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202 > cardiac PEDS > Flashcards

cardiac PEDS Flashcards

1
Q

When does fetal hear begin to beat?

A

end of 3 weeks gestation

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2
Q

What compensates for nonfunctional lungs?

A

fetal circulation

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3
Q

Where does oxygenation occur?

A

the placenta

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4
Q

Which side of the heart is arterial blood returned to?

A

right

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5
Q

What is the pathway of oxygenated blood?

A
  • 2/3 is shunted through the foramen oval
  • into the left side of the heart
  • pumped through the aorta
  • 1/3 is pumped by the right side of the heart
  • out through the pulmonary artery
  • detoured through ductus arterioles
  • to aorta
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6
Q

Which ventricle is thicker?

A

both are equal in weight and muscle wall thickness

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7
Q

When is the blood oxygenated through the lungs?

A

birth

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8
Q

When does the foramen ovale close?

A

within 1st hour

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9
Q

When does the ductus arteriosus close?

A

within 10-15 hours after birth

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10
Q

by 1 year old what is the ratio of left ventricle to right ventricle?

A

2:1

same as adult

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11
Q

What is the heart’s position in an infant?

A
  • more horizontal

- apex is higher (4th left intercostal space)

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12
Q

When does the heart reach adult position?

A

7 years old

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13
Q

What history for infants should you obtain about mother’s health during pregnancy?

A
  • unexplained fever
  • rubella in 1st trimester
  • infection
  • hypertension
  • drugs
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14
Q

When do fetal shunts usually close?

A

within 10-15 hours may take up to 48 hours

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15
Q

When do you assess the cardiovascular system on an infant?

A

-During the first 24 hours of life and then again in 2-3 days

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16
Q

What are the signs of heart failure in infants?

A
  • persistent tachycardia
  • tachypnea
  • liver enlargement
  • engorged veins
  • gallop veins
  • pulsus alternans
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17
Q

What is the purpose of palpating the apical pulse?

A

to determine size and position of heart

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18
Q

How is the infant heart different from the adult heart?

A

more horizontal and 4th intercostal space

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19
Q

What happens to the apex with cardiac enlargement?

A

shifts to left

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20
Q

What happens to the apex with pneumothorax?

A

shifts away from affected side

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21
Q

What happens to the apex with diaphragmatic hernia?

A

shifts to right b/c hernia is usually on left

22
Q

What happens to the apex with dextrocardia?

A

shifts to right

23
Q

What is the normal HR for infant?

A
  • 100-180 bpm immediately after birth
  • then 120-140 bpm after
  • > 170 bpm with crying
  • 70-90 bpm with sleeping
24
Q

What is tachycardia for an infant?

A
  • > 200 bpm in newborns

- >150 bpm in infants

25
Q

What is bradycardia for an infant?

A
  • <90 bpm in newborn

- <60 in infants or children

26
Q

What is sinus arrhythmia?

A

Phasic speeding up or slowing down with the respiratory cycle

27
Q

What makes it difficult to evaluate the heart sounds?

A

Rapid rates

28
Q

Is the heart louder in infants or adult? why?

A
  • infants

- thinner chest wall

29
Q

When is the splitting of S2 common?

A

after height of inspiration a few hours after birth

30
Q

Compare S1 to S2 in an infant?

A

S2 is higher pitch and sharper

31
Q

Are murmurs common? when? why? what are they normally graded?

A
  • yes
  • first 2-3 days
  • b/c fetal shunt closure
  • grade 1 or 2
32
Q

What is infant PDA?

A

continuous machinery and disappears within 2-3 days

33
Q

Signs that may indicate heart disease in children?

A
  • Poor weight gain
  • Developmental delay
  • Persistent tachycardia
  • Tachypnea
  • Dyspnea on exertion
  • Cyanosis
34
Q

How does clubbing affect the fingers and toes of a child?

A

usually doesn’t appear until late in first year even with severe cyanotic defects

35
Q

When is the apical pulse visible in children?

A

when the child has a thin chest wall

36
Q

where is the precordial bulge located? why?

A
  • left of sternum

- the cartilaginous rib is more compliant

37
Q

where would yo palpate the apical pulse on a child < 4? 4-6? >7?

A
  • 4th intercostal space left of mid-clavicular space
  • 4th intercostal space
  • 5th intercostal space
38
Q

What is a thrill?

A

a palpable vibration

39
Q

What is a physiologic S3?

A
  • early in diastole
  • just after S2
  • due soft sound that is best heard at the apex
40
Q

What causes the venous hum? where do you listen for it?

A
  • due to turbulence off blood flow in jugular venous system

- supraclavicular fossa at eh medial third of the clavicle, especially on the right, or over the upper anterior chest

41
Q

when might a venous hum sound louder in a children?

A

when a child stands

42
Q

how do you differentiate between venous hum and other cardiac murmurs?

A
  • occulting the jugular vein with your fingers

- obliterates the venous hums

43
Q

Characteristics of innocent murmurs?

A
  • soft
  • relatively short
  • early or mid systolic ejection murmur
  • medium pitch
44
Q

when does lymphoid tissue reach adult size?

A

6 years

45
Q

what happens to the lymphatic system by puberty?

A

surpasses adult size and slowly atrophies

46
Q

are superficial lymph nodes often palpable in child even when healthy?

A

yes

47
Q

what does enlarged tonsils indicate?

A

respiratory infections

48
Q

what causes abdominal pain in children?

A
  • excessive lymphoid response

- upper respiratory infection

49
Q

what causes a weak pulse?

A

vasoconstriction of diminished cardiac output

50
Q

what does diminished or absent femoral pulses while upper extremity pulses are normal indicate?

A

coarctation of aorta

51
Q

what do vaccines produce?

A

local lymphadenopathy

202 (6 decks)

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