Appropriate intervention is vital for many children with heart disease in order to go on to live active, full lives. Which of the following outlines an effective nursing intervention to decrease cardiac demands and minimize cardiac workload?
A. Feeding the infant over long periods
B. Allowing the infant to have her way to avoid conflict
C. Scheduling care to provide for uninterrupted rest periods
D. Developing and implementing a consistent care plan
Correct Answer: C. Scheduling care to provide for uninterrupted rest periods
Organizing nursing care to provide for uninterrupted periods of sleep reduces cardiac demand. Allow for rest periods between care; disturb only when necessary for care and procedures. This promotes rest and conserves energy.
Option A: Feeding time should be restricted to a maximum of 45 minutes or discontinued sooner if the infant tires. Rest decreases metabolic rate, decreasing myocardial and oxygen demand. Fatigue and exertional dyspnea are common problems with low cardiac output states. Close monitoring of the patient’s response serves as a guide for optimal progression of activity.
Option B: In an attempt to get her own way, the child may cry. Excessive crying should be limited; however, an appropriate limit setting should still be observed. Avoid allowing the infant to cry for long periods of time, use soft nipple for feeding; cross-cut nipple; if unable for infant to ingest sufficient calories by mouth,gavage-feed infant.
Option D: Developing and implementing a consistent care plan can be important, but it is not related to decreasing cardiac demands or workload. Assist parents to plan for care and rest schedules. Provides rest and prevents overexertion, minimizes energy expenditure.