6/11 peds day 1

neuro key points

• providing comfort for patients & families for disorders not compatible with life

• seizures: TIME, describing type of seizure, providing safety for patient

  • minimize clutter in peds beds

  • want suction in hospital room

• educating parents on safety and medications while at home for seizures; know seizures may not be super obvious

• involve PT, OT, social work in providing services to patients with neuro deficits → early intervention is key

resp key points

• get pmhx from caregiver/parents → use OLDCART

  • what has been done at home to try and relieve current issue?

• position in high-fowler for breathing distress (don’t lay flat, make sure O2 is still in nose, etc)

cardiac key points

• two types: congenital vs acquired dysfunction

• need to know hx (maternal and child hx), any exposures, presentation at birth

  • a lot of cardiac issues occur during transition from utero to outside life

• four categories of congenital heart defects:

  • incr pulm blood flow

  • decr pulm blood flow

  • obstructive disorders

  • mixed

• need to know where the defect is located, how does it impact blood flow and oxygenation, how does the heart compensate, what s/s would you expect in your patient?

  • ex: ventral septal defect

    • blood flow is being mixed due to a septal defect between the ventricles causing low oxygenation of blood

    • heart compensates by enlarged ventricles

    • see some cyanosis and see cardiomegaly on x-ray; pt needs to be on O2/meds to support

• cardiac babies typically have lower O2 sats/cyanotic tinge and that’s ok

  • may develop clubbing as an older kid

• nursing interventions would be incr nutrition, activity tolerance, management of symptoms, giving caregiver education

  • know when cluster care is appropriate d/t level of activity tolerance