Pediatric Nursing Demystified

Pulse oximetry (SpO 2 ): Device used to evaluate the degree of oxygen

saturation in the blood using a small infrared light probe. Oxygen saturation

decreased.

Electrocardiogram: Detects electrical events normal and abnormal cardiac

rhythms in the heart. Signs of ventricular hypertrophy noted.

Echocardiogram: Two-dimensional Doppler evaluation to detect evidence

of valve leakage, cardiac anatomy, size, and function. Septal defects and

ventricular hypertrophy noted.

Treatment

The palliative approach includes

Administration of indomethacin (prostaglandin inhibitor)

Application of coils to occlude the PDA

Surgical treatment includes ligation and clipping of the patent vessel.

Nursing Interventions for Child Undergoing Cardiac

Catheterization

Prepare the patient for cardiac catheterization:

• Take complete nursing history.


• Patient must be NPO for 4 to 6 hours.


• Complete assessment including calculation of body surface area.


• Check for allergies; allergies to iodine, contrast dyes, and shellfish
  should be relayed to the physician prior to the procedure.


• Document baseline assessment of pedal pulses and pulse oximetry.


• Utilize child life specialists to alleviate anxiety for the child and family.


• Arrange a tour of the lab with the child if age appropriate.


• Explain specific aspects of the procedure such as the placement of
  the IV and ECG electrodes.


• Demonstrate how the skin will be washed with brown soap and how
  the skin will be numbed.


• Explain how the contrast affects the patient and how sedation will
  make the child feel.
  Care of the patient after cardiac catheterization:


• Monitor patient with cardiac monitor and pulse oximeter prior to
  discharge.


• Monitor the patient for
  Temperature and color distal to the catheter insertion site
  A pulse of the extremity distal to the catheter insertion site


• Take vital signs every 15 minutes for the first hour and hourly thereafter.


• Monitor for trends and assess for possible hypotension, tachycardia,
  and bradycardia.


• Check the pressure dressing for evidence of bleeding.


• Observe for bleeding at the insertion site or evidence of hematoma.

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CHAPTER 6/ Cardiovascular Conditions^105