cardiovascular part 3 (2)

Question 1

Match the congenital heart defects with their blood flow!
(a= increased pulmonary flow; b= decreased pulmonary flow; c= obstructed systemic flow)
1. atrial septal defect (ASD)
2. ventricular septal defect
3. coarctation of aorta
4. tatralogy of fallot
5. patent ductus arteriosis
6. pulmonic stenosis

Answer 1

1a, 2a, 3c, 4b, 5a, 6b

Question 2

With increased pulmonary blood flow congenital defects, what side of the heart has greater pressure

Answer 2

left

Question 3

what determines the defect symptoms and increased pulmonary blood flow defacts?

Answer 3

size of defect

Question 4

What is an opening in atrial septum that permits left to right shunting of blood

Answer 4

atrial septal defect

Question 5

What symptoms do infants and young children show with atrial septal defect

Answer 5

asymptomatic

Question 6

one are small to mid sized atrial septal defects diagnosed?

Answer 6

preschool or later

Question 7

Describe the correlation between atrial septal defect and CHF?

Answer 7

rarely have CHF

Question 8

What is the usual clinical therapy for smaller atrial septal defects?

Answer 8

Spontaneous closure within the first four years

Question 9

What happens when an atrial septal defect is large or not closed by three years?

Answer 9

Transcatheter closure, device placed during. cardiac cath

Question 10

How long does it take for the heart size to return to a normal after surgical repair of large atrial septal defect?

Answer 10

4-6 months

Question 11

One month old Sarah comes to the health care provider’s office for her one month checkup. She had a small murmur noted at her one week check up. Mom tells you that Sarah’s bottle ticks 40 minutes for her to finish. She becomes diaphoretic with bottle feeding. Past couple days Mom says she has become purple when fussy.

poor weight gain, cardiac enlargement, and pneumonia found

echo shows right ventricular hypertrophy and hole in sseptum between left and right ventricles

which defect does she have

Answer 11

ventricular septal defect

Question 12

What complications can come from moderate and large ventricular septal defects?

Answer 12

CHF, Inc pulmonary infactions, and pukmknary hypertension, delayed growth, failure to thrive

Question 13

Can a ventricular septal defects increase in size?

Answer 13

no

Question 14

How are small ventricular septal defects usually solved?

Answer 14

Usually close on their own within six months

Question 15

how are moderate or large ventricular septal defects fix?

Answer 15

surgery

Question 16

What are clinical manifestations of ventricular septal defect?

Answer 16

Congestive heart failure symptoms, pulmonary infections, pork growth, and failure to thrive

Question 17

Which test establishes a diagnosis for ventricular subtle defect?

Answer 17

echo

Question 18

What is important to feel for around a chest tube?

Answer 18

crepitis

Question 19

What is crepitus and what does it feel like?

Answer 19

It’s an air leak in the subcutaneous tissue, it feels like rice crispies

Question 20

what is needed at the bedside when a patient has a chest tube?

Answer 20

1. Vaseline gauze (for leaks)
2. 2 hemostats (to connect separated tuBing)

Question 21

what is there an increased risk for after surgery for ventricular septal defect?

Answer 21

arrythmia and heart blocm

Question 22

Which congenital results has blood shunted on the aorta to the pulmonary arteries?

Answer 22

Paren’t ductus arteriosis

Question 23

what kind of infants are most at risk for patent ductus arteriosis

Answer 23

premature infants

Question 24

clinical manifestations ductus arteriosis

Answer 24

dyspnea, tachypnea, tachycardia, full bounding puless, widened pulse pressure

Question 25

what kind of manifestations are seen in a large patent ductus arteriosis

Answer 25

Congestive part failure, intercostal retractions, hepatomegaly, poor growth and development

Question 26

What is the treatment of patent ductus arteriosis

Answer 26

surgical ligation, insertion of coli

Question 27

HIV medications can stimulate culture of patent ductus arteriosis in premature infants?

Answer 27

IV ibuprofen or indomethacin

Question 28

10 y.o. Is brought in five PMS to the emergency department. mother called 911 because her baby was not acting right and turning colors while feeding. RR 70(high), HR good, pox 90 low, BP good, brachial/radial bounding pulses, femoral/pedal pulses weak CXR showed cardiomegaly, BP higher in upper extremities which congenital heart disorder?

Answer 28

coarctation of the aorta

Question 29

which ccongenital heart defect is narrowing or construction of the descending aorta which obstructs a systemic blood flow

Answer 29

coarctation of aorta

Question 30

What about coarctation of the sorts causes higher bps in upper than lower extremities

Answer 30

decreased blood flow through descending aorta

Question 31

how is coarctation of aorta diagnosed

Answer 31

CXR, cardiomegaly, pulmonary venous congestion, indentation of descending aorta

Question 32

what were the two surgical treatments of coarctation of aorta

Answer 32

1) Surgical resection of the narrowed aorta and anastomosis 2) Area that is narrow may be dilated with a balloon during a cardiac cath

Question 33

why does polycythemia occur in decreased pulmonary blood flow defects

Answer 33

excessive production of red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues

Question 34

What is the narrowing of a palmonic valve or valve area

Answer 34

pukmonic valve stenosis

Question 35

which part of the heart is affected by pulmonic stenosis and how?

Answer 35

Right ventricular hypertrophy

Question 36

what is the clinical therapy of pulmonic stenosis

Answer 36

dilation by balloon valvuloplasty during cardiac calf or surgical resection

Question 37

What kind of prophylaxis is necessary for pulmonic stenosis and for how long

Answer 37

lifelong infective endocrarditis prophylaxis

Question 38

What are the four defects that make up tetralogy of fallot

Answer 38

1. pulmonic stenosis 2. right ventricular hypertrophy 3. ventricular septal defect 4. overriding aorta

Question 39

what's an overriding aorta

Answer 39

the aortic valve is enlarged and appears to arise from both the left and right ventricles instead of just the left

Question 40

when is tetraoly of fallout usually diagnosed

Answer 40

first few days of life

Question 41

When does the infant become hypoxic and cyanotic with tetraolgy of fallot

Answer 41

when the ductus arteriosis ckoses

Question 42

what determines the severity of cyanosis and symptoms in tetraology of fallot

Answer 42

degree of pulmonic stenosis

Question 43

what is a "Tet spell"

Answer 43

hypercyanotic episode in tetrilogy of fallot

Question 44

what are hypercyanotic episodes in tetralogy of fallout caused by?

Answer 44

crying, feeding, warm bath, bowel mvmt

Question 45

what to do during a tet spell (TOF)

Answer 45

Place infant in knee trust position, calm them, oxygen, morphine to suppress respirations, beta blockers to reduce heart rate and muscle spasm, PRBCs if anemic, iv fluid

Question 46

diagnosis of tet of fallot

Answer 46

CXR, EKG, echo

Question 47

When is immediate surgical intervention required for tet of fallot

Answer 47

a hypercyanotic ep

Question 48

What device is used after surgery for tet of fallot

Answer 48

pacemaker

Question 49

How long does it take for the heart to completely heal after surgery for tet of fallot

Answer 49

4-6 mo

Question 50

An increased pulmonary blood flow defect has what type of blood shunting?

Answer 50

left to right

Question 51

Which defect repair may have an additional risk for arrhythmias due to the normal conduction of the heart

Answer 51

Ventricular septal defect

Question 52

which congenital heart defect has a distinctive murmur which helps in identifying the defect prior to diagnostic testing

Answer 52

patent ductus arteriosis

Question 53

Which defect is a decreased pulmonary blood flow defect

Answer 53

pulmonic stenosis

Question 54

what would be part of your incision assessment in an infant with surgical repair of a congenital heart defect

Answer 54

Color, temperature, drainage, edema, approximation