Heart Failure I
Pediatrics: Cardiac
Pathophysiology
Heart failure in pediatric clients has key clinical manifestations
& interventions that are different from adults.
Clinical manifestations
& Interventions
MEMORY TRICK
• HF - Heart Failure (failure to pump blood forward)
• HF - Heavy Fluid (backs up in lungs / body)
Weight Gain = Water Gain
Signs & Symptoms
HESI Questions
As the heart fails to pump blood forward, heavy fluid can back up into
the lungs making it difficult to breathe during breast or bottle feedings!
Fluid also backs up into the body resulting in WEIGHT GAIN from
Water Gain.
HF - Heart Failure
HF - Heavy Fluid
EARLY SIGN
Q1: Which is an early sign of congestive heart failure?
Tachypnea
Q2: 2 year old with … congestive heart failure.
Which information is most important for the parents
to report to the health care provider?
Exhibits a sudden and unexplained weight gain
Orthopnea
ATI Question
A nurse is assessing a preschooler who has heart
failure. Which of the following manifestations should
the nurse expect?
Orthopnea
HEAVY
FLUID
SAUNDERS Questions
1. Weight Gain = Water Gain NCLEX TIP
2. Difficulty breathing (fluid filled lungs)
Orthopnea (SOB while lying flat)
4 Signs
Q1: ... infant with congenital heart disease.
Which, if noted in the infant, should alert the
nurse to the early development of heart failure?
Diaphoresis during feeding
EXAM
?
?
?
12kg
Q2: infant with congenital heart disease … early
sign of heart failure?
Tachycardia
3. Sweating during feeding Saunders
Q3: ...infant with heart failure… call the health
care provider:
Weight gain of 1 lb (0.5 kg) in 1 day
4. Tachycardia & Tachypnea HESI Saunders
Other Classic Manifestations
R - RIGHT Sided HF
R - ROCKS BODY with fluid
• Peripheral Edema
• Weight Gain = Water Gain
• JVD (big neck veins)
• Abdominal Growth
- Ascites (fluid in abdomen)
- Hepatomegaly (big liver)
- Splenomegaly (big spleen)
L - LEFT sided HF
L - LUNG fluid
• Pulmonary Edema
• Crackles in lungs
“Rales that don't clear with
a cough”
• Pink Frothy “blood tinged”
sputum
• Orthopnea - difficulty
breathing when lying flat
Causes
Congenital heart defects
Congenital heart disease or defects, are the BIGGEST CAUSE of heart
failure in children.
The child is born with 1 or more problems with the heart's structure
that changes the way blood flows through the heart resulting in a
backup of blood.