Electrocardiogram

Non-invasive
Most frequently used procedure for detecting cardiac dysfunction in children Involves the use of ultra-high-frequency sound waves to produce an image of the hearts structure

Transducer or probe placed directly on the chest delivers pulses of ultrasound and processes the returned signal (echoes)

2 Types of Echocardiogram
Motion mode (M-mode) echocardiography Provides one-dimensional view of the heart Useful in determining the size, presence or absence of the structure, and their relationship with one another

2D echocardiography or Cross-sectional echocardiography capable of displaying a cross sectional slice of the beating heart used to check the size of the heart's chambers, the function of the heart valves, the size and movement of the heart muscle wall, and the pattern of blood flow through the heart

Has component that measures the blood flow called doppler

Preparation
Wear loose, comfortable clothing

NPO for 4 hours

Avoid caffeine for up to 24 hours

May be asked to stop some medications including nitrates, Ca channel blocker, and beta blocker

During echocardiogram

Small sticky patches called electrodes will be placed on the chest to record the hearts electrical activity A cool, clear gel will be applied to the chest and to the end of the wand-like transducer
May be asked to change position in order to get pictures from different angle Sometimes a contrast dye is used to get better pictures

Post echocardiogram May go back to the normal activities If contrast dye was used, drink plenty of fluids to wash out the dye

Considerations: Painless and with no known side effects Can be stressful children Must lie quietly in the standard position

Cardiac Catheterization

Cardiac Catheterization
Most invasive diagnostic procedure

Combined with angiography

Provides information regarding : Oxygen saturation Pressure changes Cardiac output or stroke volume Anatomic abnormalities For diagnostic, interventional, and electrophysiologic purpose

2 main types of cardiac catheterization

Right-sided or Venous Catheterization

Most common method for in children

Catheter is introduce from a vein into the RA

Left-sided or Arterial Catheterization

Catheter is threaded by way of a systemic artery retrograde into the aorta and LV

Overview Catheter is introduces through a percutaneous puncture into the femoral vein Guided through the heart with the aid of fluoroscopy

Child may feel pressure at the insertion site and vasospasm of the small vessel
Contrast medium is administered

Pre-care
Complete nursing assessment

Accurate movement of height & weight

Obtain allergic reactions

Signs & symptoms of infection

Mark pulse location

Oxygen saturation
Prepare the child and the family

Pictures, videos, or tours may be helpful

Post-care Placed on cardiac monitor and pulse oximeter

Nursing Responsibilities:
Pulse should be monitored Temperature and color of the extremity Vital signs Fluid intake Diet can be resumed as long as tolerated