Nursing homes and plans arrhythmias
INTRODUCTION
There are deviations in the normal heart rate or heart rhythm, arrhythmias are directly associated with disturbances in jaras conduction of the heart. Generally classified according to place (the ventricles or supraventrikel), arrhythmia in children is usually congenital or associated with cardiac surgery. Clinical significance depends on cardiac output, blood pressure, and his place.
Arrhythmias are not common in children. Treatment usually includes the use of antiarrhythmics medications, such as digitalis glycosides and verapamil (Calan).
ASSESSMENT
Cardiovascular
Heart rate that is not normal according to age
R-R interval irregular
The loss of P waves before each QRS complex
PR interval extends
Gelombnag P and abnormal QRS complexes
Signs of decreased cardiac output (elongated capillary filling time, peripheral edema, Crackle, ronchi, and tachycardia).
Nursing Diagnosis
Decrease in cardiac output associated with cardiac arrhythmias
Expected results
Children will maintain an effective cardiac output is characterized by capillary filling time of 3 to 5 seconds, pink mucous membranes, increasing energy levels, and increased feeding of children.
Intervention
monitor cardiovascular status of children by using a heart monitor.
Assess and record children apical pulse, peripheral pulses, blood pressure, capillary filling time, fluid intake and output, and skin characteristics (such as striped skin, skin color, edema, temperature, and diaphoresis).
Please provide cardiovascular treatment, as directed.
Help your child save energy through the grouping of nursing care.
Rational
Indications of heart monitoring and recording of various irregularities haert normal heart rate and rhythm of children.
Assessments provide data from the basic measurement change, possibly indicated arrhythmias.
Cardiovascular treatment could be given to help decide electrical disturbances associated with arrhythmias.
Clustering allows care to be a long rest period.
Nursing Diagnosis
Dosisi injury risk associated with treatment or treatment of physiological response.
Expected results
Children akantidak suffered injury due to physiological doses of medication or treatment response.
Intervention
After treatment with medication, monitor heart rate and heart rhythms of children using the heart monitor.
Monitor levels of potassium and calcium. Consider the clinical signs of the imbalance of potassium and calcium.
Do double check that all doses of medication to be accurate before giving the drug; assure that patients receive a specified amount.
Rational
Anti-arrhythmia treatment can lead to arrhythmias, which can be detected through a heart monitoring device.
Effectiveness of treatment of arrhythmia depends on the proper adjustment of intracellular electrolytes. Potassium imbalance can cause artimia; imbalance of calcium can cause cardiac arrest.
Giving too much medication or too little can cause aritimia.
Nursing Diagnosis
Risk of infection associated with intravenous actions and cardiac electrode.
Expected results
Children will tidfak no sign of infection is characterized by the absence of erythema, tenderness, swelling at the site of puncture iV or the location of electrodes; body temperature 97.6 ˚ to 99 ˚ F [36.4 ˚ to 37.2 ˚ C]), and vital signs in accordance with age.
Intervention
Check the location i.V. every hour possible signs of erythema or infiltration and the possibility of misplaced injection needle.
Replace needle i.V. every 24 to 72 hours, with the right.
Check the location of each electrode penggantianadanya signs of rash or erythema.
Rational
Kaji location I.V. every hour in order to help detect skin burns due to chemical infiltration or interruption of treatment due to an error antiaritimia yasng jarun IV-location of both a source of infection.
Changing the tubes on a regular basis helps prevent bacterial growth; location IV difficult to drain fluid that can be replaced as soon as possible.
Giving amused at electrodes cause skin irritation, which allows the occurrence of infection. Lifting pad electrodes can cause skin damage, may lead to the possibility of infiltration of bacteria at these locations. Using needle electrodes will also allow ifiltrasi bacteria are localized.
Nursing Diagnosis
The reduction varied activities associated with activity restriction due to a heart monitor installation.
Expected results
Children will participate in the activities of a child's life despite a heart monitor attached.
Intervention
Konsulkan on specific energy for a child's life (perapi play) about appropriate play activities and stimulation of children.
Encourage the child to interact with other children in the unit, set on another child that is free from respiratory infections.
give dolls, games, and books appropriate to their level of child development.
Rational
Special worker for a child's life can plan appropriate activities based on the level perekembangan child and physical limitations.
With contacts with peers will help to prevent feelings of isolation and encouraging children to participate in aktiftas.
These activities help distract children from the condition and help reduce boredom. They also provided stimulation to help for growing up children.
Nursing Diagnosis
Lack of knowledge related to diseases of children, live-patient at the hospital, and nursing home care.
Expected results
The parents will express their understanding of the disease abank, the reason for hospitalization, and nursing home care instructions and demonstrate procedures for home care.
Intervention
Teach parents the following:
Cause aritimia in children
The signs and symptoms of heart failure, including Tachypnoea, tachycardia, sweating, fatigue, difficulty eating, peripheral edema, weight increased rapidly bedan, dyspnea, and cyanosis.
Actions related to drug dose and treatment as well as possible reaction from antiaritimia treatment.
Explain the purpose and use of cardiac monitors in the elderly and children (if age appropriate). If the child is fitted with monitoring at home, explain how if the system works, how to set the alarm, and the types of problems that can be prevented when using a monitoring tool at home. If the problem occurs, tell the parents to contact the hospital or doctor.
Convince parents to attend classes resucitation cardiopulmonary (CPR) before the children were discharged from hospital.
Rational
An understanding of the nature and seriousness of the condition of the child helps parents keep medications and monitor child development.
Understanding of the causes of sick children to help parents have a sense of order to control the situation well.
The introduction of the signs and symptoms of heart failure will encourage parents seek immediate medical help is needed jik, help menceghindari serious complications.
Knowing how the drug works, dosisi the right, and antiarrhythmics medications to help parents follow the treatment of children; know further reaction will immediately seek medical attention if needed.
This explanation helps to reduce the fears of parents and prevent the things that are not necessary in the operation of monitoring tools, give parents the opportunity to give attention to matters relating to child care.
Parents need to know when and how to start CPR to support circulation and pernafasannnya children that even in case of cardiac arrest associated with arrhythmias.
Documentation checklist
During his stay in hospital care, notes:
The situation of children and the assessment undertaken during hospitalization.
Changes in the situation of children
Dealing with the results of laboratory and test diaghnostik
Fluid intake and output
Nutrition
Status of growth and development
Response of children to treatment
The reaction of children and parents of sick and stayed in hospital care.
Guidelines for teaching patients and their families
Guidelines for follow-up plan.
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