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Pediatrics > Cardiovascular Disorder > Flashcards

Cardiovascular Disorder Flashcards

1
Q

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

A

Weeks 2-8

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2
Q

Digoxin

A

Antiarrhythmic agent, cardiac glycoside

-increases contractility of the heart muscle by decreasing conduction and increasing force

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3
Q

What is Digoxin used for?

A
  • heart failure
  • atrial fibrillation
  • atrial flutter
  • supraventricular tachycardia
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4
Q

What must be done prior to administering Digoxin?

A

Count apical pulse for 1 full minute
Hold for adolescent if pulse is < 60
Hold for infant if pulse is < 90

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5
Q

Administering Digoxin

A
  • monitor serum levels
  • note signs of toxicity
  • avoid rapid IV administration
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6
Q

S/S of Toxicity w/ Digoxin

A
  • n/v
  • diarrhea
  • lethargy
  • bradycardia
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7
Q

Heparin

A
  • anticoagulant
  • interferes w/ conversion of prothrombin to thrombin
  • prevents clot formation
  • administer SQ
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8
Q

What should be done when administering Heparin?

A
  • Dose may need adjusted according to coagulation test results
  • monitor for bleeding
  • monitor platelet count
  • ensure antidote is available
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9
Q

What is the antidote for Heparin?

A

Protamine Sulfate

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10
Q

What is characteristic of ventricular heart failure in older children?

A

Edema in the lower extremities

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11
Q

Where does peripheral edema develop first in the infants?

A

Face

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12
Q

S/S of Cardiac Disorder

A
  • cyanosis
  • edema
  • clubbing
  • fever
  • retractions
  • prominence of precordial chest wall
  • visible engorged or abnormal pulsations
  • abdominal distention
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13
Q

Cardiac Catherization

A
  • definitive study of the heart
  • routine diagnostic procedure
  • may be outpatient procedure
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14
Q

What should be done before Cardiac Catherization

A
  • ask about allergies to iodine and shellfish
  • review meds; may need to withhold anticoagulants
  • pay particular attention to pedal pulses
  • NPO 4-6 hrs prior
  • get consent
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15
Q

What to do AFTER Cardiac Catherization

A
  • vitals
  • neurovascular checks of lower extremities
  • check pressure dressing q 15 mins for first hour the q 30 mins for 1 hour
  • don’t change dressing until day after
  • must remain in straight position 4-8 hours
  • no strenuous activity for 3 days
  • no tub baths
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16
Q

What to do if bleeding occurs after Cardiac Catherization

A

Apply pressure 1 inch above the site to create pressure over vessel and reduce blood flow

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17
Q

Congenital Heart Disease

A
  • structural anomalies that are present at birth

- CHD accounts for the largest percentage of all birth defects

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18
Q

Acquired Heart Disease

A
  • occur after birth

- develops from wide range of causes or can occur as complication or long term effect of CHD

19
Q

Disorders w/ DECREASED Pulmonary Blood Flow

A
  • tetralogy of fallot

- tricuspid atresia

20
Q

Disorders w/ INCREASED Pulmonary Blood Flow

A
  • patent ductus arteriosus (PDA)
  • atrial septal defect
  • ventricular septal defect
21
Q

Obstructive Disorders

A
  • Coarctation of the Aorta
  • Aortic stenosis
  • Pulmonary stenosis
22
Q

Mixed disorders

A
  • Transposition of the Great Vessels
  • Total Anomalous pulmonary venous return
  • Truncus arteriosus
  • Hypoplastic Left Heart Syndrome
23
Q

Tetralogy of Fallot

A

mixing of oxygenated and poorly oxygenated blood and then pumped to systemic circulation

  • child will look cyanotic
  • surgical intervention w/in first year
24
Q

Why is Tetralogy of Fallot usually diagnosed early?

A

B/c infant has a LOUD HARSH murmur and is cyanotic

25
Q

S/S of Tetralogy of Fallot

A
  • Hypercyanotic spells
  • Infant will get in fetal position
  • Toddlers will squat
  • Infants may become unresponsive
26
Q

AFTER Blalock-Taussig Surgery for Tetralogy of Fallot

A
  • no BP in affected arm

- pulse is not palpable in arm b/c subclavian artery has been used for shunt

27
Q

What are the 4 heart defects that come w/ Tetralogy of Fallot?

A
  • pulmonary stenosis
  • VSD
  • overriding aorta
  • right ventricular hypertrophy
28
Q

Atrial Septal Defect

A
  • a hole in the wall (septum) that divides the RA from the LA
  • will spontaneously close w/in first 18 months
  • most asymptomatic
  • fixed split second heart sound
  • systolic ejection murmur best heard in pulmonic valve area
29
Q

If Atrial Septal Defect does not close by age 3 what happens?

A

surgery

30
Q

Ventricular Septal Defect

A
  • opening b/t the RV and LV
  • can spontaneously close by age 2
  • Holosystolic HARSH murmur along the left sternal border
31
Q

Moderate VSD can result in what?

A
  • Heart failure by 4-8 weeks
  • infant tires easily
  • does not eat well
32
Q

Atrioventricular Canal Defect

A
  • endocardial cushion fails to fuse
  • necessary to separate the central parts of the heart near the tricuspid and mitral valves
  • creates large left to right shunt
  • 45% of children w/ Down Syndrome
33
Q

Patent Ductus Arteriosus

A
  • failure of the ductus arteriosus to close w/in first few weeks of life
  • causes a connection b/t aorta and pulmonary artery
  • increases workload of left side of heart
  • most frequent in premies
34
Q

What type of murmur is heard with Ductus Arteriosus?

A

Harsh continuous machine like murmur under left clavicle at the 1st and 2nd intercostal space

35
Q

What would a chest x-ray show for Ductus Arteriosus?

A

Cardiomegaly-large heart

36
Q

Hypoplastic Left Heart Syndrome

A
  • structures on left side of the heart are severely underdeveloped
  • left side is unable to supply blood to systemic circulation
37
Q

Treatment for Hypoplastic Left Heart Syndrome

A
  • palliative care
  • cardiac transplant
  • palliative reconstructive surgery in 3 stages
38
Q

S/S of Hypoplastic Left Heart Syndrome

A
  • may be asymptomatic until ductus arteriosus closes and then newborn becomes cyanotic
  • gallop rhythm single heart sounds, soft systolic, ejection, holosystolic murmur
39
Q

What are the focuses of Nursing Care for a child w/ Cardiac Disorder?

A
  • improving oxygenation
  • promoting adequate nutrition
  • assist child and fam w/ coping/education
  • providing post op care
  • preventing infection
40
Q

What position can the patient be put in for relieving hypercyanotic spells and provide supplemental oxygen?

A

knee-to-chest

41
Q

Preop Assessments during Cardiac Surgery

A
  • temperature and weight measurements
  • exam of extremities for peripheral edema, clubbing, and evaluation of peripheral pulses
  • auscultation of heart
  • respiratory assessment
42
Q

What is the most common reason for admission to hospitals for kids w/ CHD?

A

Congestive Heart Failure

43
Q

CHF occurs most often in who?

A

Children w/ congenital heart defects

Pediatrics (24 decks)

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