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LVAD Careplan

School   (766 Views 8 Comments)
by tining tining, BSN, RN (Member) Member Expert Nurse

tining has 25 years experience as a BSN, RN and specializes in School Nurse.

1 Follower; 13,637 Profile Views; 804 Posts

Does anyone have an LVAD care plan for a student?

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OldDude specializes in Pediatrics.

7 Followers; 1 Article; 4,782 Posts; 30,047 Profile Views

Are you talking about a kid awaiting a heart transplant?

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tining has 25 years experience as a BSN, RN and specializes in School Nurse.

1 Follower; 804 Posts; 13,637 Profile Views

Yes, Left Ventricular Assistance Device

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OldDude specializes in Pediatrics.

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I'd use the MD orders for school attendance as the care plan...heart wrenching but hopefully prayers will be answered.

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Mavnurse17 has 2 years experience as a BSN, RN.

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Wow! You have a kiddo with an LVAD?  I'm in a HS now but I was on a heart failure floor, directly caring for LVAD patients for a year and a half so I am somewhat nostalgic about this.  (Obviously I wish this kid wasn't sick enough to need an LVAD, but I hope you know where I'm coming from).

The basics: know what kind of VAD it is.  Heartware vs. Heartmate II vs. Heartmate III.  Depending on how old this kid is, they should somewhat know what their PI, flow, and power should be and recognize when their numbers are off compared to how they're feeling.  Also, Heartwares and Heartmate II's require you to take a MAP using a doppler (if you ever need to assess this), Heartmate III's are SOMETIMES pulsatile so you MIGHT be able to get a regular BP.  Ask the parent.  

Make sure they are bringing a backup controller and batteries to school.  Maybe have their parent show you how to do a controller change (extremely rare but would be helpful in an emergency) and battery changes (if the student can't do this on their own).  

Obviously safety is a big concern here.  You want to make sure that the driveline is protected.  

I've heard mixed information about initiating CPR on people with LVADs-- some sources say it can damage the machinery and the heart, some say it's safe.  

LVADs are dependent on preload and afterload, so I'd probably put assessing fluid volume status somewhere in your care plan.  

If I think of anything else, I'll let you know! 

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ruby_jane has 10 years experience as a BSN, RN and specializes in ICU/community health/school nursing.

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38 minutes ago, Mavnurse17 said:

Wow! You have a kiddo with an LVAD?  I'm in a HS now but I was on a heart failure floor, directly caring for LVAD patients for a year and a half so I am somewhat nostalgic about this.  (Obviously I wish this kid wasn't sick enough to need an LVAD, but I hope you know where I'm coming from).

The basics: know what kind of VAD it is.  Heartware vs. Heartmate II vs. Heartmate III.  Depending on how old this kid is, they should somewhat know what their PI, flow, and power should be and recognize when their numbers are off compared to how they're feeling.  Also, Heartwares and Heartmate II's require you to take a MAP using a doppler (if you ever need to assess this), Heartmate III's are SOMETIMES pulsatile so you MIGHT be able to get a regular BP.  Ask the parent.  

Make sure they are bringing a backup controller and batteries to school.  Maybe have their parent show you how to do a controller change (extremely rare but would be helpful in an emergency) and battery changes (if the student can't do this on their own).  

Obviously safety is a big concern here.  You want to make sure that the driveline is protected.  

I've heard mixed information about initiating CPR on people with LVADs-- some sources say it can damage the machinery and the heart, some say it's safe.  

LVADs are dependent on preload and afterload, so I'd probably put assessing fluid volume status somewhere in your care plan.  

If I think of anything else, I'll let you know! 

And this is why I love our little corner of All Nurses!

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tining has 25 years experience as a BSN, RN and specializes in School Nurse.

1 Follower; 804 Posts; 13,637 Profile Views

The training nurse came out and we got the deets on who what where why and how.  I need a written IHP/careplan for her file.  I've looked at the cardiac careplans (CHF was the one that fit most).  I was just hoping someone had already invented that wheel.

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