Pediatric Nursing Demystified

• Institute preoperative teaching to reduce anxiety.


• Prepare child and family for postoperative procedures such as naso-
  gastric tube, wound care, and monitoring apparatus.


• Administer preoperative sedation.
  Provide postoperative care for the child undergoing cardiac surgery:


• Make sure child is in safe position of comfort according to the physician’s
  order.


• Perform stat orders.


• Use proper handwashing.


• Assess wound for bleeding and signs of infection.


• Provide appropriate wound care.


• Assess breath sounds.


• Perform neurologic checks.


• Take frequent vital signs.


• Administer fluids to prevent hypotension.


• Monitor fluids losses through chest tube.


• Administer pharmacologic support as ordered.


• Monitor electrolytes and supplement with infusion as ordered.


• Administer sedatives and analgesics for comfort.


• Allow caregivers to visit as soon as possible.


• Explain procedures and equipment to caregivers.


• Encourage caregivers to ask questions.


• Involve child life specialist and social services in the care to support
  the child and family.

Transposition of Great Arteries

What Went Wrong?

In transposition of great arteries (TGA), the pulmonary artery rises from

the left ventricle and the aorta exists from the right ventricle.

There is no communication between the systemic and pulmonary

circulation.

Life is sustained due to defects associated with the TGA.

The common defects are patent ductus arterious and ventricular septal

defects.

Signs and Symptoms

Severely cyanotic

Characteristics of CHF

Test Results

Cardiac catheterization: Catheters are inserted into the heart via a large

peripheral vein and advanced into the heart to measure pressures and

oxygen levels in heart chambers and visualize heart structures and blood

3

2

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CHAPTER 6/ Cardiovascular Conditions^117