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PEDS > Cardiac 2 > Flashcards

Cardiac 2 Flashcards

1
Q

describe pulmonary/pulmonic stenosis

A
  • narrowing at the entrance to pulmonary artery
  • causes increased workload on R side of heart
  • congestive heart failure occurs when severe
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2
Q

s/s of pulmonary/pulmonic stenosis

A

-loud systolic injection heart murmur

thrill in pulmonic area may be present

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3
Q

treatment of pulmonary/pulmonic stenosis

A

balloon angioplasty or OHS

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4
Q

4 defects of tetrology of fallot (TOF)

A

1) pulmonic stenosis
2) R ventricular hypertrophy
3) overriding aorta
4) ventricular septal defect

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5
Q

s/s of tetrology of fallot (TOF)

A
  • digital clubbing
  • poor growth
  • exercise intolerance
  • murmur
  • thrill
  • hypoxemia
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6
Q

what happens during tetrology of fallot (TOF)

A

decreased pulmonary BF (unoxygenated blood enter circulation)

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7
Q

treatment of tetrology of fallot (TOF)

A
  • prostaglandin E1 to maintain open ductus arteriosus

- palliative surgery to improve oxygenation (ie/ patch on VSD)

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8
Q

describe transposition of great vessel

A
  • aorta arises form RV and pulmonary artery from LV

- survival depends on foramen ovale reaminaing open to mix blood

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9
Q

s/s of transposition of great vessel

A
  • tachypnea, poor feeding, failure to grow,

- progressive cyanosis to hypoxia to acidosis (CHF)

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10
Q

treatment of transposition of great vessel

A
  • prostaglandin E1 to maintain openings
  • prophylatic antibiotics to prevent endocarditis
  • palliative and corrective surgery (aggressive)
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11
Q

malformation and narrowing of aorta

A

aortic stenosis

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12
Q

what happens in aortic stenosis

A

increased workload on LV, leads to hypertrophy and HF

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13
Q

s/s of aortic stenosis

A

audible murmur, ejection click, and thrill

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14
Q

treatment of aortic stenosis

A

angioplasty or surgicla intervention to repair or replace valve

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15
Q

describe hypercyanosis spells (TET)

A
  • acute episodes of cyanosis and hypoxia

- aka blue spells

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16
Q

how are hypercyanosis spells (TET) relieved

A

squatting and drawing up the legs

*assume squatting to decrease blood return from extremities

17
Q

when do hypercyanosis spells (TET) occur

A

when infants O2 requirements exceed the blood supply (ie/ after feeding or play)

18
Q

s/s of hypercyanosis spells (TET)

A

hypoxia
pallor
cyanosis
tachypnea

19
Q

treatment of hypercyanosis spells (TET)

A

place child in knee chest position, calm, supplemental O2, administer morphine and propanolo IV and IV fluids

20
Q

this is the narrowing and descending of aorta

this restricts blood flow from the heart

A

coarctation of aorta (COA)

21
Q

describe COA

A
  • left ventricular hypertrophy
  • blood pressure difference between upper and lower extremities
  • femoral pulses are weak
  • murmur and thrill
  • CVA from HTN
  • can lead to CHF
22
Q

treatment of COA

A
  • prophylatic antibiotics to prevent endocarditis

- surgical resection of balloon dilation

23
Q

nutrition with heart disease

A
  • feeding can be difficult and tiring
  • feed in relaxed ennvironment
  • frequent small feedings
  • if cannot eat during 30 min every 3 hrs, will need NG tube
24
Q

describe innocent murmurs (functional)

A
  • do not cause bad effects
  • investigate, see cardiologist with any murmur to be safe
  • *does NOT affect growth and development but harmful murmurs will
25
Q

what is important to remember about children in the hospital

A
  • children need adequate rest
  • do everything at once
  • do not continuously go in to disturb them
26
Q

describe congestive heart failure

A
  • disorder of circulation

- occurs when cardiac output is inadequate to support body’s circulation and metabolic needs

27
Q

what can CHF result from

A
  • congential heart defect
  • heart contractility
  • acquired heart disease (Kawasaki)
28
Q

early signs of CHF

A
  • fatigue
  • irritability
  • change in play behavior
  • wt loss and lack of normal wt gaint
  • sweating during feeding
29
Q

s/s as CHF progresses

A
  • tachycardia
  • pallor/cyanosis
  • tachypnea
  • resp distress
30
Q

treatment of CHF

A
  • give oxygen
  • Digoxin (Lanoxin)
  • ACE inhibitors
  • diuretics (lasix, aldactone)
31
Q

management goals of CHF

A
  • remove accumulated fluid and sodium
  • decrease cardiac demands
  • improve tissue oxygenation
  • decrease consuption

PEDS (24 decks)

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