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328 Pediatrics Final Exam > Cardiac > Flashcards

Cardiac Flashcards

(39 cards)

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1
Q

Compare Congenital Heart Defects vs. Acquired Heart Defects

A
  • Congenital Cardiac Defects (CHD): Defects in the heart structure that occur during fetal heart development.
  • Acquired Heart Disorders: Occurs after birth related to infection, autoimmune responses, or environmental factors.
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2
Q

S/S of Cardiac Dysfunction in Infants?

A
  • Poor feeding-fatigues during feedings
  • Diaphoresis with feeding (Sweating on the head/brow)
  • Tachypnea/tachycardia
  • Failure to thrive-weight loss
  • Recurrent respiratory infections
  • Developmental delays
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3
Q

S/S of Cardiac Dysfunction in Older Childrens?

A
  • Activity intolerance
  • Fatigue
  • Chest pain
  • Fainting with exercise
  • Cardiac murmur
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4
Q

How is Cardiac Dysfunction diagnosed?

A
  • ECG
  • Chest X-ray
  • Echocardiogram
  • Cardiac catherization
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5
Q

What does an Echocardiogram look for?

A
  • Size of heart and chambers
  • Movement of valves
  • Blood flow-normal vs turbulence
  • Presence or absence of structures
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6
Q

Describe Cardiac Catherization.

A
  • Balloon catheter dilates vessels/valves
  • Insertion of valves or stents
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7
Q

How is the pulse oximeter used to detect critical congenital heart disease?

A
  • All infants are screened for Critical Congenital Heart Defects (CCHD) using a Pulse Oximeter prior to being discharged from hospital.
  • Newborn Pulse Oximetry Screening
    Performed after 24 hours of age or prior to discharge if baby is < 24-hours-old.
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8
Q

Post Cardiac Catheterization Care?

A
  • Child must lay flat and supine, with affected leg straight for 4-6 hours.
  • Monitor vitals, pulses, temperature
  • Observe for bleeding at insertion site
  • Observe for reactions to dye
  • Push fluids to flush dye out of body.
  • Acetaminophen for minor discomfort
  • Discharge instructions: Keep the area of insertion dry and avoid tub baths and swimming for 3 days
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9
Q

Cardiac defects characterized by Increased Pulmonary Flow?

A
  • Atrial Septal Defect
  • Ventricular Septal Defect
  • Patent Ductus Arteriosus.
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10
Q

Atrial Septal Defect pathophysiology?

A
  • Abnormal opening between the atria
  • Left to right shunt
  • Right atrial and ventricular hypertrophy due to increased workload
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11
Q

Atrial Septal Defect manifestations?

A
  • Asymptomatic
  • May close spontaneously
  • Undiagnosed ASD:
    - Heart failure in 3rd and 4th decade of life
    - Atrial Arrhythmias
    - Emboli
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12
Q

Atrial Septal Defect treatments?

A

If large close in cardiac cath lab or open heart surgery

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13
Q

Ventricular Septal Defect pathophysiology?

A
  • Abnormal opening between the ventricles.
  • Pressures higher on the left side of the heart- left to right shunt
  • Right ventricle hypertrophy due to increased workload
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14
Q

Ventricular Septal Defect manifestations?

A

Small Ventricular Septal Defect:

  • Asymptomatic
  • Watchful Waiting- 75% of small VSD close within the first year of life without treatment

Large Ventricular Defect:
- Surgical-Dacron patch
- Closure during cardiac catherization.

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15
Q

Patent Ductus Arteriosus pathophysiology?

A
  • Ductus Arteriosus - normal fetal connection between the aorta and the pulmonary artery. - should close at 72hrs.
  • Patent Ductus Arteriosus - Persistent, abnormal connection between aorta and pulmonary artery.
  • Left to right shunt
  • Left ventricular hypertrophy
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16
Q

Patent Ductus Arteriosus management?

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A
  • Medical management
    • Indomethacin IV in preemies
    • Stimulates muscles in PDA to tighten and close.
  • Surgical management or cardiac cath
17
Q

Cardiac defect characterized by Obstruction?

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A

Coarctation of the Aorta

18
Q

Coarctation of the Aorta pathophysiology?

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A
  • Narrowing of the aorta
  • Left ventricular hypertrophy
19
Q

Coarctation of the aorta manifestations?

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A
  • Blood pressure higher in the upper extremities than the lower extremities.
  • Bounding pulses in the arms (radial/brachial)
  • Weaker or absent pulses in lower extremities
    • Cool lower extremities
20
Q

Coarctation of the Aorta treatment?

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A

Resection and anastomosis (removal and reconnection of unaffected aorta)

21
Q

Cardiac defects characterized by Decreased Pulmonary Flow?

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A

Tetralogy of Fallot

22
Q

Tetralogy of Fallot pathophysiology?

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A

Right to Left Shunt- Pressures on right side of heart higher than left

23
Q

4 Defects of Tetralogy of Fallot?

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A

1) Ventricular septal defect
2) Pulmonary Stenosis
3) Overriding aorta- positioned above the VSD allows both oxygenated and deoxygenated blood to enter the aorta.
4) Right ventricular hypertrophy

24
Q

Tetralogy of Fallot manifestations?

Study These Flashcards
A
  • Cyanosis
  • Dyspnea
  • Hypercyanotic (TET) spells
25
Tetralogy of Fallot treatment?
Repair through open heart surgery
26
Hypercyanotic (TET) Spells management?
1. First-Knee to chest position-increases SVR and blood flow to pulmonary artery. 2. Administer blow-by oxygen 3. Give Morphine subq or through existing IV line (decreases HR) 4. Begin IV fluids (Increase preload) 5. Phenylephrine – vasoconstriction –increases SVR
27
S/S of Heart Failure?
- Tachycardia - Tachypnea - Decreased pulses - Decreased B/P - Decreased urinary output - Sleep more or have less energy - Poor weight gain/growth - Infants difficulty with feeding - Older children exercise intolerance
28
Pediatric Heart Failure management?
Medication: - Diuretics - Ace inhibitors - Beta blockers - Digoxin Oxygen – improve tissue oxygenation
29
Digoxin considerations?
- Measure **apical pulse** (for 1 minute) prior to administrating digoxin - Order will specify **at what heart rate the drug is withheld** (depends on age) - Do not repeat a dose if the child vomits after administering drug –wait until next scheduled dose.
30
Feeding interventions for pediatric Heart Failure?
- Provide periods of rest - Neutral thermal environment - Hold infant in upright position, improves respiratory effort - Frequent, small feedings - High calorie - NGT may be necessary
31
Etiology of Rheumatic Heart Disease?
- Rheumatic Heart Disease most common **acquired** cardiac disease. - Rheumatic Fever is an autoimmune response to an infection caused by Group A Streptococcus - Widespread inflammatory response affects connective tissues, especially in the heart, joints, skin, and brain
32
Rheumatic Heart Disease manifestations?
- Fever of 38.2–38.9 °C (100.8–102.0 °F), - Carditis: Inflammation of the heart muscle (most common manifestation) - Polyarthritis - Subcutaneous nodules - Erythema marginatum: Reddish ring-shaped rash
33
Rheumatic Heart Disease complications?
- Cardiac valve stenosis and scarring - Mitral valve is the most common valve damaged.
34
Rheumatic Heart Disease treatments?
- Penicillin (oral or IM)-long term - Corticosteroids may be required - Severe RHD may require surgical intervention to repair or replace damaged valves. - Surgery is often needed early in life to prevent CHF
35
Laboratory findings that indicate a recent history of a streptococcal infection?
- Positive ASO (Antistreptolysin)-streptococcal antibody titer - Positive throat culture or rapid antigen detection test
36
Kawasaki Disease etiology?
- Acute febrile syndrome with **generalized vasculitis affecting blood vessels** throughout the body, including the coronary arteries - Commonly seen in children less than 5 years of age
37
Kawasaki Disease manifestations?
- **Abrupt onset of fever > 5 days (unresponsive to antibiotics)** - Bilateral conjunctivitis - Red cracked lips - Erythematous (Strawberry) tongue - Edema and erythema of hands and feet with peeling skin - Cervical Lymphadenopathy - Irritability
38
Kawasaki Disease complications?
Coronary artery aneurysms and abnormalities
39
Kawasaki Disease management?
- Echocardiogram (serial) - Intravenous immunoglobulin (IVIG)  - High dose aspirin 6-8 weeks-decrease inflammation and antiplatelet - Activity restriction for 6-8 weeks

328 Pediatrics Final Exam (5 decks)

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