Question

1. Describe 3 clinical manifestations specific to right sided heart failure

2. Describe the pathophysiology and list 4 risk factors associated with infective endocarditis

3. Which items should be included in the medication education for a pediatric patient taking digoxin and furosemide?

4. What is Rheumatic Fever and how is it treated?

5. What is a hypercyanotic spell, who suffers from it, and how is it treated?

Answer 1

The clinical manifestation of right sided heart failure includes

a.Sweling over the legs,ankles and feet

b. Swelling of the abdomen

c. Sudden weight gain

These symptoms occur as a result of heart's (right ventricle)inability to receive cpmplete blood from different parts of the body.As result the blood gets stagnated in the veins and causes edema on the legs,abdomen and other vital organs also it leads to sudden increase in the body weight.

2. Infective endocarditis is the infection of the heart valves or the endocardium.This is not a common infection as it require three process,which include the preparation of the heart valve or the surface to adhere the bacterium,adherence of the bacterium and the survival of the bacterium on the adhered surface.This mainly happens due to the structural abnormalities. This allows the moving bacterias in the blood to adhere to the platelet and fibrin and it creats a biofilm and make vegetation and colony.This leads to the infective endocarditis.

The risk factors of infective endocarditis includes artificial heart valves,previous history of infective endocarditis,presence of artificial implants,chronic rheumatic heart disease.

3. Explain that digixin can cause changes in the heart rate according to the age.So instruct the parents at what heart rate the digoxin should withheld according to the age of the child.Also teach the parents that the administration of frusemide can cause hypokalemia which intern can increase the risk of digoxin toxicity .So monitor the electrolye balance periodocally and manage the dose of digoxin and the frusdemide according to the doctors advice.

4. Rheumatic fever is an inflammatory disease.It affects the throat,joints and the heart.It can be treated with early diagnosis and treatment with proper antibiotics.The treatment includes the use of anti infammatory drugs,analgesics ,anticonvulsants,steroids .Drugs like aspirin and penicillin are used.The aim of treating this is to avoid recurrence,and we provide the symptomatic treatments .

5. What is a hypercyanotic spell, who suffers from it, and how is it treated?

Hyper cyanotic spell is the sudden reduction in the oxygen saturation.

The people who suffer from this include child with tetrology of fallot,and congenital heart disease.

The treatment includes the positioning ofthe child in a knee chest position,also give analgesics.However there are certain surgical management to at the age of 2-6 months or early of the symptoms gets worse