Question

Claire is an 8-year-old girl who was born with critical aortic stenosis that was repaired surgically at 1 week old. Her growth and development have been on target since then. Over the last few weeks, she has begun to complain of dyspnea and has an accelerated heart rate. She has been lethargic and finds it difficult to play on the playground at school. She has not had an appetite for the last week. Her mother took her to the pediatrician and she was admitted to the pediatric unit at the hospital and diagnosed with CHF. She has no known allergies and weighs 40 pounds.

Her vital signs are: HR 120, RR 22, T 98.9F, B/P 100/50

The doctor ordered digoxin 9mcg/kg PO and Lasix 1mg/kg IV push.

You are getting ready to administer the medication. The drugs are available in digoxin 100mcg/ml liquid and Lasix 40mg/4ml IV. How much of each medication would you give?

Why did the doctor order these medications for Claire?

What are your priority interventions with rationale for Claire in the hospital?

Claire is discharged home; how might CHF affect the developmental process for Claire?

Answer 1

1. The doctor ordered digoxin 9mcg/kg PO and Lasix 1mg/kg IV push.

Claire is an 8-year-old girl weighs 40 pounds(18.1kg)

The drugs are available in digoxin 100mcg/ml liquid and Lasix 40mg/4ml IV.

So, Claire need 163mcg of digoxin

$9mcg/kg\times 18.1kg=162.9mcg$ (approx 163mcg)

Drug availlabe100mcg/ml liquid. So,

$163mcg\div 100mcg/ml=1.6ml$

Answer - Nures will give 1.6 ml of Diagoxine to Claire

order dose is 1mg/kg of Lasix

So, Claire need

18.1kg x Img/kg = 18.1mg

The drug Lasix contain 40mg/4ml(10mg/ml)

$18.1mg\div 10mg/ml=1.8ml$

Answer - The nurse will give 1.8ml of Lasix.

2.

Digoxin belongs to cardiac glycoside which treats Heart failure, Arrthymias and maintains a heart rate.

The doctor advises digoxin because she is having dyspnea, which suggests heart failure. Claire also having tachycardia, Digoxin also controls heart rate.

Lasix is otherwise known as a water pill, it belongs to the diuretics group.

The doctor advises Lasix because she was showing symptoms of heart failure, Lasix will drain extra fluid from the lungs and relives from dyspnea.

3.

a. Provide fowler position to relieve from dyspnea.

b. Monitor vital signs and do an ECG to monitor heart rate and rhythm as Claire has a pulse rate of 120 b/min.

c. Administer oxygen therapy to maintain the saturation of oxygen in the body.

d. Monitor intake and output chart as we are giving Lasix(water pill) for pulmonary edema.

4.

CHF(Congestive heart failure) seriously affects the growth of a child because due to weaker heart muscle, the heart does not pump properly which leads to the poor blood supply to the body tissue. Poor blood supply leads to poor oxygen and poor nutrient supply to body cells.

it also causes poor appetite, and affects in food absorption.