LVAD Careplan

OldDude · Feb 20, 2019

Are you talking about a kid awaiting a heart transplant?

tining, BSN, RN · Feb 20, 2019

Yes, Left Ventricular Assistance Device

Home Health Columnist / Guide · Feb 20, 2019

Check this powerpoint: Caring for the Ventricular Assist Device Patient in the Community

OldDude · Feb 21, 2019

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

Mavnurse17, BSN, RN · Feb 22, 2019

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!

ruby_jane, BSN, RN · Feb 22, 2019

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!

tining, BSN, RN · Feb 25, 2019

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.