Question

specific ways you can focus the nursing care of a child with a cardiac disorder to improve oxygenation, promote nutrition, prevent infection, provide post-op care, assist with coping, and provide education.

Answer 1

Nursing care of a child with cardiac disorder:

Cardiac disorders in children may caused due to various factors such as congenital heart diseases, bacterial or viral infections, associated medical disorders etc. Care of a child , who is having a cardiac disorder is a very stressful task for parents as well as for the health professionals..

Specic ways for nursing care:

* To improve oxygenation:

- Monitor pulse oximetry and oxygenation level for the child

- Provide adequate rest periods to decrease the metabolism and oxygen demand for the tissues

- Semi Fowler's position can help the child for easy breathing by providing increased lung expansion.

- Administer oxygen as per physician's order

- Administer medications to improve cardiac functions as per physician's order.  

* Promote nutrition :

-A child with congenital heart disease need more calories to grow and to maintain the weight. Child's heart has to pump more effectively to meet the increased metabolism of this stage and due to cardiac instability. Provide a high calorie formula, breast milk or milk to meet the calorie needs.

- Inform the mother, Infants may get tired even with the breast feeding session and they may sleep off. Mother's has to take care of the baby during breast feeding to prevent aspiration

-Tube feeding;  Supplemental tube feeding, whenever necessary. Older children can have orally whatever they want at day time , night time , they can get the supplemental feeding through tube.

* Provide the child with high calorie diet and snacks, but not to give any sugary drinks, soft drinks,fast food etc. The diet should be balanced with the variety of food items and nutrients but the calorie should be more.

* Prevent infection :

- Maintain aseptic environment for the betterment of the child.  

- Hand hygiene must observed by parents and health care providers.

- Aseptic techniques while changing the dressing for wound and surgical incision.

- Balanced diet and Vitamin C rich food ( citrus fruits) can increase the immunity against infection.

- Administer the Antibiotics as per physician's order.

* Provide postoperative care :

* Maintain an aseptic environment for post operative care for  the child with cardiac disorders.

* In ICU and in Post operative care unit, reassure the child by touching , talking and soothing the child . Even if the child is sedated, encourage the parents to be with him or her and gently caress them.

*Light physical activity can be encouraged as per physician's order, after the surgery.

* Assist with Coping:

- Provide Counselling for the parents and the children to accept and adapt to the disease condition. After developing an understanding and acceptance about the health status, it will be easy to adjust more with illness and Coping strategies.  

- Educate the parents and child regarding the care of the child.

* Provide education:

- Instruct the parents on how to identify the symptoms of heart failure and seek early medical help.

Due to slow circulation, the symptoms like weakness, coldness, light headedness, palpitations, Shortness of breath etc may occur in heart faiilure.

- Educate the parents on diet modification, lifestyle changes, medication regimen and the importance of follow up care.  

- Clarify the child's and parents ' doubt regarding the disease condition .

- Be compassionate to them.