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NURS 2356 - CARDIOLOGY | UPDATE | COMPREHENSIVE MOST FREQUENTLY TESTED QUESTION WITH VERIFIED SOLUTIONS| GRADED A+| GET IT 100% ACCURATE!! compared to those above 7 years old, where is the stethoscope placed for a child under 7?$17.99
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NURS 2356 - CARDIOLOGY | UPDATE | COMPREHENSIVE MOST FREQUENTLY TESTED QUESTION WITH VERIFIED SOLUTIONS| GRADED A+| GET IT 100% ACCURATE!! compared to those above 7 years old, where is the stethoscope placed for a child under 7?
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Course
NURS 2356
Institution
NURS 2356
NURS 2356 - CARDIOLOGY | UPDATE |
COMPREHENSIVE MOST FREQUENTLY TESTED
QUESTION WITH VERIFIED SOLUTIONS| GRADED
A+| GET IT 100% ACCURATE!!
compared to those above 7 years old, where is the
stethoscope placed for a child under 7?
NURS 2356 - CARDIOLOGY | UPDATE |
COMPREHENSIVE MOST FREQUENTLY TESTED
QUESTION WITH VERIFIED SOLUTIONS| GRADED
A+| GET IT 100% ACCURATE!!
compared to those above 7 years old, where is the
stethoscope placed for a child under 7?
➣ why
between the 4th & 5th intercostal space
➣ this is because the heart lies more horizontally,
resulting in the apex lying higher in the chest
since the normal HR in an infant is higher than in
adulthood, how does this impact cardiac output
the faster HR in infants limits the ability
to increase cardiac output when HR is increased
are murmurs and physiologic splitting of heart
sounds common and "normal" in infancy and
childhood
➣ reasoning
yes
➣ these findings are related to the change in the size
of the heart in relation to the thoracic cavity
,normal HR & BP of an infant
90 - 160 BPM
80/55 mmHg
normal HR & BP of a toddler or preschooler
80 - 115 BPM
how long do most ARF attacks last?
6 - 12 weeks
how is ARF diagnosed?
modified jones criteria which requires the presence
of either 2 major criteria or 1 major plus 2 minor
criteria
major criteria
➣ carditis
➣ migratory polyarthritis
➣ erythema marginatum
➣ sydenham chorea
minor criteria
➣ arthralgia - joint stiffness
➣ fever
➣ elevated erythrocyte sedimentation rate or C-
reactive protein
,➣ prolonged PR interval
also requires recent strep infection
ARF clinical management (4)
➣ managing inflammation & fever
➣ eradicating the causative bacteria
➣ preventing permanent heart damage
➣ preventing recurrences (likely to result in RHD)
prophylactic therapy duration for ARF without
carditis
5 years or until 21 years old
➣ whichever is longer
prophylactic therapy duration for ARF with carditis
10 years or until 21 years of age
➣ whichever is longer
prophylactic therapy duration for rheumatic heart
disease (RHD)
until the age of 40 years or indefinitely
medications that have bactericidal action against
susceptible bacteria and used for prevention of ARF
(2)
penicillin G (IM or IV)/penicillin V (PO)
erythromycin ethylsuccinate (Erythromycin)
, nursing considerations for penicillin G/penicillin V
(3)
➣ assess for PCN allergy
➣ monitor bowel function
➣ report signs of CDAD aka c diff (diarrhea, blood
stools, abdominal cramping or fever)
side effects of penicillin G/penicillin V (8)
➣ seizures
➣ c. diff (CDAD)
➣ anaphylaxis
➣ serum sickness
➣ epigastric distress
➣ N/V/D
➣ rash
➣ pain at IM site/phlebitis at IV site
nursing considerations for erythromycin
monitor bowel function and report signs of CDAD
➣ requires contact precautions and bleach cleaning,
washing of the hands with soap and water
side effects of erythromycin (5)
➣ torsade de pointes
➣ ventricular arrhythmias
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