inflammation of tonsils

viral, bacterial

may be r/t --> strep infection -->

WARNING risk of developing

acute glomerulitis or rheumatic heart disease

sore throat, fever

enlarged tonsils (purulent?)

obstructive breathing "kissing tonsils"

throat culture --> viral, bacterial

PT, PTT

history of prolonged/excessive bleeding or bleeding disorders in the family

warm salt gargles

acetaminophen for fever

antibiotics

ice chips

NO straws

continuous swallowing

clearing of throat

vomitus with fresh blood

vasoconstriction

relieves pain

1st 24 hours

5-10 days after surgery

Adrenergic: Epinephrine HCl

(SusPhrine)

rapid acting bronchodilator,

choice drug for actue asthma attack

adverse rxns: tachycardia, jittery, HTN, nausea

nx implications: subQ, IV, nebulizer, can repeat in 20 minutes

Adrenergic: theophylline

(Theo-Dur)

bronchodilator, bronchospasm reversal in asthma

adv. rxn: n/v, tachycardia, irritable, hypotension, palpitations

nx implications: auscultate lungs before and after administration, monitor blood levels

acyanotic heart defect

ventricular septal defect

increase pulmonary BF

hole b/t ventricles

O2 blood from L ventricle -->

R ventricle, then recirculated to lungs

small defects may close spontaneously 

large defects cause CHF & needs surgery to close

acyanotic heart defect

atrial septal defect

hole b/t atria

O2 blood from L atrium -->

R atrium and lungs, b/c pressure changes

most defects do not seriously compromise child

surgical closure before school age

can lead to significant problems like CHF or atrial dysrhythmias

acyanotic heart defect

patent ductus arteriosus

opening b/t aorta and pulmonary artery

usually closes w/i 72 hours of birth

increases BF to the lungs causes pulmonary HTN

might need medical intervention with indomethacin or surgery

Acyanotic heart defect

Obstructive defect (BF from ventricles)

Obstructive narrowing of aorta

HTN in upper extremities

decrease or no pulses in lower extremities

take BP in all 4 limbs, may need surgery

Acyanotic heart defect

Obstructive blood flow from ventricles

Aortic stenosis (near aortic valve)

O2 BF from L ventricle into systemic circulation is decreased

symptoms because of low cardiac output

may need surgery

Cyanotic Heart Defect

Decreased pulmonary blood flow

unoxygenated blood pumped into circulation

decrease pulmonary circulation b/c of pulmonary stenosis

P.R.O.V.e

Pulmonary stenosis, Right ventricular hypertrophy, Overriding Aorta, Ventricular septal defect

"tet" spells relieved by knee-chest position or squatting

surgery is needed

Cyanotic heart defect

Mixed blood defect

Pulmonary/Aorta arteries don't separate

1 main vessel gets blood from L and R ventricles together

increase pulmonary resistance = increase cyanosis

needs surgical correction

VSD is only means of survival

use prostaglandin 

Cyanotic heart defect

Mixed blood flow defect

Pulmonary circulation arises from L ventricle

Systemic circulation arises from R ventricle

must have ASD, VSD, or/and PDA to live

medical emergency!

prostaglandin e

murmur (present/absent; thrill, rub)

cyanosis, clubbing digits

poor feeding & wt gain

frequent regurgitation

frequent respiratory infection

activity intolerance, fatigue

heart rate, rhythm, sounds

pulse quality and symmetry

BP in upper and lower extremities

hx of maternal infection during pregnancy

HR increases with crying or infection