cardiovascular part 2 (2)

Question 1

where is arterial blood pumped in a fetus in utero

Answer 1

right side of heart

Question 2

does blood go through the fetus lungs in utero?

Answer 2

no, rerouted

Question 3

what is the fetal vascular channel between the pulmonary artery and the descending aorta

Answer 3

ductus arteriosis

Question 4

where does the majority of blood pumped by the right side of the heart go to?

Answer 4

ductus arteriosis

Question 5

what is the fetal opening in the atrial septum, takes blood from right atrium to left atrium

Answer 5

foramen ovale

Question 6

what stimulates the foramen ovale to close?

Answer 6

increased left atrium pressure

Question 7

when does foramen ovale close

Answer 7

shortly after birth?

Question 8

when does the ductus arteriosis close, and by when is it permanently close?

Answer 8

closes within 10-15 hours after birth, permanently after 10-21 days of birth

Question 9

what does a patent ductus arteriosis cause?

Answer 9

oxygenated blood from aorta to lead into unoxygenated blood in the pulmonary artery

Question 10

when does the heart develop in gestation

Answer 10

4th-7th weeks

Question 11

when do most cardiac defects develop in utero

Answer 11

8th week

Question 12

what are some factors that can contribute to congenital heart disease

Answer 12

• maternal drug/alc use
• maternal viral infections
• maternal metabolic disorders
• genetics
• increased age
• chromosomes

Question 13

what is an increased pulmonary blood flow defect with a defect in the right atrium

Answer 13

atrial septal defect

Question 14

how does blood shunt in atrial septal defect

Answer 14

left → right

Question 15

what kind of symptoms will occur with atrial septal defect

Answer 15

heart failure symptoms

Question 16

which defect is an opening between ventricles

Answer 16

ventricular septal defect

Question 17

describe ventricular septal defects pressure and blood flow

Answer 17

increased pressure on the left side, shunts left to right, increased pulmonary blood flow

Question 18

what symptoms will occur in ventricular septal defect`

Answer 18

heart failure symptoms

Question 19

when is patent ductus arteriosis classified?

Answer 19

if it does not close by 21 days

Question 20

where is blood shunted from and to in patent ductus arteriosis

Answer 20

from aorta to pulmonary artery

Question 21

what kind of blood flow is in patent ductus arteriosis

Answer 21

increased pulmonary blood flow

Question 22

where is the most pressure in a patent ductus arteriosis defect

Answer 22

aorta

Question 23

what defect is narrowing of the descending aorta

Answer 23

coarctation of the aorta

Question 24

what kind of blood flow does coarctation of the aorta have

Answer 24

obstructed systemic blood flow (restricted flow from aorta = less to the body)

Question 25

where does coarctation of the aorta restrict flow from?

Answer 25

the left ventricle

Question 26

what are signs and symptoms of coarctation of the aorta dependent on?

Answer 26

size of the defect

Question 27

which defect is a cyanotic heart defect

Answer 27

tetralogy of fallot

Question 28

what kind of bloodflow does tetralogy of fallot have?

Answer 28

decreased pulmonary blood flow

Question 29

what are the 4 defects that make up tetralogy of fallot?

Answer 29

1. right ventricular wall hypertrophy (narrowing) 2. narrowing of pulminary valve (pulmonic stenosis) 3. ventricular septal defect 4. overriding aorta

Question 30

what causes the right ventricle hypertrophy in tetralogy of fallot

Answer 30

pulmonic stenosis causes the right ventricle to work harder than it should

Question 31

where is the shunting of blood in tetralogy of fallot

Answer 31

there is none

Question 32

why is there decreased pulmonary blood flow in tetralogy of fallot?

Answer 32

pulmonic stenosis (narrow pulmonsry valve)

Question 33

which procedure has a radiopaque catheter inserted into the heart from a peripheral blood vessel, has contrast media put through

Answer 33

cardiac cath

Question 34

what can assess congenital heart defects, valve disease, and coronary heart disease

Answer 34

cardiac cath

Question 35

where does a cardiac cath measure oxygen saturation

Answer 35

in the hearts chambers and great arteries

Question 36

where dies a cardiac cath measure pressure gradients

Answer 36

pulmoanry vessels and heart chambers

Question 37

how long is rpessure held on a cardiac cath afterward?

Answer 37

15 mins

Question 38

describe dressing assessment intervals directly after a cardiac cath

Answer 38

every 5 min for 15 mins, every 15 mins for 1 hour, then hourly

Question 39

which vital signs indicate bleeding

Answer 39

increased pulse and decreased bp

Question 40

wha tcan contrast media cause

Answer 40

diuresis (watch I&O)

Question 41

how long should the HOB be flat for after a cardiac cath

Answer 41

4-6 hours

Question 42

where should pressure be held if a cardiac cath site bleeds?

Answer 42

an inch above the site (inch closer to heart, this is on leg)

Question 43

what is when cardiac putput is inadequate to support the bodys circulatory and metabolic needs

Answer 43

congestive heart failure

Question 44

what is congestive heart failure cuased by?

Answer 44

congenital heart defect or acquired heart disease

Question 45

what are some clinical manifesttions of CHF in infants

Answer 45

* tires easily, with feeds especially * weight loss or lack of gain * diaphoresis (esp. feeding) * frequent resp infections * color changes; mottling or pallor

Question 46

CHF clinical manifestations in toddler/older child

Answer 46

* exercise intolerance * dyspnea * abd pain/distention * peripheral edema

Question 47

what does pulmonary venous cingestion (left sided HF) in CHF look like?

Answer 47

* tachypnea, wheezing, crackles, retractions, cough, dyspnea, grunt, flare, cyanosis

Question 48

what does systemic venous congestion (right sided HF) in CHF look like?

Answer 48

* tender/enlarged liver * ascites * periorbital edema * peripheral edema * weight gain * neck vein distention

Question 49

Which diagnostic method of congestive heart failure shows cardiac enlargement in venous congestion or signs of pulmonary edema

Answer 49

CXR

Question 50

Which diagnostic tool of congestive heart failure confirms the diagnosis, and shows cardiac defects or ventricular dysfunction

Answer 50

Echocardiogram

Question 51

which diagnostic method of congestive heart failure identifoes arrythmias

Answer 51

electrocardiogram

Question 52

goals of CHF?

Answer 52

* treat the cause * make the hard work more efficiently and remove excess fluid

Question 53

Which medications promote fluid excretion in congestive heart failure

Answer 53

diuretics like furosemide

Question 54

what needs supplemental when on diuretics?

Answer 54

potassium

Question 55

Which medications for congestive heart failure are used to decrease blood pressure, therefore decreasing the workload of the heart

Answer 55

angiotensin converting enzyme (ACE) inhibitors (captopril), and beta blockers!!!! (propranolol)

Question 56

what is the most common sign of digoxin toxicity in congestive heart failure treatment

Answer 56

arrythmias

Question 57

which medication for congestive heart failure slows the heart rate, increases cardiac filling time and myocardial contractility to improve systemic circulation

Answer 57

digoxin

Question 58

What kind of dosing is used with digoxin?

Answer 58

loading dose and then maintenance dose

Question 59

Which heart rates lead to digoxin being held in infants and children?

Answer 59

infants = <90, children = <70

Question 60

A decrease in which electrolyte increases the risk of digoxin toxicity?

Answer 60

potqssium

Question 61

What kind of diets are recommended for infants with congestive heart failure?

Answer 61

High calorie formula and NG feeds

Question 62

What kind of meals should an older child with CHF have?

Answer 62

small frwqunt meals

Question 63

What position is best for CHF?

Answer 63

semi-fowlers

Question 64

Fetal circulation includes which of the following? 1. ductus arteriosis 2. foramen ovale 3. pulmonary artery 4. pulmonary vein

Answer 64

1 and 2

Question 65

Diagnosis and testing for CHF would include? 1. EKG, CXR, and ultrasound 2. Stress test, cardiac catheterization, EKG 3. EKG, CXR, echocardiogram, cardiac catheterization 4. Echocardiogram, cardiac catheterization

Answer 65

3

Question 66

T or F? cardiac catheterization puts the infant or child at risk for arrhythmias

Answer 66

true

Question 67

early clinical manifestations for an infant with congestive heart failure could include which of the following? choose all 1. Inc weight gain 2. eager eater 3. emesis 4. poor weight gain 5. bottle feeding taking longer than 30 min

Answer 67

4 and 5

Question 68

Two month old infant is admitted with congestive heart failure. Which would be a daily nursing intervention 1. weight 2. Elevating head of bed 3. small frequent meals 4. assessment q8h

Answer 68

1