Chapter 17: Caring for the Child With a Cardiovascular Condition

Understanding these physiologic principles is essential for recognizing when the heart fails to maintain adequate systemic perfusion. Congestive heart failure in children presents distinctly across age groups, with infants manifesting poor feeding and growth failure while older children experience dyspnea and exercise limitation; medical management employs inotropic agents, diuretics, and vasodilators to restore hemodynamic balance. The chapter extensively covers congenital heart defects, categorizing them as acyanotic lesions involving left-to-right shunting (such as ventricular septal defects and patent ductus arteriosus), obstructive lesions that impede forward flow, and cyanotic defects where deoxygenated blood bypasses pulmonary circulation. Complex conditions like tetralogy of fallot and hypoplastic left heart syndrome require staged surgical interventions and demand sophisticated nursing assessment for acute decompensation. Acquired cardiac diseases including subacute bacterial endocarditis, Kawasaki disease with its risk of coronary complications, and rheumatic fever following streptococcal infection represent additional challenges requiring both acute management and long-term surveillance. The chapter details critical diagnostic modalities including electrocardiography, cardiac catheterization with its associated complications and post-procedure protocols, and echocardiography. Nursing care emphasizes energy conservation strategies, meticulous postoperative monitoring for hemorrhage and organ dysfunction, precise medication administration using metric measurements, family education regarding cardiopulmonary resuscitation and subtle signs of decompensation, and coordination of school accommodations for children with significant cardiac limitations.