Cardiac

Question 1

stenosis

Answer 1

narrowing causing obstruction to blood flow

Question 2

Atresia

Answer 2

Complete blockage of blood flow

Question 3

heart murmurs

Answer 3

abnormal struture of the heart, making blood travel in an abnormal fashion resulting in noise

Question 4

Physical indicators of cardiac dysfunction

Answer 4

Tachypnea, tachycardia, diaphoresis, crackles, edema, cyanosis, murmur, sternal lift, clubbing of the fingers

Question 5

Normal heart rate:

1. Newborn
2. 3 Years
3. 10 years
4. 16 years

Answer 5

1. 120-160
2. 80-125
3. 70-120
4. 55-90

Question 6

Cardiac catherization

Answer 6

Invasive routine and diagnostic procedure using radiopaque catheters placed in peripheral blood vessel and then guided into heart with aid of fluoroscopy

Question 7

Biggest risks of cardiac cath

Answer 7

BLEEDING

Question 8

Cardiac cath post op care includes:

Answer 8

Check pulses

Monitor coolness, blanching

Vitals taken every 15 minutes, HR for full 60 seconds

Hypotension could indicate hemorrhage

Fluid intake, blood glucose levels

Question 9

What do you do if bleeding occurs after a cardiac cath?

Answer 9

Direct continuous pressure is applied 1 inch above the site to localized pressure of the vessel puncture

Question 10

What do you do before giving digoxin?

Answer 10

Check apical pulse for a full 60 seconds prior to administration

Question 11

What pulse would indicate not to give digoxin?

• Infants?
• Older children

Answer 11

90 -110 bpm in infants

70 beats/min in older children

Question 12

Signs of toxicity in digoxin

Answer 12

N/V
Anorexia
Bradycardia
Dysrhythmias

Question 13

Prostaglandins - IMPORTANT TO KNOW!

Answer 13

Metabbolizes rapidly - infusion must be continuous and have it’s own IV line

Question 14

Side effects of prostaglandins

Answer 14

Reduced glomerular filtration

Impaired Plt function
Decreased GI blood flow

Question 15

What is the major cause of death in the first year of life?

Answer 15

Congenital Heart Disease

Question 16

Left to Right Shunting

Answer 16

Involves blood flow from the left side(blood that goes to the body) of heart to the right side(blood that goes to the lungs) resulting in increased pulmonary blood flow

Question 17

Ventricular septal defect(VSD)

Answer 17

MOST COMMON

• Abnormal opening is present in the septum between the two ventricles

Allows blood to shunt L-R

Blood that should go to aorta and out of the body shunts back into pulmonary circulation

Question 18

VSD assessment upon child

Answer 18

occurs when 4-8 years old

Fatigue, loud and harsh murmur

• SOB, crackles, feeding difficulty, murmur, FTT. respiratory infections, cardiomegaly
• Fatigue, Harsh murmur(at 4-8 weeks of life) is when shunting starts

Question 19

Treatment of VSD

Answer 19

Most close spontaneously by age of 1

Cardiac cath: moderate size

Prophylatic abx 6 mos - prevents endo carditis and other infections before/after surgery

Question 20

When would you perform open heart surgery for a patient with VSD?

Answer 20

Over 3mm

-age of 2

Question 21

Nursing interventions of VSD:

Answer 21

Monitor feeding - give breaks during

S/S CHF

Monitor WOB

Question 22

Medication for VSD

Answer 22

-Diuretic or digoxin - prevent fluid accumulation in lungs

Question 23

Atrial Septal Defect(ASD)

Answer 23

• abnormal opening between the atria that causes an increased flow of oygenated blood into the right side of the heart
• Blood shifts L to R
• Most common in girls

Question 24

How will a patient present with ASD?

Answer 24

Asymptomatic until infection from recirculating blood occurs

Question 25

Treatment for ASD

Answer 25

- Surgery between 1-3 years old

Question 26

What happens if ASD is not repaired?

Answer 26

Emboli formation later in life Infection - endo carditis, HF

Question 27

S/S of ASD

Answer 27

Asymptomatic - Harsha systolic murmur over pulmonic area - Increased blood volume right side of heart - Split second heart sound(lub-dud-dud) - Most close spontaneously

Question 28

Patent Ductus Arteriosus(PDDA)

Answer 28

Failure of the fetal ductus arteriosus(sjunt connecting the aorta and the oulmonary artery) to close within first weeks of life

Question 29

What would you see in PDA?

Answer 29

- Continuous murmur - Shunting blood from aorta to pulmonary artery d/t higher pressure in aorta - Same s/s as ASD - wide pulse pressure, murmur, wet bs, tachypnea, poor feeding, sweating w/ feedings

Question 30

Treatment of PDA

Answer 30

- Iv Indomethacin or ibuprofen - PGE inhibitors - Cardiac cath - 6mos -1 year Ductal ligation

Question 31

When should PDA close on its own?

Answer 31

Should close hours to days after birth, may take up to 3 months

Question 32

Nursing Interventions for PDA

Answer 32

Risk for CHF/endocarditis - Decrease WOB, Give rest periods, I&O, Diueretics, Dopamine, Digoxin, Daily weight

Question 33

Pulmonic Stenosis

Answer 33

narrowing at the entrance of the pulmonary artery

Question 34

S/S of pulmonic stenosis

Answer 34

- Mild right sided CHF - Cyanosis - Loud murmur - SOB, RV hypertrophy - Cardiomegaly

Question 35

Nursing interventions for pulmonic stenosis

Answer 35

- Calm envirnment - Monitor BP/O2 sat -If atresia - Give PGE keep PDA open, IV own line, continuous infusion

Question 36

Treatment for pulmonic stenosis

Answer 36

- Cardiac cath - Balloon angioplasty - Normal life span - Restenosis may occur

Question 37

Aortic Stenosis

Answer 37

narrowing or stricture of the aortic valve, causing resistance to blood flow from the left ventricle into the aorta, causing a decreased cardiac output

Question 38

Symptoms of aortic stenosis

Answer 38

- Murmur(may or may not be present) - Faint pulses - Hypotension - Tachycardia - Poor feeding - Chest pain - Exercise tolerance

Question 39

Treatment of Aortic stenosis

Answer 39

- Stabilization with beta blocker or CCB - Balloon valvuloplasty - May need valve repalcement - Anticoagulation - Antiplts - Abx - Exercise test before competitive sports

Question 40

Coarctation of the aorta

Answer 40

- Localized narrowing near the insertion of the ductus arteriosus - Aorta brings blood to the rest of the body

Question 41

What is the only mild symptom that you would see in COA?

Answer 41

- Dec/Absent femoral pulse -Cardiomegaly - R sided heart failure - HTN(headache) - SOB, Poor feeding Chest xray

Question 42

Nursing interventions for COA

Answer 42

Medication - digozin/lasix - Mild( wait ti repair) at age 2 - Cardiac cath dilation(baloon angioplasty) - Stent placed

Question 43

What would be done if severe COA?

Answer 43

Baloon cath then surgery

Question 44

Decreased pulmonary blood flow:

Answer 44

Blood is having a difficult time leaving the right side of the heart via the pulmonary artery