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Flashcards in Congeital Heart Defects Deck (55):
0

Embryonic development of heart is by ______ weeks

12 weeks

1

Shunts for fetal circulation

Ductus venosus
Foremen ovale
Ductus arteriosis

2

Foremen ovale shunts blood from which ____ side to the ______ side

Left to right

3

Ductus arteriosus shunts blood from the...

Lungs

4

Path of fetal circulation

From mother, to fetus via umbilical vein, through fetal circulation...
Returns partially oxygenated and deoxygenated blood to mother via umbilical arteries

5

Incidence of congenital heart defects

5 to 8 in every 1000 live births

6

Congenital heart defects have an increased incidence in what kind of babies/births?

Premature, stillborns, low birth weight infants, and spontaneous abortions

7

Two major groups of heart defects are...

Congenital heart defects and acquired cardiac disorders

8

Types of congenital heart defects

Congestive heart failure and hypoxemia

9

Acquired cardiac disorders are from...

Infection, autoimmune responses, environmental factors, familial

10

Prenatal and maternal factors for congenital heart defects

Rubella, alcohol abuse, older than 40, type 1 diabetes

11

Genetic factors that put infants at risk for congenital heart defects

Sibling with a defect, parent with CHD, chromosomal problem, born with other noncardiac abnormality

12

What is pulmonary congestion?

A backup of fluid into lungs

13

What is a right to left blood shunt and the results of it?

Blood from right side enters left side of heart and causes hypoxemia, cyanosis, and polycythemia

14

What is polycythemia?

Increased viscosity in the blood because there are more RBCs than needed, prone to strokes

15

What is a left to right shunt and results of it

Blood flow from the high pressured left side to low pressure right side and causes tachypnea, dyspnea, and pulmonary edema

16

Symptoms of pediatric pulmonary hypertension

Tachycardia- over 160, tachypnea- over 60, s3 and s4 heart sounds, dyspnea, diaphoresis, easily fatigued,

17

What are acyanotic defects?

Increased pulmonary blood flow, ASD, VSD, PDA

18

What are cyanotic defects?

Decreased pulmonary blood flow, tetrology of fallot, transportation of great arteries

19

What is atrial septal defect (ASD)?

An abnormal opening between the right and left atrium from an incompetent foremen ovale and cause incorrect development of atrial septum

20

Clinical manifestations of Atrial septal defect

Can be asymptomatic, congestive heart failure symptoms, a murmur, and atrial dysrhythmiasw

21

Treatment of atrial septal defect (ASD)

Surgical with a Dacron patch or no surgical with cardiac catheterization

22

Surgical treatment of ASD requires...

Bypass and a 4-6 day stay

23

What is ventricular septal defect (VSD)?

An abnormal opening between the left and right ventricles

24

Types of ventricular septal defects

Membranous and muscular

25

Clinical manifestations of ventricular septal defect

CHF, murmur, bacterial endocarditis, eisenmenger syndrome

26

Ventricular septal defect treatment

Surgical (palliative or a repair)
Nonsurgical with cardiac cath
Need bypass

27

What is Patent Ductus Arteriosus (PDA)?

Failure of ductus arteriosus to close after the first weeks of life. Blood flow is altered. Increased workload on left side of heart

28

Patent Ductus Arteriosus (PDA) blood flow alteration

Left side of heart has increased workload -- increases pulmonary vascular congestion and resistance, potential increase in right ventricular pressure and hypertrophy.

29

Clinical manifestations of patent ductus arteriosus (PDA)

Asymptomatic, CHF symptoms, machinery like murmur (humming top), widened pulse pressure, bounding pulse

30

Treatment of patent ductus arteriosus (PDA)

medical- endocin, or surgical is open heart surgery

31

What is Coarctation of the Aorta (COA)?

Narrowing of the aortic arch near the insertion of the ductus arteriosus with increase pressure near the narrowing and decreased pressure distal to the narrowing-- causes ventricular workoverload

32

Clinical manifestations of coarctation of the aorta (COA)?

increased BP, bounding pulses, weak/absent femoral pulses
Cool lower extremities, symptoms worsen
dizziness, faintness, headaches, increased BP

33

Treatment of coarctation of the aorta (COA)?

Surgical or nonsurgical

34

What is tetrology of fallot (TOF)?

When right ventricle contracts, blood resistance occurs related to pulmonary stenosis. Blood is shunted across ventricular septal defect, into the aorta, and the left ventricle gives persistent arterial unsaturation--- CYANOSIS

35

Four main defects of tetrology of fallot (TOF)?

Pulmonary stenosis, ventricular septal defect, overriding aorta, right ventricular hypertrophy

36

Clinical manifestations of tetrology of fallot (TOF)?

Cyanosis, clubbing, systolic murmur, delayed growth and development, hypoxia, tet spells, squatting

37

Risks associated with tetrology of fallot (TOF)?

Emboli, brain abscesses, seizures, loss of consciousness,

38

Treatment of Tetrology of fallot (TOF)?

surgical- palliative- Balock-Taussig or Modified Blalock-Taussig Shunt and a complete repair in the 1st year of life

39

What is Transposition of the Great Areries and Transposition of the Great Vessels (TGA/TGV)?

When the pulmonary artery leaves the left ventricle and the aorta exits the right ventricle with no communication between the systemic and pulmonary circulations- mixed defect

40

What is basically happening with TGA and TGV?

the aorta and pulmonary artery are switched.

41

What are symptoms of TGA and TGV?

dependent on type and size of defects

42

Treatment of TGA/TGV

therapeutic prostaglandin and increased oxygen
Cardiac catheterization- rashkind
surgical- transection and anastomosis

43

Nursing Care- Patient history

family history of heart disease- sibilings too
contact with teratogens- infections, drugs, alcohol
history of genetic chromosomal abnormality
poor weight gain and appetite
Respiratory infections, heart murmurs, cyanosis

44

Assessment of clinical manifestations

activity intolerance with/without color changes, rest periods, weight gain/loss, difficulty eating and sucking, unusual position, skin assessment, lab studies, Tets

45

Physical Assessment of Peds patient

VS, Inspect skin, posture, clubbing, Palpate peripheral pulses and cap refill, Percuss liver size, Auscultate apical pulse, murmurs, lungs

46

Diagnostic procedures for Ped cardiac defects

Chest Xray, ECG, Echo, TEE, Cath, Stress test, MRI

47

How to hook up leads

Right side- White side
Left side- black on top, red/green on bottom (smoke over fire)

48

What is cardiac cauterization?

Diagnostic procedure where radiopaque dye is injected via catheter in a vein and is guided by fluoroscopy into heart chamber

49

Medication for cardiac cath

digoxin q 12 hrs= check HR
ACE inhibitors- --pril
Diuretics- Lasix

50

What is Kawaski disease?

Inflammatory process that causes thickening and scarring of the vascular walls of coronary arteries

51

Acute stage of Kawaski disease

10-14 days- very sick with fever, conjunctivitis, strawberry tongue, hand edema tachycardia

52

Subacute stage of kawaski disease

15-25 days, fever gone, irritable, peeling, coronary aneurysms

53

Convalescent Stage of kawaski disease

26 days until ESR returns to normal and symptoms disappear- beaus lines on nails

54

Treatment of Kawaski Disease

Prevent coronary artery complications, IV immune globulin, antipyretics, aspirin therapy, corticosteroids, no live immunizations