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Cardiac Issues Flashcards

(72 cards)

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1
Q

What side is deoxygenated blood on?

A

Right side of heart

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2
Q

what two holes need to close after baby is born?

A

foramen ovale and ductus arteriosus

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3
Q

what are things you investigate in a child’s cardiac hx?

A

poor weight gain
poor feeding habits and fatigue during feeding
frequent respiratory tract infections
exercise intolerance

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4
Q

What is the most common cardiac disease?

A

Congenital heart disease

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5
Q

what are two major clinical consequences of congenital heart disease?

A

heart failure and hypoxemia

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6
Q

What is the foramen ovale?

A

an opening between the atria that allows blood flow from right to left atrium

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7
Q

What is ductus arteriosus?

A

opening that allows blood flow between pulmonary artery and aorta

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8
Q

When are the four chambers of the heart formed during gestation?

A

between 2 and 8 weeks

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9
Q

Where is the heart located in infants?

A

high in chest below the 4th intercostal

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10
Q

How do you do a cardiac assessment on a child?

A

obtain full med hx
birth complications
past med hx of parents
prenatal care
assess feedings and growth and development
dizziness
assess vitals
look for edema, clubbing, click or murmurs

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11
Q

between the ages of 1-6 the heart is […]

A

4x the size of birth

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12
Q

between the ages of 6-12 the heart is […]

A

10x the size of birth

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13
Q

What prenatal factors can predispose children to congenital heart disease?

A

maternal rubella, alcohol use, age older than 40, and type 1 diabetes

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14
Q

what are the 4 main groups of congenital heart defects?

A

1.) defects that result in increased pulmonary blood flow
2.) obstructive defects
3.) defects that decreased pulmonary blood flow
4.) mixed defects

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15
Q

What is atrial septal defect?

A

A hole located in septum between left and right atrium > which causes an increase in blood volume to the right atrium > which causes mixture of oxygenated and deoxygenated blood in right atrium

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16
Q

As a nurse what are you gonna do for Atrial Septal Defect?

A

assess feeding and growing
auscultate for loud and harsh heart sounds

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17
Q

What is a Ventricular septal defect?

A

opening between right and left ventricle that causes increased pulmonary blood flow which causes pulmonary hypertension

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18
Q

What are ventricular septal defect cues? What do you need to consider?

A

Symptoms may start at 4-8 weeks of age
infant may tire easily when feeding
failure to thrive
decreased appetite
fever
muscle joint pain
systolic murmur
frequent pulmonary infections
a chest radiography reveals cardiomegaly

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19
Q

VSD cues

Ventricular septal defect

A

loud/harsh murmur at the left sternal border
a thrill may be felt on chest
wet lung sounds if pulmonary edema present

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20
Q

What is the treatment for ASD and VSD?

A

low does aspirin after cathe lab procedure for ASD
surgery
closure in cathe lab
diuretics

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21
Q

Patent Ductus Arteriosus

A

ductus arteriosus fails to close at birth which causes blood flow in pulmonary artery from aorta instead of systemic circulation causing pulmonary vascular congestion

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22
Q

Patent ductus arteriosus cues

A

machine like hum murmur
bounding pulse
rales on auscultation
large gap between systolic and diastolic BP readings

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23
Q

patent ductus arteriosus treatment

A

Lasix
Extra calories for infants formula or breastmilk
Indomethacin

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24
Q

What is indomethacin?

A

NSAID normally used for arthritis but for PDA infants it causes constriction and closure of the PDA defect

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25
Aortic Stenosis and what does it cause?
obstruction/narrowing of the aortic valve between the left ventricle and aorta causes decreased cardiac output and left ventricular failure
26
Symptoms of aortic stenosis for infants
Hypotension, tachycardia, poor feeding
27
Symptoms of AS for children
activity intolerance, dizziness, chest pain,
28
Treatment for AS
dilation in cath lab beta blockers or calcium channel blockers
29
Pulmonary stenosis and what does it cause?
Narrowing of pulmonary valve/artery causing obstruction from right ventricle to pulmonary arteries Results in a backup of blood to right atrium
30
Pulmonary stenosis symptoms
systolic ejection murmur, cyanosis depending on size of narrowing, lead to heart failure
31
PS treatment | Pulmonary Stenosis
balloon angioplasty in cath lab
32
What is tetralogy of fallot
Combination of 4 heart defects present at birth
33
What are the 4 major defects of tetralogy of fallot?
1.) Pulmonary stenosis 2.) Right ventricular hypertrophy 3.) Overriding Aorta 4.) Ventricular Septal Defect
34
What is an overriding aorta?
enlarged aortic valve so it sits over both sides of ventricles instead of only the left ventricle
35
What is right ventricular hypertrophy?
enlargement/thickening of right ventricular muscle walls due to increased pressure
36
When is tetralogy of fallot diagnosed?
Within the first weeks of life and when infant is showing signs of cyanosis
37
What are cues of TOF?
color changes during feeding or crying *hyper cyanotic spells, dyspnea, agitation, hypoxemia*
38
What is a Tet spell what do you do?
dyspnea, agitation, hypoxemia If this occurs you place infant in a knee-chest position
39
What do you assess for TOF?
increased work of breathing decreased o2 sat clubbing of fingers (older child)
40
What is a lab result for children with a Hx of TOF?
POLYCYTHEMIA
41
what is transposition of the great arteries and what does it cause?
defect where the pulmonary artery and aorta are not in their normal position Aorta is connected to right vent instead of left Pulmonary artery is connected to left vent instead of right Causes poorly oxygenated vital organs
42
When is transposition of the great arteries diagnosed?
the first few days of life when infant has cyanosis septal defect or PDA must exist to oxygenate blood
43
What is the main medication given for TGA before corrective surgery is performed and what does it do?
PROSTAGLANDIN E1 -maintains ductal patency and ensure adequate systemic blood flow
44
What is Truncus arteriosus and what does it cause?
Failure of the septum formation resulting in a single vessel between the left and right ventricle Causes mixed blood which increases blood flow to lungs and decreases systemic circulation
45
Cues of Truncus Arteriosus
HF, murmur, cyanosis, delayed growth, fatigue, lethargy, poor feeding
46
What is hypoplastic left heart syndrome? What does it cause?
Defect where all structures on left side of heart are underdeveloped Cannot supply blood for systemic circulation and blood is pumped thru PDA
47
Symptoms of Hypoplastic left heart syndrome
HF, cyanosis, lethargy, cold hands and feet When PDA closes there is a decrease in cardiac output which results in cardiac collapse
48
Treatment of Hypoplastic left heart syndrome
3 separate reconstruction surgeries, poor prognosis
49
What is coarctation of aorta?
narrowing of the lumen of the aorta leading to obstruction
50
What can result from coarctation of aorta?
aortic rupture, aneurysm, and stroke
51
Symptoms of COTA
Elevated BP bounding pulse in upper extremties low BP and cool skin in lower extremities HF in infants Dizziness headaches
52
Rheumatic Fever
An inflammatory disease that is a reaction to BETA-HEMOLYTIC STREPTOCOCCUS (GABHS)
53
How do you get rheumatic fever?
within 2-6 weeks of a untreated upper resp infection
54
Symptoms of rheumatic fever
tachycardia heart murmur muffled heart sounds chest pain
55
What are 4 major signs of rheumatic fever?
large joints with painful swelling Fever of 38.2 - 38.8 (100.8 - 102.0) Erythema marginatum (non itchy rash) Narrowed mitral value causing heart murmur
56
How is rheumatic fever diagnosed?
throat culture for GABHS elevated CRP/ESR blood antistreptolysin O titer
57
What is the nursing care for rheumatic fever?
bedrest during acute phase administer antibiotics Assess for chorea which is sudden involuntary muscle movement monitor rash
58
Infective bacterial endocarditis and what does it cause?
infection of inner lining of the heart that can enter the bloodstream
59
What bacteria can cause bacterial endocarditis?
S. viridans, C. albicans, S. aureus
60
S/s of bacterial endocarditis
fever malaise arthralgias diaphoresis weight loss splinter hemorrhages under fingernails
61
what is the nursing care for bacterial endocarditis?
high dose antibiotics for 2-8 weeks and may require a picc line
62
What kids are high risk if they have bacterial endocarditis?
children with artificial heart valves, hx, unrepaired heart disease, repaired congenital heart disease and residual
63
what is Kawasaki disease?
an acute systemic inflammation of small and medium blood vessels
64
what are the symptoms during the acute phase of kawasaki disease? | name 3 specific to this disease
rash fever for 5+ days/unresponsive to meds chills *red eyes with no drainage *red chapped lips *strawberry tongue swelling hands and feet enlarged lymph nodes
65
What is happening in the subacute phase of kawasaki?
resolved fever peeling of palms and soles temp arthritis irritability
66
what is happening in the convalescent phase of kawasaki and when does it fully resolve?
no s/s abnormal lab values resolves in 6-8 weeks of onset
67
what is the nursing care for kawasaki?
monitor vitals I&O Daily weight cardiac status IV fluids oral care keep room dark and quiet
68
what are the main meds and dosages for kawasaki treatment?
Gamma globulin 2g/kg over 8-12 hrs Asprin 80-100mg/kg/day q6hrs then 3-5mg/kg/day until platelets stabilize
69
What is the education for kawasaki?
Follow up irritability may last for 2 months parent may have to perform ROM as arthritis may last up to several weeks avoid live immunizations for 11 months
70
What is the nursing care preop for catheterization?
Asses for allergies to dye or shellfish keep NPO 4-6 hrs mark pedal and radial pulses skin prep for older children
71
What is the nursing care post cathe lab?
continuous pulse ox ABCs I&O push fluids to flush out contrast Assess insertion site
72
Heart Failure
Volume overload pressure overload decreased contractility

Pediatrics (17 decks)

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