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CARDIO Flashcards

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1
Q

3 Heart defects associated with increased pulmonary blood flow?

A

ASD (atrial septal defect
VSD
PDA

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2
Q

which congenital heart defects are associated with decreased pulmonary flow?

A

Tricuspid atresia
Tetralogy of Fallot

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3
Q

GI or organ s/sx of Congestive HF?

A

poor feeding
enlarged liver/edema

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4
Q

s/sx of congestive HF

A

poor feeding/growth
SOB/Sweating
peripheral edema

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5
Q

how does peripheral edema present in children

A

puffy eyelids
swelling of hands/feet
bulging fontanelle

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6
Q

what are “staple” clinical manifestations of L & R sided congestive heart failure?

A

pulmonary congestion (Left sided = lung)
Systemic venous congestion (R sided)

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7
Q

s/sx of pulmonary congestion

A

tachypnea, dyspnea, respiratory card, exercise intolerance, cyanosis

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8
Q

s/sx of systemic venous congestion

A

peripheral & periorbital edema, weight gain, ascites w/ neck vein distention

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9
Q

what 3 meds(&their type) would you give for congestive HF?

A

Digoxin
Furosemide - Lasix (diuretic)
Captopril (vasodilator)

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10
Q

what is Digoxin used for in HF?

A

When poor contractility is the cause of HF

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11
Q

s/sx of Digoxin toxicty?

A

N/V
Blurred vision (halos)
yellow/green distortion
confusion/vertigo/convulsion

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12
Q

treatment for dig toxicity?

A

Stop meds immediately
Digi Fab
Activated charcoal

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13
Q

cyanotic defects mechanism

A

DeO2/venous blood from R side is forced into L

overall O2 will drop (as low as 70)

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14
Q

acyanotic defect mechanism?

A

O2 blood shunts from the L to the R

This type of mixing doesnt affect the amount of O2 in the body - wont change O2 sat

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15
Q

what is atrial septal defect?

A

Septal overlap & defect btwn R/L atrium

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16
Q

s/sx for atrial septal defect?

A

Periorbital edema
increased respiratory infections
Harsh systolic murmur
R atrial enlargement from fluid overload

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17
Q

why are ASD pt’s at risk for stroke?

A

Tendency for blood pooling

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18
Q

where is ASD murmur heard at?

A

2nd IC L sternal border

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19
Q

what is a ventricular septal defect & when does it form?

A

hole in ventricular septal wall (lower portion)
4-8wk

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20
Q

blood movement thru VSD?

A

O2 (red) blood pass abnormally from L ventricle thru septal opening mixing with O2poor(blue) blood

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21
Q

what can physical change to heart can happen from the mixing of bloods/abnormal flow from VSD?

A

RV overload from high pressure gradient of L to R

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22
Q

s/sx of VSD?

A

Harsh Murmur w/thrill
Pansystolic
Easy fatigue
Poor growth

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23
Q

what does VSD murmur sound like & where?

A

harsh & Lower L sternal border

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24
Q

is the ductus a normal part of infant anatomy?

A

Y

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25
what happens in patent ductus arteriosus?
too much blood flow to lungs O2 rich blood flows from aorta to mix with O2poor blood in PA
26
what physical/visual s/sx would you see with PDA?
bounding pulses
27
what happens to PDA BP?
widening pulse pressure
28
medication for PDA? & why
Indomethacin (Indocin) Keep PDA open
29
s/sx of PDA?
Machine like harsh murmur
30
what would you physically see in PDA?
Bounding pulse
31
care for PDA
Fluid restriction (diuretics) indomethacin
32
edu for mom about PDA?
mom cant take ibu - bc its a prostaglandin inhibitor
33
what is coaractaition of aorta?
"sausage defect" narrowing of descending aorta distal to carotid arteries
34
what physical change to heart & body effect happens from coaractaition of aorta?
L ventricle hypertrophy & Impeded circulation to LE ONLY!
35
s/sx of coaractation of aorta
increased pressure to Head/UE Pain in legs/cyanotic LE Decreased pressure to LE
36
what is the characteristic sign of coaractation of aorta
BP in LE is >10mmHg less than UE
37
Coaractation of aorta murmur is?
Isnt always present systolic ejection murmur @ UR/L sternal border
38
what is the official diagnosis of CoA?
pressure differential btwn arms/legs
39
Care for CoA?
May have rebound HTN - give antihypertensives for 6months to 1Y
40
ex of meds given for COA
Captopril & Enalapril (Vasotec) * they reduce afterload & control BP
41
what is the surgical treatment for CoA?
Stent placement & balloon angioplasty
42
what type of heart defect is Tricuspid Atresia?
cyanotic
43
what is tricuspid atresia (TA)
error in tricuspid valve = no blood reaches lungs
44
what are the s/sx of TA?
Dramatic! Severe cyanotic/dyspneic Heart murmur present at L sternal border
45
what type of murmur is present in TA?
Pansystolic
46
care & surgery for TA?
Prostaglandins to keep PDA open Balloon atrial septoplasty Glenn procedure & Fontan procedure
47
what type of defect is Pulmonary Atresia? (PA)
cyanotic
48
what is pulmonary atresia?
Absence of pulmonary valve, pulm artery or both
49
What other condition(s) must a child have to live with PA?
ASD, PDA PDA = blood flow into lungs for oxygenation
50
treatment for PA?
PGE (prostaglandins) Atrial septostomy shunt/conduit
51
what is total anomalous pulmonary venous return?
pulm blood flow returns to heart thru R atrium rather than the L
52
what can the mixing of blood in TAPV cause?
Cyanosis
53
s/sx of total anomalous pulm venous return?
systolic ejection murmur heard @ pulmonic area R sided hypertrophy respiratory distress = frequent resp infections
54
treatment for TAPV
Complete surgical repair
55
post surgery education for TAPV?
can live normal life post surg follow up PCP Q1-2y
56
what is transposition of the great arteries/vessels
aorta rises from the R side of the heart & the PA is on the L
57
what is the surgery for transposition of great arteries/vessles?
arterial switch operation
58
s/sx of transposition of great arteries?
Cyanosis SOB clubbing of fingers/toes (!!)
59
what is truncus atreiosus?
Neither trunk has formed a septum PA's & Aorta are combined classified I-IV
60
treatment for TA
aggressive medical regiment w/ Inotropic medication
61
s/sx of truncus ateriosus?
low cardiac output systolic ejection murmur
62
what is tetralogy of fallot?
combo defect made up of 4 diseases
63
what are the 4 diseases from tetralogy of fallot?
PROV P: Pulm stenosis R: R ventricle hypertrophy O: Overriding aorta V: Ventral septal defect
64
walk thru of tetralogy of fallot?
Starts as outflow disorder w/ pulm stenosis, blood cant exit properly thru R side of heart & turns into RV hypertrophy
65
s/sx of TOF?
Dyspnea on exertion Harsh/loud/radiating murmur RV hypertrophy
66
what can happen with tetralogy of fallot?
"TET" spells
67
what are TET spells?
turn blue when crying/excitement drop in oxygenation in periphery
68
hallmark sign for TOF?
Cyanosis when crying/playing Can lead to fainting
69
what can be given to children in TET spells?
Morphine (in hospital)
70
position for TET spells?
Child in knee to chest position during episode older children go into squat
71
s/sx of TOF?
tachypnea dyspnea on exertion loud systolic ejection murmur thats "harsh"
72
what is hypoplastic L heart syndrome
ventricle is extremely small & can't maintain adequate cardiac output not enough oxygenated blood
73
medication for hypoplastic L heart syndrome
prostaglandins to keep PDA open
74
procedures for HLH
Norwood & blaock taussing shunt eventually Glenn for more blood flow
75
feeding edu about cyanotic conditions?
small frequent feedings use soft nipple to ease stress of sucking mom can pump breastmilk if infant lacks strength
76
what to monitor when giving Digoxin
Apical HR for 1 full minute
77
what can fluid retention indicate in cyanotic?
right sided heart failure
78
what pulse do you hold digoxin for?
infant: Under 90 1-9: <70 10+: 60
79
what electrolyte should today when given lasik for cyanotic care?
Potassium (K)
80
infant blood pressure range
65-100 / 55-65
81
toddler BP range?
90-105 / 55-70
82
pre-school BP range?
95-110 / 60-75
83
what med would you administer for a child hospitalized with heart failure & extremely high BP?
Enalapril (Vasotec)
84
what test would a child presenting with neurally mediate syncope be given?
Tilt table test
85
if a 4 year old presents with a systolic BP of 112, whats the next response?
refer to a provider (20 mg too high)
86
where would the murmur be for PDA?
L subclavian border
87
what skin symptom presents in kawasaki disease?
erythema marginatum rash
88
a child with suspected Rheu fever, how are they diagnosed?
JONES criteria
89
what is often the cause of rheumatic fever?
Group A Beta hemolytic strep phargyn Hx of strep & chronic pharyngitis
90
what medication is given for rheumatic fever?
Amoxicillin/penicillin Aspirin
91
edu for rheumatic fever long term effects?
may need valve replacement
92
in the JONES criteria, what is a standout development for rheumatic fever?
a new murmur without ever having one.
93
what disease presents with a harsh murmur w/ thrill @ L lower sternal border
ventricular septal defect (VSD)
94
what type of patient would you hesitate/further evaluate when giving digoxin?
One retaining fluid (weight gain over short period)
95
what is pulmonary stenosis?
malformation/narrowing of pulmonic valve/artery
96
narrowing of the pulmonic valve causes what in the heart?
CHF & hepatomegaly of RV
97
2 conditions PS is associated with?
Noonon syndrome TOF
98
age most cases of pulmonary stenosis is caught? (when heart muscle is more developed)
3y
99
what manifestations are present with PS?
murmur crying, exercise or fever induced dyspnea
100
when would a child with PS experience dyspnea?
Increased BP from: Excitement Exercise Crying Fever
101
how to diagnose PS?
ECG showing RV hypertrophy
102
how is surgical care of PS based?
Gradient Observation of child over period of time "Watch & wait"
103
what is Kawasaki disease?
systemic vasculitis of unknown cause (thought to be bad immune resp)
104
Long term Sequela of Kawasaki?
arterial vessels aneursym & myocarditis
105
S/sx of Kawaski?
Fever up to 104 for 5 days unilateral lymphadenopathy strawberry tongue conjuctivitis without exudate red maculopapular rash
106
blood tests run to diagnose Kawaski?
CBC, Erythrocyte sedimentation (ESR)
107
edu about taking medication w/ Kawasaki?
Monitor closely if on anticoagulant = at risk of bleeding/bruising
108
Kawasaki treatment?
High dose aspirin & IVIG
109
edu about vaccines & kawasaki?
can't get live virus vaccine bc of IVIG
110
what food should a patient avoid post op a tonsilectomy
milk/dairy it increases secretions
111
what are 3 expected side effects of tamiflu?
vomiting unusual behavior hallucinations
112
what is an unexpected side effect of tamiflu?
dilated pupils
113
what would the primary nursing intervention be for transposition of the great arteries?
administering prostaglandin E1 - keep ductus arteriosus open
114
which heart defects are given prostaglandin E to keep the PDA open?
Hypoplastic left heart transposition of G Vessel CoA
115
what is a priority nursing intervention for a foreign body aspiration w/ coughing, wheezing & diminished breath sounds
administer high flow o2
116
what is not associated with esophageal atresia?
purulent nasal discharge
117
what can be used to evaluate size of VSD?
Echocardiogram
118
what would be the first priority if admitted for bacterial endocarditis?
obtain blood cultures
119
if a HF patient is recieving Furosemide (Lasix) what is needed?
Administer O2
120
why give O2 to a patient with HF & receiving lasix?
pulmonary congestion from fluid back up into lungs
121
how much of the arm should the BP cuff cover
at least 80
122
A child with Truncus arteriosus, has hyptension & poor perfusion - what med should be administered?
Clopidogrel (Plavix)
123
124
What is the education for post cardiac cath?
Bed rest for 6 hr & 2 weeks of quiet play with pressure dressing

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