Cardiovascular Dysfunction Flashcards
(114 cards)
1
Q
atresia
A
congenital absence or pathological closure
2
Q
Stenosis
A
anatomic narrowing
3
Q
Normal cardiac flow
A
S/IVC - RA - Tricuspid valve - RV - Pulmonary valve - pulmonary artery - lungs - pulmonary veins - LA - mitral valve - LV - aortic valve - aorta - body
4
Q
high pressure side prenatally
A
right side
5
Q
high pressure side after birth
A
left side
6
Q
blood follows the path of
A
least resistance
7
Q
congenital heart disease
A
abnormalities present at birth
8
Q
acquired heart disease
A
occur after birth
9
Q
biggest cause of death in the first year of life
A
congenital heart defects
10
Q
most common congenital heart defect
A
VSD
11
Q
cause of congenital heart defects
A
etiology unknown in 90% of cases
12
Q
FAS relation to congenital heart defects
A
50% of FAS kids have a heart defect
13
Q
what chromosomal abnormality is associated with heart defects
A
downs syndrome
14
Q
diagnostic procedures for cardiac abnormalities X4
A
EKG, CXR, ECHO, cardiac cath
15
Q
CXR shows X3
A
size, cardiomegaly, pulmonary congestion
16
Q
what is an echo
A
high frequency sound waves to produce real time image
17
Q
cardiac cath as a diagnostic
A
defines a defect prior to surgery by determining blood flow patterns
18
Q
cardiac cath as interventional
A
balloon to correct aorta/valve issues or mesh devices to close septal defects
19
Q
cardiac cath electrophysiology
A
stimulate different areas of the heart to determine which area is causing arrhythmia then cauterize it
20
Q
cardiac cath pre procedural care
A
mark pulses prior to cath in case it is hard to find after procedure
21
Q
cardiac cath post procedure
A
pulses for equality and symmetry
22
Q
how long do you keep extremity straight for venous caths
A
4-6 hours
23
Q
how long do you keep extremity straight for arterial caths
A
6-8 hours
24
Q
for bleeding at cath entry site
A
apply direct continuous pressure 1 inch above entry site
25
how long should activity be limited following a cardiac cath
24 hours
26
left to right shunt
blood flows from systemic circulation to pulmonary leading to increased pulmonary blood flow
27
right to left shunt
blood flows from pulmonary circulation to systemic, allowing deoxygenated blood to flow into body
28
atrial septal defect shunting
left to right - increased pulmonary blood flow
29
ASD patho
abnormal opening between the atria
30
small ASD defect s/s
potentially asymptomatic
31
large ASD defect s/s X3
fatigue, SOB, respiratory infections
32
ASD treatment - spontaneous closure
depends on the size of the defect and the age of the child
33
ASD treatment - catheter closure
septal occluders - smaller defects
34
ASD treatment - surgical closure
pericardial/dacron patch for moderate to large defects
sutures for smaller defects
35
Ventricular Septal Defect shunting
left to right shunt
36
VSD patho
abnormal opening between the right and left ventricle
37
VSD s/s small defect
probably asymptomatic. no physical restrictions. only requires reassurance and periodic follow-ups
38
VSD s/s moderate to large defect
CHF common
39
VSD treatment - spontaneous closure
occurs 20-60% of the time - depends on size of defect and the age of the child
40
VSD treatment small defects
sutures
41
VSD treatment large defects
patches
42
VSD palliative care
pulmonary artery banding with the goal to decrease pulmonary blood flow
43
preferred approach in VSD
complete repair in infancy
44
PDA shunting
left to right shunt
45
PDA patho
failure of the ductus arteriosus to close within the first 3 weeks of life
46
small PDA s/s
asymptomatic
47
large PDA s/s
CHF, FTT, *machinery like murmur* with frequent respiratory infections
48
PDA non surgical treatment
indomethacin (close), prostaglandin (open) and coils
49
indomethacin is used in X2
premature infants and some newborns
50
PDA surgical treatment
ligation
51
tetraology of fallot patho
4 cardiac defects - VSD, pulmonary stenosis, overriding aorta, right ventricular hypertrophy
52
tetraology of fallot s/s X4
cyanosis, tachypnea, clubbing and growth retardation
53
tet spells preceded by
feeding, crying, defecation or stressful procedures
54
tet of fallot shunting
right to left shunt
55
tet spells occur during X YOL before X months old and usually at X time of day
1st year of life, usually before 2 months old and usually in the morning
56
what are tet spells
acute episodes of cyanosis and hypoxia
57
tet spells nursing interventions X4
knee chest positioning, blow by 100% O2, morphine, IVF replacement
58
tet of fallot treatemtn
prevent infections, monitor/treat anemia, surgical correction
59
surgery for tet of fallot
palliative shunt with complete repair at 6 mo-1 yr
60
coarctation of aorta patho
narrowing of aorta at or near the ductus arteriosus
61
coarctation of aorta s/s
elevated BP in arms with bounding pulses, decreased BP in legs with weak/no pulses, cool lower extremities
62
coarctation of aorta treatment - non surgical
infants and children - balloon angioplasty
adolescents - stent placement
63
coarctation of aorta treatment - surgical post op complications
HTN and recoarctation
64
aortic stenosis patho
narrowing of the aortic valve from 3 to 2 leaflets
65
aortic stenosis leads to X4
left ventricular enlargement, decreased cardiac output, left ventricular hypertrophy, increased left atrial pressure
66
aortic stenosis s/s mild to moderate
asymptomatic
67
aortic stenosis s/s severe in newborns
decreased cardiac output, faint pulses, hypotension, tachycardia, poor feeding
68
aortic stenosis s/s severe children
*chest pain, SOB, syncope*, exercise intolerance, dizziness
69
aortic stenosis physical restrictions in mild cases
able to participate in most sports and activities
70
aortic stenosis physical restrictions in mod-severe cases
no sustained strenuous activities, no competitive sports
71
the only heart defect where activity may be restricted
aortic stenosis
72
non-surgical aortic stenosis treatment
balloon valvuloplasty
73
surgical aortic stenosis treatment
valvotomy, valve replacement
74
pulmonic stenosis patho
narrowing of pulmonary valve or artery
75
mild pulmonic stenosis s/s
asymptomatic or mild cyanosis
76
mod-severe pulmonic stenosis s/s
CHF and requires elective treatment
77
non-surgical pulmonic steonsis tx
balloon valvuloplasty
78
surgical pulmonic stenosis tx
valvotomy and valve replacement
79
hypoplastic left heart syndrome patho
underdevelopment of the left side of the heart d/t hypoplastic left ventricle, aortic atresia with oxygenation dependent on ASD or PFO and systemic blood flow is dependent on PDA
80
HLHS s/s
mild cyanosis, heart failure, lethargy, cold hands and feet
81
normal O2 level in HLHS
75-80%
82
HLHS treatment
staged reconstruction (3 operations), heart transplant
83
HLHS prognosis without treatment
fatal within 3 weeks of life
84
HLHS medication
prostaglandin infusion
85
right sided failure
right ventricle is unable to pump blood effectively into pulmonary artery
86
left sided failure
left ventricle is unable to pump blood into the systemic circulation
87
digoxin method of action
effects the rate and power of contraction
88
DNU digoxin in infants when X
90-110
89
DNU digoxin in children when X
below 70
90
captopril
ACE inhibitor
91
enalapril
ACE inhibitor
92
lisinopril
ACE inhibitor
93
carvediolol
beta blocker
94
furosemide
diuretic
95
chlorothiazide
diuretic
96
spirnolactone
diuretic
97
infection endocarditis patho
infection of the valves and inner lining of the heart caused by bacteria that enter the blood stream and settle in the heart lining, heart valve or blood vessel
98
infective endocarditis treatment
blood cultures, abx, surgery, echo
99
highest risk for infective endocarditis
children who have undergone surgical repair/palliative surgery for valvular abnormalities, prothetic valves, conduits/shunts
100
infective endocarditis prognosis
fatal if untreated
101
infective endocarditis s/s
hx of dental procedure with a new murmur or change in existing one
102
infective endocarditis prevention
good oral hygiene and amoxicillin 1 hr before dental procedures
103
rheumatic fever patho
inflammatory disease that occurs as a rxn to GABHS pharyngitis
104
rheumatic fever s/s
usually 2-4 weeks after a strep throat infection, elevated ASO titer, polyarthritis, erythema marginatum, chorea, arthralgia
105
erythema marginatum
round, 2 circle rash - characteristic for rheumatic fever
106
rheumatic fever complications
inflammation in joints, skin, brain, serous surfaces, and heart - most common mitral valve damage
107
rheumatic fever treatment
10 day PCN with aspirin and prednisone
108
kawasaki disease patho
acute systemic vasculitis
109
kawasaki risk factors
males, asians, kids under 5
110
kawasaki diagnostic
elevated CRp and ESR and Plt
111
kawasaki acute phase
fever for 5+ **very irritable**, erythema/edema of hands/feet, strawberry tongue
112
kawasaki subacute phase
desquamation of fingers/toes
113
kawasaki convalescent phase
begins when all clinical signs start to resolve 6-8 weeks after onset
114
kawasaki treatment
IVGG - high doses, aspirin,
