2. HF: Diagnostics & Nursing Management

what imaging and cardiac tests help evaluate pediatric heart failure?

• chest x-ray

• enlarged heart or pulmonary edema

• EKG to show ventricular hypertrophy

• echocardiogram: finds underlying cause of HF

what laboratory tests help evaluate pediatric heart failure?

• CBC

• blood chemistry

• BNP

• lactic acid

• arterial blood gas

what does a CBC help identify in pediatric heart failure?

anemia or infection

what electrolyte abnormalities may occur in pediatric heart failure?

• low 🔻 sodium from fluid retention

• high 🔺 potassium from tissue destruction or impaired kidney function

what happens to B-type natriuretic peptide (BNP) in heart failure?

BNP increases

what does elevated lactic acid suggest in pediatric heart failure?

tissue hypoxia

what acid–base abnormalities may appear on an arterial blood gas in pediatric heart failure?

respiratory alkalosis or metabolic acidosis, depending on the underlying changes

what are the four nursing management priorities for pediatric heart failure? *

• promote oxygenation

• support cardiac function (meds)

• provide adequate nutrition

• promote rest

what interventions promote oxygenation in pediatric heart failure?

• positioning

• suctioning

• chest physiotherapy and postural drainage

• supplemental oxygen as ordered

what medications support cardiac function in pediatric heart failure?

digoxin, ACE inhibitors, and diuretics

why do children with heart failure need increased calories?

heart failure increases metabolic rate and caloric needs

how should meals be provided for older children with heart failure?

small, frequent meals to reduce fatigue from eating large meals

what feeding adjustments may help infants with heart failure?

• concentrated formula

• modified bottle nipple to ease feeding

• nasogastric or orogastric tube feeding

• parenteral nutrition when needed

why is rest important in pediatric heart failure? *

limiting activity reduces metabolic needs and cardiac demand, especially during the acute phase

what quiet activities are appropriate for children with heart failure?

reading, coloring, drawing, video games, or board games

how should nursing care be organized to promote rest in pediatric heart failure? *

cluster assessments, vital signs, and medications when possible to minimize interruptions