Cathy covers heart Failure, including the pathophysiology, signs/symptoms, labs, diagnosis, treatment, and nursing care of patients with heart failure. A detailed explanation of the differences between left and right-sided heart failure. The topic of hypoxemia, including causes, signs/symptoms, labs/diagnosis, treatment, and nursing care of this disorder.
Our Pediatric Nursing video tutorial series is taught by Cathy Parkes BSN, RN, CWCN, PHN and intended to help RN and PN nursing students study for their nursing school exams, including the ATI, HESI and NCLEX.
This is your one-stop-shop for materials to help you LEARN \u0026 REVIEW so you can PASS Nursing School.
🤔🤔🤔 DO YOU WANT TO PASS your classes, proctored exams and the NCLEX? 🤔🤔🤔 Our resources are the best you can buy. They are built with a single goal: help you pass with no fluff. Everything you need, and nothing you don’t. Don’t take our word for it, though! Check out our hundreds of ⭐️⭐️⭐️⭐️⭐️ reviews from nurses who passed their exams and the NCLEX with Level Up RN.
🗂️ Our Ultimate Nursing School Survival kit is your number 1 resource to get through nursing school and to pass the NCLEX. Whether you’re just starting school or you’re already prepping for the NCLEX, this bundle of flashcards is the best you can buy. It covers all the information you need to know to pass all your exams and it has FREE shipping! ➡️ https://bit.ly/TUNSSK ⬅️
📧 LOOKING FOR FREE RESOURCES TO HELP WITH YOUR EXAMS? Get exclusive tips, latest video releases and more delivered to your email! ➡️ https://leveluprn.com/signup ⬅️
⚕ 👩 LEVEL UP NURSE SQUAD 👩⚕️ All of the nurses at Level Up RN are here to help! Cathy Parkes started helping her fellow classmates back when she was in nursing school, tutoring so they could pass their exams and graduate. After she got her BSN and started working as an RN at Scripps Encinitas Hospital, she started this YouTube channel to help nursing students around the world. Since then she has built a team of top-notch dedicated nurses and nurse educators who are focused on improving nursing education and supporting career advancement for nurses everywhere. With flashcards, videos, courses, organizational tools and more, we are singularly focused on helping students and nurses Level Up on their exams and nursing careers.
Content
0.45 -> Hi.
1.45 -> I'm Cathy with Level Up RN.
2.57 -> In this video, we are going to talk about
heart failure and hypoxemia, which are two
7.559 -> big things that occur when a patient has a
congenital heart defect.
13.219 -> At the end of the video, I'm going to give
you guys a little quiz to test your knowledge
17.56 -> of some of the key points I'll be covering
in this video, so definitely stay tuned for
21.56 -> that.
22.56 -> And if you have our Level Up RN pediatric
nursing flashcards, definitely pull those
26.89 -> out so you can follow along with me.
29.55 -> Heart failure is the inability of the heart
to adequately supply blood to meet the body's
35.97 -> needs.
36.97 -> And this may be due to a congenital heart
defect.
40.84 -> It could be due to cardiomyopathy, which is
a disease of the heart muscle, or some other
46.739 -> cardiac abnormality.
49.01 -> So with heart failure, we end up with volume
overload on the heart muscle and/or pump failure.
56.6 -> So general signs and symptoms of heart failure
can include poor feeding, tachycardia, activity
64.35 -> intolerance, pallor, weak pulses, as well
as cardiomegaly, so enlargement of the heart.
73 -> We can also end up with pulmonary congestion
with left-sided heart failure.
78.97 -> So symptoms of left-sided heart failure include
tachypnea, dyspnea, as well as nasal flaring,
86.369 -> retractions, and wheezing, so issues with
breathing.
90.7 -> If we are dealing with right-sided heart failure,
that will cause systemic congestion, and it
97.09 -> will cause symptoms such as peripheral edema,
ascites, as well as hepatomegaly - so enlargement
104.209 -> of the liver - and jugular vein distension.
108.459 -> So we have some Cool Chicken hints on the
card here to help you remember what symptoms
114.959 -> are associated with left-sided heart failure
and right-sided heart failure.
119.99 -> So with left-sided heart failure, that primarily
affects the lungs, and with right-sided heart
127.31 -> failure, that affects the rest of the body.
131.319 -> And if you think about the blood flow through
the heart, it really makes sense.
136.349 -> So we have blood that is coming in to the
right side of the heart, then going to the
140.81 -> lungs, and then to the left side of the heart,
and then out to the body.
145.569 -> So if the left side of the heart is not functioning
correctly, that blood is going to back into
151.55 -> the lungs.
153.08 -> What about the right side?
154.36 -> So the blood's coming into the right side
of the heart, and if the right side of the
158.019 -> heart is not functioning correctly, that blood
is going to back up into the body and cause
163.29 -> that systemic congestion.
165.64 -> So I hope that Cool Chicken hint, as well
as that explanation, helps you to remember
170.579 -> what you can expect with left- versus right-sided
heart failure.
175.769 -> Diagnostic tools that are helpful in the diagnosis
of heart failure include an echocardiogram,
181.659 -> EKG, as well as a chest X-ray.
185.269 -> In addition, when we obtain labs, the HBMP
level will be elevated.
191.319 -> So HBMP is a hormone that is released by the
heart in response to stretching of that heart
198.87 -> muscle, which we definitely have with heart
failure because we have this fluid volume
203.98 -> overload on the heart, and that will result
in stretching, which results in the release
209.79 -> of HBMP.
211.93 -> In terms of treatment, digoxin is going to
be a key medication used to help improve contractility
219.56 -> of the heart.
220.739 -> So it will slow down the heart rate and help
those contractions be more effective and efficient.
227.68 -> In addition, we would provide diuretics such
as furosemide to help get rid of that excess
233.67 -> fluid.
234.67 -> And then other medications that are used to
treat heart failure include beta blockers
238.37 -> and ACE inhibitors.
240.58 -> In terms of nursing care, because our patients
with heart failure have poor feeding, we're
246.48 -> going to make sure our child is sitting upright
while they're eating, and we want to use a
252.2 -> nipple with an enlarged opening to help decrease
the amount of energy required by the child
258.85 -> while they are feeding.
260.16 -> In addition, we may need to use high-calorie
formula to help supplement their calorie intake,
266.93 -> and then we want to make sure we are providing
frequent rest periods because the child's
272.1 -> going to have activity intolerance.
275.1 -> And then when we are administering digoxin,
we absolutely want to take the child's pulse
281.78 -> before administration.
283.56 -> And we would hold the digoxin - so do not
administer it - for a pulse rate under 90
290.04 -> beats per minute for infants or under 70 beats
per minute for older children, or per orders.
298.13 -> And then we want to monitor for signs and
symptoms of digoxin toxicity, which can include
304.47 -> nausea and vomiting, bradycardia, as well
as dysrhythmias.
309.48 -> And then we're going to want to closely monitor
the patient's serum digoxin levels.
314.72 -> So the therapeutic range for that typically
is between 0.8 and 2.
321.15 -> Next, let's talk about hypoxemia, which is
where we have inadequate oxygenation of the
327.61 -> blood.
328.61 -> This in turn can cause hypoxia, which is where
we have inadequate oxygenation of the body's
334.64 -> tissues.
336.07 -> And congenital heart defects are a key thing
that can cause hypoxemia.
342.39 -> Other causes include respiratory disorders,
as well as anemia.
346.63 -> In the case of congenital heart defects, many
of those defects cause unoxygenated blood
354.19 -> to enter systemic circulation.
356.66 -> So that's how congenital heart defects cause
hypoxemia.
360.95 -> Signs and symptoms of hypoxemia include cyanosis,
tachypnea, dyspnea, clubbing - which is where
369.26 -> we have those upside-down, spoon-shaped nails
- as well as polycythemia.
375.21 -> So with polycythemia, the body is compensating
for that lack of oxygenation in the blood
382.24 -> by increasing the amount of red blood cells
it produces.
386.02 -> So the body is like, "Oh no, we don't have
enough oxygen.
389.1 -> Let's crank out some more red blood cells."
391.34 -> So polycythemia is an elevation in red blood
cells in response to the hypoxemia.
398.27 -> In terms of diagnosis, ABGs will show a decrease
in the partial pressure of oxygen.
406.09 -> We will also see decreased oxygen saturation
with pulse oximetry.
412.12 -> In terms of treatment, we can provide oxygen,
morphine, as well as IV fluids to the child.
418.28 -> And then for cyanotic episodes, we would want
to place the child in a knee-chest position
424.95 -> to help improve blood flow to the lungs.
427.85 -> All right, it's time for a quiz.
429.97 -> I've got three questions for you.
432.16 -> First question.
433.58 -> What medication is used to improve heart contractility
in a child with heart failure?
441.06 -> The answer is digoxin.
444.99 -> Question number two.
446.34 -> When feeding a child with heart failure, why
is a nipple with an enlarged opening used?
455.09 -> The answer is to decrease the amount of energy
required during feeding.
461.19 -> Question number three.
462.8 -> Blank is an increase in red blood cells to
compensate for hypoxemia in a child with a
470.14 -> congenital heart defect.
474.5 -> The answer is polycythemia.
476.02 -> All right.
477.84 -> That's it for this video.
478.98 -> I hope it was helpful.
480.83 -> Take care and I'll see you soon.
484.47 -> In terms of other diagnostic tools we can
use to diagnose hypoxemia, if-- I wasn't ready.
497.07 -> [Ugh?].
498.61 -> Signs and symptoms of hypoxemia includes cyanosis,
tachycardia, [inaudible].
502.73 -> I can't talk today.
507.71 -> [inaudible] or some other cardiac abnormality.
514.96 -> And it causes [inaudible].
518.38 -> I invite you to subscribe to our channel and
share a link with your classmates and friends
525.5 -> in nursing school.
526.83 -> If you found value in this video, be sure
and hit the like button, and leave a comment
532.08 -> and let us know what you found particularly
helpful.
