volume of blood going to the head the child may experience what? RWhat is common in infants?

TREATMENT OF COARCTATION OF AORTA Surgical treatment: Involves what correction? z What if the

TREATMENT OF COARCTATION OF AORTA Surgical treatment: Involves what correction? z What if the narrowed area is large, what might the surgeon have to do? z Is this open or closed heart surgery? z What is the common age of this surgery?

TREATMENT OF COARCTATION OF AORTA RWhat is the Nonsurgical treatment called? RIs this method

TREATMENT OF COARCTATION OF AORTA RWhat is the Nonsurgical treatment called? RIs this method performed everywhere?

POSTOP COARCTATION SYNDROME RPostop pts develop abdominal pain for what reason? RSURVIVAL POSTOP: 95%

POSTOP COARCTATION SYNDROME RPostop pts develop abdominal pain for what reason? RSURVIVAL POSTOP: 95%

PULMONIC STENOSIS R Stenosis means what and where? R RV hypertrophy occurs as a

PULMONIC STENOSIS R Stenosis means what and where? R RV hypertrophy occurs as a result of what R What happens to the volume of blood flow to the lungs? R S&S:

TX OF PULMONIC STENOSIS R SURGICAL TX: 1. Infants: closed heart surgery transventricular valvotomy

TX OF PULMONIC STENOSIS R SURGICAL TX: 1. Infants: closed heart surgery transventricular valvotomy 2. Children: open heart surgery pulmonary valvotomy R NONSURGICAL TX: balloon angioplasty in cardiac cath lab to dilate valve (TREATMENT OF CHOICE) R SURVIVAL RATE BOTH PROCEDURES: 98%

NEXT GROUP OF CHD: INCREASED PULMONARY BLOOD FLOW R How would you describe the

NEXT GROUP OF CHD: INCREASED PULMONARY BLOOD FLOW R How would you describe the blood flow in relationship to the pressures in this type of defect? R What happens to blood volume and where? R WITH THIS TYPE WHAT COMMONALITY WOULD YOU SEE IN TERMS OF S&S? R WHAT TYPE OF DEFECTS:

ATRIAL SEPTAL DEFECT R WHERE IS THE Abnormal opening? R WHERE DOES THE Blood

ATRIAL SEPTAL DEFECT R WHERE IS THE Abnormal opening? R WHERE DOES THE Blood FLOW from & to? R What enlarges?

ATRIAL SEPTAL DEFECT RS&S: RSurgical correction: R 99% survival rate postop

ATRIAL SEPTAL DEFECT RS&S: RSurgical correction: R 99% survival rate postop

VENTRICULAR SEPTAL DEFECT (VSD) R Abnormal opening between? R What can happen at birth?

VENTRICULAR SEPTAL DEFECT (VSD) R Abnormal opening between? R What can happen at birth? R Describe the effects of the shunt? And where the blood flows? R S&S: R Complications? R Corrective Surgery:

PATENT DUCTUS ARTERIOSUS R Failure of what to close at birth? R How does

PATENT DUCTUS ARTERIOSUS R Failure of what to close at birth? R How does Blood flow? R causing what kind of shunt?

Patent Ductus Arteriosus R S&S: R What complications? R What long term effects? R

Patent Ductus Arteriosus R S&S: R What complications? R What long term effects? R What changes in heart muscle?

PDA CONTINUED R What might be administered by the nurse to newborns/premies to close

PDA CONTINUED R What might be administered by the nurse to newborns/premies to close the shunt? R What Surgical Tx is used to correct problem? R Survival Rate postop: 99%

NEXT GROUP OF CHD: DECREASED PULMONARY BLOOD FLOW R Obstruction of pulmonary blood flow

NEXT GROUP OF CHD: DECREASED PULMONARY BLOOD FLOW R Obstruction of pulmonary blood flow caused by what type of anatomical defect? R How does the defect cause problems with blood flow? R What effect does it have on desaturated blood? R Where does the desaturated blood flow go?

TETRALOGY OF FALLOT R FOUR DEFECTS IDENTIFIED 1. 2. 3. 4.

TETRALOGY OF FALLOT R FOUR DEFECTS IDENTIFIED 1. 2. 3. 4.

TETRALOGY OF FALLOT R FOUR DEFECTS

TETRALOGY OF FALLOT R FOUR DEFECTS

SHUNTS IN TETRALOGY OF FALLOT VARY RIf pulmonary vascular resistance is higher than systemic

SHUNTS IN TETRALOGY OF FALLOT VARY RIf pulmonary vascular resistance is higher than systemic resistance WHICH DIRECTION IS THE SHUNT? RIf systemic resistance is higher than pulmonary vascular resistance WHICH DIRECTION IS THE SHUNT?

S&S OF TOF IN INFANTS R ASSESSMENT OF INFANTS WITH TOF? R WHAT IS

S&S OF TOF IN INFANTS R ASSESSMENT OF INFANTS WITH TOF? R WHAT IS A BLUE SPELL, HYPERCYANOTIC SPELL OR TET SPELL: R WHAT NORMAL INFANT SITUATIONS LEAD TO A SPELL? R CAUSE of TET SPELL? R WHAT IMPACT DOES THIS SPELL HAVE ON PULMONARY BLOOD FLOW? R HOW DOES IT EFFECT THE SHUNTING?

TET SPELLS RISKS 1. 2. 3. 4.

TET SPELLS RISKS 1. 2. 3. 4.

TREATING TET SPELLS OR HYPERCYANOTIC SPELLS R WHAT position helps the infant? R What

TREATING TET SPELLS OR HYPERCYANOTIC SPELLS R WHAT position helps the infant? R What approach needs to be used by caregiver? R What treatment needs to be instituted immediately? R What drug is given and why? R Why does the infant need IV fluid replacement and volume expanders? R What can be repeated if needed?

S&S OF TOF IN CHILDREN RWith long term cyanosis what develops in the fingers

S&S OF TOF IN CHILDREN RWith long term cyanosis what develops in the fingers RWhat position do children assume when in Tet spell? RHow does TOF effect growth? RWhat life threatening risks of TOF in children?

SURGICAL TX OF TOF R PALLIATIVE: R COMPLETE REPAIR: R Postop risks? R SURVIVAL:

SURGICAL TX OF TOF R PALLIATIVE: R COMPLETE REPAIR: R Postop risks? R SURVIVAL: 95%

TRICUSPID ATRESIA R What fails to develop? R What does this failure prevent between

TRICUSPID ATRESIA R What fails to develop? R What does this failure prevent between RA and RV? R Blood flows through another defect where? R When would the child die with this defect? R What keeps the child alive?

TRICUSPID ATRESIA R S&S: R Palliative surgery: R Corrective surgery: R Survival: 80 -90%;

TRICUSPID ATRESIA R S&S: R Palliative surgery: R Corrective surgery: R Survival: 80 -90%; many postop complications

MIXED DEFECT EXAMPLES RTRANSPOSITION OF THE GREAT VESSELS (TGV) OR TRANSPOSITION OF THE GREAT

MIXED DEFECT EXAMPLES RTRANSPOSITION OF THE GREAT VESSELS (TGV) OR TRANSPOSITION OF THE GREAT ARTERIES (TGA) RTRUNCUS ARTERIOSUS (TA)

TRANSPOSITION OF THE GREAT VESSELS R PA leaves the LV taking what blood back

TRANSPOSITION OF THE GREAT VESSELS R PA leaves the LV taking what blood back to the lungs R Aorta exits from where? R No communication between what? R What other defect allows child to live at birth?

TRANSPOSITION OF THE GREAT VESSELS RWhat assessment and complications seen at birth? RSurgical Tx:

TRANSPOSITION OF THE GREAT VESSELS RWhat assessment and complications seen at birth? RSurgical Tx: RSurvival: 80%

TRUNCUS ARTERIOSUS R What does this look like? R What other defects? R S&S

TRUNCUS ARTERIOSUS R What does this look like? R What other defects? R S&S R Surgical repair: R Survival of surgery: 80%. Other surgeries required

CONGESTIVE HEART FAILURE IN CHILDREN RWhat happens to the heart? RIs it able to

CONGESTIVE HEART FAILURE IN CHILDREN RWhat happens to the heart? RIs it able to meet the body’s demands? RWhat situations would lead to CHF?

SUBTLE S & S OF CHF in CHILDREN RHow does it effect feeding? RHow

SUBTLE S & S OF CHF in CHILDREN RHow does it effect feeding? RHow does it effect energy? RWhat happens during feeding?

CONGESTIVE HEART FAILURE IN CHILDREN R Impaired myocardial function R How does it effect

CONGESTIVE HEART FAILURE IN CHILDREN R Impaired myocardial function R How does it effect ? R VS? R Energy? R appetite R Temperature of skin? R Heart muscle? R Urinary elimination?

CHF IN CHILDREN R Systemic venous congestion R Weight? R Liver? R Fluid accumulation?

CHF IN CHILDREN R Systemic venous congestion R Weight? R Liver? R Fluid accumulation? R How does it effect? R Neck vein? R Respiratory assessment?

THERAPEUTIC MANAGEMENT GOALS RImprove cardiac function by? RRemove accumulated fluid and sodium leading to

THERAPEUTIC MANAGEMENT GOALS RImprove cardiac function by? RRemove accumulated fluid and sodium leading to what effect on the heart? RWhat on cardiac demands? RWhat effect on oxygenation?

IMPROVE CARDIAC FUNCTION RDigitalis RWhich class of drug? RUsed to?

IMPROVE CARDIAC FUNCTION RDigitalis RWhich class of drug? RUsed to?

MAJOR ACTIONS OF DIGITALIS R positive inotropic: means what? R negative chronotropic: means what?

MAJOR ACTIONS OF DIGITALIS R positive inotropic: means what? R negative chronotropic: means what? R negative dromotropic: means what? R Indirectly enhances what?

DIGOXIN (Lanoxin) IN PEDS R Elixir (50 ug/ml) po R IV (O. 1 mg/ml)

DIGOXIN (Lanoxin) IN PEDS R Elixir (50 ug/ml) po R IV (O. 1 mg/ml) R Dose calculated in micrograms (1000 ug=1 mg R Give Digitalizing dose to bring serum dig level into therapeutic range R Maintenance dose = 1/8 of digitalizing dose

THERAPEUTIC SERUM DIGOXIN RANGE RRange from 0. 8 to 2 ug/l

THERAPEUTIC SERUM DIGOXIN RANGE RRange from 0. 8 to 2 ug/l

Digoxin administration guide RApical pulse checked RDrug not given if pulse below 90110/min in

Digoxin administration guide RApical pulse checked RDrug not given if pulse below 90110/min in infants and young children or below 70/min in older children RDo one full minute

DIGOXIN Toxicity: REffect on heart rate? REffect on appetite and feeding?

DIGOXIN Toxicity: REffect on heart rate? REffect on appetite and feeding?

MEDS CONTINUED RAngiotensin converting enzyme inhibitors (ACE): Vasotec, Capoten RUsed to

MEDS CONTINUED RAngiotensin converting enzyme inhibitors (ACE): Vasotec, Capoten RUsed to

OTHER MEDICATIONS R For severe CHF, other IV inotropic drugs used in the ICU:

OTHER MEDICATIONS R For severe CHF, other IV inotropic drugs used in the ICU: 1. Dopamine 2. Dobutamine 3. Amrinone Used to

GOALS OF TREATMENT CONTINUED RRemove accumulated fluid and sodium with which group of drugs?

GOALS OF TREATMENT CONTINUED RRemove accumulated fluid and sodium with which group of drugs? RGive examples? RCAUTION:

GOALS OF TREATMENT CONTINUED: R Decrease cardiac demands: R GIVE EXAMPLES OF NURSING ACTIONS:

GOALS OF TREATMENT CONTINUED: R Decrease cardiac demands: R GIVE EXAMPLES OF NURSING ACTIONS:

GOALS OF TREATMENT CONTINUTED: R Improve tissue oxygenation NURSING ACTIONS:

GOALS OF TREATMENT CONTINUTED: R Improve tissue oxygenation NURSING ACTIONS:

NRSG DX FOR ACYANOTIC HEART DEFECTS

NRSG DX FOR ACYANOTIC HEART DEFECTS

NRSG DX FOR CYANOTIC HEART DEFECTS

NRSG DX FOR CYANOTIC HEART DEFECTS

NURSING CARE IN ICU POST -OP CARDIAC SURGERY R What is done to keep

NURSING CARE IN ICU POST -OP CARDIAC SURGERY R What is done to keep child calm? R How is the infant’s temp regulated R How often VS? R How is the heart monitored? R What measures Cardiac output? R Why does the child have Pacemaker leads in place?

POSTOP NURSING CARE CONTINUED R What is used to monitor BP? R What is

POSTOP NURSING CARE CONTINUED R What is used to monitor BP? R What is used to provide oxygen? R How are increased secretions managed R How is oxygenation measured? R Why is an NGT used? R Dressing over chest incision checked q 15 minutes for 24 hr for what?

POSTOP NURSING CARE CONTINUED POSTOP NU R 2 -3 chest tubes draining what from

POSTOP NURSING CARE CONTINUED POSTOP NU R 2 -3 chest tubes draining what from thoracic cavity which entered during surgery R Foley checked how often? R What urinary output would you expect for an infant? And a child? If Less than that normal what does this indicate? R Accurate I & O hourly including what drainage? R IV solutions and blood replacement

POSTOP NURSING CARE CONTINUED RWhat class of meds for pain? RWhat used to prevent

POSTOP NURSING CARE CONTINUED RWhat class of meds for pain? RWhat used to prevent infection? RWhat diet? RWhat needs to be done for the mouth? RHow to Support parents?

POTENTIAL COMPLICATIONS R HEMORRHAGE R *****ARRHYTHMIAS R CHF R PNEUMONIA R RENAL FAILURE R

POTENTIAL COMPLICATIONS R HEMORRHAGE R *****ARRHYTHMIAS R CHF R PNEUMONIA R RENAL FAILURE R CVA R PULMONARY EMBOLISM R DEATH

NURSING ASSESSMENTS RParents Rchild

NURSING ASSESSMENTS RParents Rchild

ENDOCARDITIS

ENDOCARDITIS

CAUSATIVE ORGANISMS RStreptococcus RStaphylococcus aureus, enterococci

CAUSATIVE ORGANISMS RStreptococcus RStaphylococcus aureus, enterococci

PREDISPOSING FACTORS R Who would get endocarditis?

PREDISPOSING FACTORS R Who would get endocarditis?

PATHOPHYSIOLOGY R Where does the Infective organisms travel? R Where is it deposited on

PATHOPHYSIOLOGY R Where does the Infective organisms travel? R Where is it deposited on the heart? R What aggregation is triggered? R What forms on valves and endocardium?

EMBOLIZATION RWhat happens to the Fragments of friable vegetative lesions? RWhere do they go?

EMBOLIZATION RWhat happens to the Fragments of friable vegetative lesions? RWhere do they go? RWhat assessments would the nurse look for with regard to embolization?

Clinical manifestations INITIAL SYMPTOMS SEEM LIKE FLU: FEVER: VASCULAR MANIFESTATIONS: R Splinter hemorrhages R

Clinical manifestations INITIAL SYMPTOMS SEEM LIKE FLU: FEVER: VASCULAR MANIFESTATIONS: R Splinter hemorrhages R Petechiae R Roth’s spots:

Clinical manifestations PERIPHERAL MANIFESTATIONS: R Osler’s Nodes: R Janeway lesions:

Clinical manifestations PERIPHERAL MANIFESTATIONS: R Osler’s Nodes: R Janeway lesions:

Clinical manifestations CARDIAC: RHeart murmur: indicates? RWhat happens to the size of the heart?

Clinical manifestations CARDIAC: RHeart murmur: indicates? RWhat happens to the size of the heart? RWhat other complication?

Clinical manifestations CEREBRAL EMBOLIZATION: RWhat assessments?

Clinical manifestations CEREBRAL EMBOLIZATION: RWhat assessments?

Clinical manifestations PULMONARY EMBOLIZATION: RWhat assessments?

Clinical manifestations PULMONARY EMBOLIZATION: RWhat assessments?

Clinical manifestations CORONARY ARTERY EMBOLIZATION: RWhat assessments?

Clinical manifestations CORONARY ARTERY EMBOLIZATION: RWhat assessments?

Clinical manifestations SPLENIC EMBOLIZATION: What assessments?

Clinical manifestations SPLENIC EMBOLIZATION: What assessments?

Clinical manifestations EMBOLIZATION OF THE RENAL ARTERY: RWhat assessments?

Clinical manifestations EMBOLIZATION OF THE RENAL ARTERY: RWhat assessments?

Clinical manifestations CENTRAL NERVOUS SYSTEM: RWhat assessments?

Clinical manifestations CENTRAL NERVOUS SYSTEM: RWhat assessments?

LABORATORY FINDINGS

LABORATORY FINDINGS

Nursing care R What medications are used to treat the infection? What route? R

Nursing care R What medications are used to treat the infection? What route? R What activity is best for the client? R What drug is used for the fever? R What drug is used for comfort R What labs indicate the infection status? R Observe for what complication? R What should be done prophylactically?

NURSING DIAGNOSIS EXPECTED OUTCOMES

NURSING DIAGNOSIS EXPECTED OUTCOMES

ABDOMINAL AORTIC ANEURYSM

ABDOMINAL AORTIC ANEURYSM

ANEURYSM RDefined

ANEURYSM RDefined

SIGNS AND SYMPTOMS

SIGNS AND SYMPTOMS

EXPANDING ANEURYSM ASSESSMENT

EXPANDING ANEURYSM ASSESSMENT

RUPTURED ANEURYSM R ASSESSMENT

RUPTURED ANEURYSM R ASSESSMENT

TREATMENT: SURGICAL REPAIR

TREATMENT: SURGICAL REPAIR

BEFORE SURGERY ASSESSMENT

BEFORE SURGERY ASSESSMENT

COMPLICATIONS DURING SURGERY

COMPLICATIONS DURING SURGERY

MYOCARDIAL INFARCTION RHow would you know?

MYOCARDIAL INFARCTION RHow would you know?

GRAFT OCCLUSION OR RUPTURE

GRAFT OCCLUSION OR RUPTURE

HYPOVOLEMIA & RENAL FAILURE

HYPOVOLEMIA & RENAL FAILURE

RESPIRATORY DISTRESS

RESPIRATORY DISTRESS

PARALYTIC ILEUS

PARALYTIC ILEUS

POSTOPERATIVE NURSING CARE

POSTOPERATIVE NURSING CARE

POST-OP ASSESSMENTS for ISCHEMIA

POST-OP ASSESSMENTS for ISCHEMIA

POST-OP ASSESSMENTS for: ARTERIAL OCCLUSION

POST-OP ASSESSMENTS for: ARTERIAL OCCLUSION

DISCHARGE PLANNING

DISCHARGE PLANNING

Valvular Heart Disease

Valvular Heart Disease

GENERAL CONCEPTS VALVULAR DISEASE INVOLVES THE 4 VALVES OF THE HEART PRESSURES:

GENERAL CONCEPTS VALVULAR DISEASE INVOLVES THE 4 VALVES OF THE HEART PRESSURES:

PRESSURE ALTERATIONS DUE TO STENOTIC VALVE

PRESSURE ALTERATIONS DUE TO STENOTIC VALVE

VALVULAR DISEASE DEFINED: RStenosis: RRegurgitation:

VALVULAR DISEASE DEFINED: RStenosis: RRegurgitation:

STENOSIS & REGURGITATION RSTENOSIS: RREGURGITATION:

STENOSIS & REGURGITATION RSTENOSIS: RREGURGITATION:

MITRAL VALVE STENOSIS

MITRAL VALVE STENOSIS

ASSESSMENT

ASSESSMENT

MITRAL VALVE REGURGITATION

MITRAL VALVE REGURGITATION

ASSESSMENT

ASSESSMENT

MITRAL VALVE PROLAPSE

MITRAL VALVE PROLAPSE

ASSESSMENT

ASSESSMENT

AORTIC VALVE STENOSIS

AORTIC VALVE STENOSIS

ASSESSMENT

ASSESSMENT

AORTIC VALVE REGURGITATION RACUTE AORTIC VALVE REGURGITATION RCAUSES

AORTIC VALVE REGURGITATION RACUTE AORTIC VALVE REGURGITATION RCAUSES

ASSESSMENT • ACUTE: • CHRONIC:

ASSESSMENT • ACUTE: • CHRONIC:

TRICUSPID AND PULMONIC VALVE DISEASE RRESULTS: RTRICUSPID STENOSIS RESULTS in RPULMONIC STENOSIS: results in

TRICUSPID AND PULMONIC VALVE DISEASE RRESULTS: RTRICUSPID STENOSIS RESULTS in RPULMONIC STENOSIS: results in

DIAGNOSTIC STUDIES FOR VALVULAR HEART DISEASE

DIAGNOSTIC STUDIES FOR VALVULAR HEART DISEASE

TREATMENT DEPENDS UPON SYMPTOMS:

TREATMENT DEPENDS UPON SYMPTOMS:

TEACHING RDescribe disease and complications RDiscuss ways to prevent complications: prophylactic antibiotics prior to

TEACHING RDescribe disease and complications RDiscuss ways to prevent complications: prophylactic antibiotics prior to invasive procedures RWear Medic Alert RTeach about anticoagulants if prescribed