ch 26 cardio-2

Question 1

pulmonic stenosis-5

Answer 1

1. Obstruction of blood flow from the right ventricle to the pulmonary artery.
2. Causes right ventricular hypertrophy
3. Second most common congenital heart defect
4. Treated by balloon valvuloplasty during heart cath for mild cases
5. Surgically repaired for more serious cases

Question 2

pulmonic stenosis-s/s-5

Answer 2

• may be asymptomatic

- moderate/severe- dyspnea, fatigue w exertion, heart fail, chest pain

Question 3

tetrology of fallot- the 4

Answer 3

Pulmonic stenosis
Right ventricular hypertrophy
Ventricular septal defect
Overriding aorta

Question 4

tetrology of fallot general info-3

Answer 4

1. One of the most common congenital heart defects causing cyanosis
2. Increased pressure within the right side of the heart causing a right to left shunt-causing a cyanotic disease
3. Typically appears as a “boot” on CXR

Question 5

tetrology of fallot s/s-4

Answer 5

1. as ductus arteriosus closes becomes hypoxic and cyanotic
2. degree of stenosis determines symptoms
3. instinctive squat
4. surgical repair

Question 6

transpostion of the great arteries-5

Answer 6

1. Pulmonary artery is the outflow tract for the left ventricle and the aorta is the outflow tract for the right ventricle
2. 2 parallel circulation patterns without mixing of oxygenated blood and unoxygenated blood
3. One of the most common causing cyanosis
4. Life threatening at birth and survival depends on a method for mixing of blood (PDA, ASD, VSD)
5. Murmur heard if a VSD is present, otherwise typically no murmur present

Question 7

transpostion of the great arteries s/s-3

Answer 7

1. cyanosis at birth does not improve w O2
2. TachyP 60+
3. feed difficulties

Question 8

transpostion of the great arteries tx

Answer 8

prosaglandinE to keep ductus arteriosus open

Question 9

defects obstructing blood flow general s/s-5

Answer 9

CHF, pulm edema, BP 10-15 higher in legs is now lower, low cardiac output, necrotizing enterocolitis

Question 10

aortic stenosis-3

Answer 10

narrowing of aortic valve obstructs systemic blood flow

• bicuspid
• left vent heart fail

Question 11

aortic stenosis s/s-2

Answer 11

1. asymptomatic

2. normal BP w narrow pulse pressure and weak peri pulse

Question 12

coarctation of the aorta-2

Answer 12

narrowing or constriction of the descending aorta obstructs systemic blood flow
-treat w PGE and balloon

Question 13

coarctation of the aorta s/s-4

Answer 13

1. asymptomatic
2. cyanosis in lower extremities, heart fail, shock when ductus arteriosus close
3. lower BP in legs and higher in arms
4. systolic ejection murmur

Question 14

digoxin-3

Answer 14

1. increase contractility
2. HR for 1 min before giving
3. monitor for toxicity

Question 15

furosemide-2

Answer 15

1. rapid diuresis

2. monitor for hypokalemia

Question 16

spironolactone-2

Answer 16

1. maintenance diuretic

2. ass fl and electrolyte imbalance

Question 17

propanolol-3

Answer 17

1. increase contractility
2. mon I&O, daily weight
3. Na restriction

Question 18

dilated cardiomyopathy-3

Answer 18

-emboli from pooling, CHF, arrhythmias-cardiac arrest

Question 19

hypertrophic cardiomyopathy-2

Answer 19

-rigid vent walls, sudden death

Question 20

infective endocarditis-3

Answer 20

recurrent fever, new murmur, prophylaxis

Question 21

rheumatic fever-5

Answer 21

group A strep

-carditis, polyarteritis, erythema marginatum, aimless movements

Question 22

Kawasaki disease-2

Answer 22

high fever more than 5 days, IV immune globulin