•Must be careful. Some of the symptoms are very subtle.
•Some symptoms do not show up right after birth
•Typical presentations of infants are tachycardia, tachypnea, and poor feeding
•Older children may present with fatigue and frequent lower respiratory infections. Some children may perspire excessively
•Edema is a late sign and usually presents first as periorbital edema.
•May complain of decreased UOP
•May have headaches, nose bleeds, high blood pressure in upper extremities
•Obtain a detailed prenatal history including exposure to infections (cytomegalovirus, toxoplasmosis, rubella or varicella), medication usage, drug and alcohol use, nutrition, exposure to radiation
•Determine if there is any family history of congenital heart defects or heart disease, cognitive impairments, renal disease
▫VS every 15 minutes progressing to q 1 hr, ventilatory support, monitoring of heart rate and rhythm, BP, heart pressures, heart sounds, UOP, fluid status, ABG's, PT, PTT, Plt, Hgb, Hct., K, Na, O2 sat, lung sounds, bowel sounds, measurement of chest tube integrity and drainage •Acute Phase (Stage I)
▫High fever that doesn't respond to antipyretics
▫Lethargic and irritable
▫May have red, swollen hands and feet, conjunctivitis, strawberry tongue and red, cracked lips, enlarged cervical lymph nodes, variety of rashes, abdominal pain as internal lymph nodes swell, anorexia, diarrhea, red and swollen joints
▫Elevated WBC and ESR