Key Concepts
Introduction
Cardiovascular assessment in children requires knowledge of both normal pediatric cardiovascular physiology and the spectrum of findings that may indicate congenital or acquired heart disease. Congenital heart disease (CHD) affects approximately 8 in 1,000 live births and is the most common category of serious congenital anomaly. Many children with CHD are identified in the neonatal period through routine screening, but some defects present later in infancy or childhood with symptoms such as poor feeding, tachycardia, failure to thrive, cyanosis, or heart murmur. The RPN's cardiovascular assessment is not diagnostic โ the RPN does not interpret echocardiograms or catheterization data โ but accurate assessment of perfusion, cardiac rhythm, heart sounds, murmur characteristics, and systemic effects of cardiac compromise (hepatomegaly, edema, poor feeding) is within the RPN scope and is critical for identifying children who need escalation. This lesson covers the components of a systematic pediatric cardiovascular assessment, with emphasis on the physical examination findings most likely to appear on the REx-PN examination and most relevant to RPN practice in pediatric settings. On the exam, writers often pair stable-sounding options with **unstable...