Paediatric Respiratory & Cardiac Disorders - Concept Map
Paediatric Respiratory & Cardiac Disorders
Related concepts
Recognising Respiratory Distress in Children
Sub concepts
- Early compensating signs: restlessness, tachypnea, tachycardia, nasal flaring, mild retractions
- Worsening signs: intercostal/subcostal/suprasternal retractions, grunting, head-bobbing, accessory muscle use, stridor/wheeze
- Late ominous signs: cyanosis, bradycardia, decreased breath sounds, lethargy (impending respiratory failure)
- IMCI fast-breathing thresholds: ≥60/min if <2 mo; ≥50/min if 2-12 mo; ≥40/min if 1-5 yr
- Nursing priority: Early recognition prevents rapid deterioration
Relationship to central
Foundation for early intervention and triage
Congenital Heart Defects (CHD)
Sub concepts
- Acyanotic defects (left-to-right shunt): VSD, ASD, PDA, coarctation of aorta
- Cyanotic defects (right-to-left shunt): Tetralogy of Fallot, TGA, tricuspid atresia, truncus arteriosus, TAPVR
- Heart failure management: detect early signs (feeding difficulty, poor weight gain, hepatomegaly), small frequent feeds, cluster care
- Digoxin therapy: count apical pulse 1 full minute; hold if <90-100 bpm (infant) or <70 bpm (child); watch for toxicity (bradycardia, vomiting, anorexia)
Relationship to central
Most common cardiac disorder in children; classified by cyanosis
Specific Respiratory Infections
Sub concepts
- Croup (laryngotracheobronchitis): viral (parainfluenza), barking cough + inspiratory stridor, steeple sign on X-ray, cool mist + dexamethasone
- Epiglottitis: bacterial (Hib) emergency, 4 D's (Drooling, Dysphagia, Dysphonia, Distress), thumb sign, DO NOT inspect throat, prepare for intubation
- Bronchiolitis (RSV): infants <2 yr, wheezing + retractions, contact precautions mandatory, supportive care + suctioning, palivizumab is prophylaxis not treatment
Relationship to central
Leading causes of paediatric hospitalisation requiring distinct nursing interventions
Asthma in Children
Sub concepts
- Pathophysiology: bronchospasm + mucosal edema + mucus production
- Clinical signs: wheezing (expiratory), cough, chest tightness, prolonged expiration; silent chest = ominous
- Pharmacology: SABA (salbutamol/albuterol) = reliever; ICS (inhaled corticosteroids) = controller
- Management: spacer technique, trigger avoidance, written asthma action plan, mouth rinse after ICS use
Relationship to central
Chronic reversible airway inflammation with specific pharmacology and management
Acquired Heart Disease
Sub concepts
- Rheumatic fever: follows untreated GABHS pharyngitis, Jones criteria diagnosis, carditis causes valve damage (mitral), prevent with full penicillin course + long-term prophylaxis
- Kawasaki disease: vasculitis in children <5 yr, fever >5 days + strawberry tongue + peeling hands/feet, coronary artery aneurysm risk, treat with IVIG + high-dose aspirin
Relationship to central
Post-infectious or inflammatory cardiac conditions requiring prevention and long-term management
Cleft Lip and Cleft Palate
Sub concepts
- Priority nursing problems: feeding difficulty, aspiration risk, speech development, otitis media
- Pre-operative feeding: upright position, special wide/cross-cut nipples, slow feeding, frequent burping
- Surgical timing - Rule of 10s for lip repair: ~10 weeks old, ~10 lb (4.5 kg), Hgb ~10 g/dL; palate ~6-12 months
- Post-operative cleft lip care: supine/side position (never prone), elbow restraints, clean suture line, avoid tension
- Post-operative cleft palate care: nothing hard in mouth (no straws/pacifiers/suction), cup feeding, liquid diet, elbow restraints
Relationship to central
Congenital facial malformations with feeding and developmental implications
Concept connections
- Recognising Respiratory Distress in ChildrenCroupEarly signs of respiratory distress help identify croup as the diagnosis; nasal flaring and retractions are present in mild croup
- Recognising Respiratory Distress in ChildrenEpiglottitisLate ominous signs (severe distress, potential lethargy) suggest epiglottitis as a medical emergency requiring immediate intervention
- Recognising Respiratory Distress in ChildrenBronchiolitisRetractions, nasal flaring, and wheezing are hallmark early signs of bronchiolitis that guide assessment and intervention priority
- Recognising Respiratory Distress in ChildrenAsthmaWheezing and retractions in asthma exacerbation follow the progression pattern of respiratory distress; silent chest indicates severe distress
- Congenital Heart Defects (CHD)CHF ManagementAcyanotic defects (VSD, PDA, ASD) commonly lead to congestive heart failure, requiring digoxin and diuretic therapy management
- Acyanotic defectsPatent Ductus ArteriosusPDA-specific therapy: indomethacin/ibuprofen closes the duct; prostaglandin E1 keeps it open in duct-dependent lesions
- Cyanotic defectsTetralogy of FallotTOF is the most common cyanotic CHD; tet spells require immediate knee-chest positioning and morphine therapy
- Tetralogy of FallotTet Spell ManagementTet spells are acute episodes of deep cyanosis in TOF patients; knee-chest position is the priority nursing intervention
- CHF ManagementDigoxin TherapyDigoxin is a key drug for CHF; apical pulse count and toxicity monitoring are essential nursing responsibilities
- Respiratory InfectionsCroupCroup is a viral respiratory infection managed with cool mist, dexamethasone, and racemic epinephrine
- Respiratory InfectionsEpiglottitisEpiglottitis is a bacterial airway emergency; airway examination must be avoided to prevent laryngospasm
- Respiratory InfectionsBronchiolitisBronchiolitis (RSV) requires contact precautions and supportive care; palivizumab is prophylaxis for high-risk infants
- BronchiolitisContact PrecautionsRSV spreads via droplet/contact; contact precautions are mandatory to prevent nosocomial spread
- Asthma in ChildrenSABA PharmacotherapySalbutamol/albuterol is the reliever drug for acute asthma exacerbations; acts quickly on beta-2 receptors in airways
- Asthma in ChildrenICS Controller TherapyInhaled corticosteroids are used for long-term asthma control; mouth rinse after use prevents oral thrush
- Asthma in ChildrenSilent Chest SignSilent chest (no audible wheeze) in an asthmatic child indicates severe obstruction and impending respiratory failure
- Acquired Heart DiseaseRheumatic FeverRheumatic fever follows untreated GABHS pharyngitis and causes carditis with permanent valve damage; prevention via full penicillin course is key
- Acquired Heart DiseaseKawasaki DiseaseKawasaki disease is a vasculitis with coronary artery aneurysm risk; treated with IVIG and high-dose aspirin (exception to no aspirin in children)
- Cleft Lip and PalatePre-operative FeedingPre-operative feeding challenges include aspiration risk; upright positioning and special nipples are essential
- Cleft Lip and PalatePost-operative Lip CareAfter cleft lip repair: side/supine position, elbow restraints, and protection of suture line are priorities
- Cleft Lip and PalatePost-operative Palate CareAfter cleft palate repair: nothing hard in mouth (no straws, pacifiers, or suction), cup feeding only
- Cleft Lip and PalateRule of 10sCleft lip repair timing: ~10 weeks old, ~10 lb weight, Hgb ~10 g/dL; palate repair at 6-12 months
- Rheumatic Fever PreventionPenicillin TherapyComplete penicillin course for strep throat is the single most important prevention strategy; incomplete treatment allows rheumatic fever development
- Kawasaki DiseaseIVIG and AspirinIVIG and high-dose aspirin are the treatments for Kawasaki disease; aspirin is used here despite typical avoidance in children due to Reye syndrome risk
- EpiglottitisAirway Emergency PreparationEpiglottitis is a medical emergency; preparing for intubation/tracheostomy with emergency equipment at bedside is essential
- Patent Ductus ArteriosusDuct-Dependent LesionsIn duct-dependent cyanotic lesions (TGA, interrupted aortic arch), prostaglandin E1 keeps the ductus open to maintain systemic circulation
- Digoxin ToxicityHypokalemiaHypokalemia increases digoxin toxicity risk; diuretics like furosemide lower potassium and require monitoring
- Asthma Trigger AvoidanceEnvironmental ControlIdentifying and avoiding triggers (smoke, dust, cold, allergens) is part of comprehensive asthma management
- Bronchiolitis SuctioningAirway ClearanceGentle suctioning (bulb or nasal) maintains airway patency in bronchiolitis with copious secretions
Diagrams
Paediatric Respiratory & Cardiac Disorders - Complete Concept Hierarchy
Comprehensive mind map showing the complete hierarchy of paediatric respiratory and cardiac disorders, including recognition of distress, classification of congenital heart defects, specific infections, asthma, acquired heart disease, and cleft lip/palate. This map displays how all major topics relate to the central concept and shows the detailed sub-concepts within each category.
Recognition and Management of Respiratory Distress in Children
Step-by-step flowchart demonstrating the nursing assessment and management pathway for children presenting with respiratory distress. Shows how to differentiate between early compensating signs and late ominous signs, and directs care toward specific diagnoses with appropriate interventions. This is critical for NLE exam preparation and clinical practice.
Tetralogy of Fallot (Tet) Spell - Emergency Management
Critical emergency management flowchart for Tetralogy of Fallot hypercyanotic (tet) spells. Emphasizes the key nursing priority intervention: knee-chest or squatting position to increase systemic vascular resistance and reduce the right-to-left shunt. This is a high-yield NLE topic that requires quick recognition and appropriate intervention.
Digoxin Administration & Monitoring in Paediatric Heart Failure
Detailed flowchart for safe digoxin administration and monitoring in children with congestive heart failure. Emphasizes the critical nursing action of counting the apical pulse for a full minute before every dose and recognizing signs of digoxin toxicity. Highlights the relationship between hypokalemia and toxicity—a key concept for the NLE.
Cleft Lip and Palate - Pre-operative Feeding and Post-operative Care
Comprehensive flowchart comparing pre-operative feeding management and post-operative care for cleft lip versus cleft palate repairs. Highlights the critical differences in positioning, restrictions on oral care, and feeding methods specific to each type of repair. Essential for paediatric nursing practice and NLE exam questions.
Epiglottitis vs Croup - Differential Diagnosis & Management
Critical differential diagnosis flowchart comparing epiglottitis (bacterial emergency) and croup (viral, usually benign). Emphasizes the key differences in presentation, assessment approach (especially the danger of examining epiglottitis throat), and management. The emphasis on NOT examining the throat in epiglottitis is a crucial NLE teaching point.
Child with Asthma - State Transitions in Acute Exacerbation
State diagram showing the progression of asthma severity from stable through mild, moderate, severe, and critical exacerbation stages. Illustrates how children can transition between states based on trigger exposure, treatment response, and adequacy of intervention. Helpful for understanding when to escalate care and what interventions are appropriate at each level.
Congenital Heart Defects - Distribution of Types
Pie chart showing the relative frequency and distribution of common congenital heart defects. Highlights that VSD (ventricular septal defect) is the most common overall CHD, while Tetralogy of Fallot is the most common cyanotic defect. This distribution is important for understanding clinical priorities and likely exam questions.