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Flashcards in Alterations in Cardiac Deck (3)
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1
Q

tetralogy of fallot

A

Congenital heart defect that consist of 4 heart defects: Pulmonary stenosis, Rt ventricular hypertrophy, Overriding aorta, VSD (PROVe). Equal Rt & Lt sided ventricular pressures & desaturated blood is entering the systemic system

Manifestations: Onset and severity of S&S depends on the obstruction of pulmonary blood flow, as ductus arteriosus closes the signs become worse on the neonate, Cyanosis, extreme fatigue, hypercyanotic episode, and chronic hypoxemia, Palpable thrill and harsh systolic murmur and boot shaped heart on X-ray

Management: PGE 1 (alprostadil) to maintain patency of ductus arteriosus and blood flow to the lungs;
Surgical Management: Repair defects after 4 months of infancy (cardiopulmonary bypass required);
Monitor for complications: Residual VSD and Rt sided HF, low cardiac output, PV regurgitation, rhythm disturbances.

Goals: Improve O2, provide adequate nutrition, help with coping, prevent infection, provide pre/postop care.

“Tet” Spells Intervention: Provide calm environment, place pt. in knee to chest position, Provide O2, Administer morphine sulfate, Supply IVFs, Administer propranolol

2
Q

Reyes syndrome

A

Rare illness that affects children younger than 15 y/o that is recovering from an illness, the cause is unknown. Reaction causes brain swelling, liver failure and can be deadly in hours if not treated

Risk factors: Salicylates or salicylate containing products (Alka-Seltzer, Pepto) to treat viral infection.

S&S: Severe continual vomiting, mental status changes, lethargy, irritability, confusion, hyperreflexia, seizures, LOC

Lab Tests: ↑ALT and AST, ↑Ammonia, Electrolyte imbalance (due to cerebral edema and liver changes), Extended coagulation times

Diagnostics: Liver biopsy and CSF analysis

Management: IVFs, HOB elevated with head midline in a neutral position, monitor coagulation to prevent hemorrhage, monitor pain status, implement seizure precautions; Mannitol to decrease cerebral swelling

Complications: Neurologic sequalae and death

3
Q

ventriculoperitoneal shunt

A

Used to treat hydrocephalus, this shunt in placed in the enlarged ventricle and diverts CSF in the peritoneum. The excess CSF is absorbed in the peritoneal cavity.

Complications are infection, obstruction, and will need to be replaced as the child grows.