Chapter 33: Cardiovascular Disorders (Pediatric Nursing)

Heart failure in infants and children presents with distinctive signs including tachycardia, tachypnea, and scalp diaphoresis, requiring nursing interventions focused on improving oxygenation, administering diuretics and inotropic agents, and optimizing nutritional intake to support growth. Congenital heart defects are systematically classified by their hemodynamic effects: defects causing increased pulmonary blood flow such as atrial septal defect, ventricular septal defect, and patent ductus arteriosus; obstructive lesions including aortic stenosis, pulmonary stenosis, and coarctation of the aorta; cyanotic defects with decreased pulmonary flow like Tetralogy of Fallot and tricuspid atresia; and complex mixed lesions such as transposition of the great arteries and truncus arteriosus. Management of hypercyanotic episodes involves positioning strategies, oxygen supplementation, pharmacological support, and fluid resuscitation. The chapter addresses rheumatic fever as a sequela of untreated streptococcal infection, with clinical manifestations assessed using the Jones criteria, and details the acute and chronic complications including carditis and valvular disease. Kawasaki disease is presented through its three stages with emphasis on early immunoglobulin and aspirin therapy to prevent coronary artery complications. Critical nursing responsibilities include medication administration and monitoring for digoxin toxicity, electrolyte management during diuretic therapy, assessment for signs of decreased cardiac output, surveillance for post-operative infections, and comprehensive family education regarding activity restrictions, medication administration, infection prevention, and follow-up specialized care.