Congenital Heart Defects

Question 1

Right to Left Blood Flow is Serious and causes Hypoxia

Truncus Arteriousus & Tricuspid Atresia ( Less Tested)

Name the 2 more tested

Answer 1

Tetrology of Fallot

Transposition of the great arteries

Question 2

Right to Left Blood Flow is Serious and causes Hypoxia

S/S Polycythaemia

Why is this dangerous & what is a priority intervention

Answer 2

Polycythaemia

Excessive RBC

They can Clot together and cause a CVA (stroke)

Priority Intervention: Hydration

Question 3

Always report a hemoglobin over ____ to HCP

Answer 3

22

Question 4

Name S/S associated with Right to Left Blood Flow

Answer 4

Cyanosis, Poor Feeding, Clubbed Fingers, Dyspnea, Tachycardia, Polycythaemia (excess RBC)

Question 5

Primary reason for a newborn with congenital heart disease to be well-hydrated

Answer 5

Reduce the risk of CVA

Question 6

Cyanotic congenital heart defect. The nurse understands that chronic hypoxia from this disorder can result in which finding.

Answer 6

Polycythaemia

Question 7

Congestive heart failure

(Right to left) or (Left to Right)

Answer 7

Left to Right- less serious than Right to left

Question 8

Congestive heart failure

S/ S
Most important
Describe skin
Eyes
Diapers
During feeding

Answer 8

Weight gain

Skin: Pale, Cool extremities
Eyes: Puffyness around (periorbital edema)
Diapers; Fewer
Feeding: Diaphoresis & Grunting

Question 9

Child diagnosed with Right-to-Left shunt… which is the most common finding?

Answer 9

Blueish discoloration of the skin

Question 10

During Hypercyanotic Spell of TOF

Interventions
Infant
Older children

Answer 10

Infant: Knees to Chest
Older children: Squatting Posistion

Question 11

Prevention of cyanosis in TOF

Don’t
Do

Answer 11

Don’t interrupt sleep

Do offer a pacifier during crying
Do small & frequent meals

Question 12

1. Treatment for TOF

Answer 12

1. Surgical repair

Which post op findings indicate surgery was successful

Absence of Cyanosis when feeding
Lips pink when crying
32 breaths per minute

Question 13

Decreased feedings
Reduction in Wet Diapers
Pale, cool extremities
Periorbital edema
Weight gain

Report all of these to a HCP

Which disease are they associated with

Answer 13

Heart Failure

Question 14

Reversal of the 2 main arteries leaving the heart

Pulmonary Artery & aorta

Is called….

Answer 14

Transposition of the Great Vessels

90% fatal if not corrected in 1st year

Question 15

(Left to Right) or (Right to Left)Cardiac Shunts

S/S

Diaphoresis (During Feeding)
Heart Murmur
Poor weight gain
Increased Risk: Heart Failure/ Pulmonary HTN

Answer 15

Left to Right

Question 16

Left to Right Blood flow

ASD
Atrial Septal Defect (Hole in Septum)

This finding ____ is normal and to be expected

Treatment….

Answer 16

Murmur is normal and to be expected

Treatment closes naturally/ Surgical repair

Question 17

VSD

Ventricular Septal Defect
Hole between the ventricles

S/S

_____ during feeding (increased respitory effort)

Systolic heart murmur (left sternal border)

Treatment….

Answer 17

Grunting during feeding

Treatment: Closes naturally/ Surgical repair

Question 18

Machinery-like murmur on Ausculation of the heart and signs of heart failure…which disorder

Answer 18

PDA
Patent Ductus Arterious

Question 19

Surgical repair for PDA patent ductus arteriosus is preformed to prevent which complications….

Answer 19

Worsening of Pulmonary Vascular Congestion

Question 20

What does Stenosis mean

Answer 20

Stiffness & Narrowing

Question 21

Pulmonic Stenosis

Symptoms

Right Ventricular ____
Loud “systolic ejection” heart murmur

Treatments

Answer 21

Right Ventricular Hypertrophy

Treatments
Ballon angioplasty
Surgical Repair: Valveotomy

Question 22

Aortic Stenosis

Symptoms
(Decreased/ Increased) Cardiac output
Vital signs: BP / HR

Answer 22

Decreased

Low BP / tachycardia

Question 23

Which cardiac defect causes narrowing of the aortic valve

Answer 23

Aortic Stenosis

Question 24

Decreased cardiac output

S/S
Upper extremities:
High BP, Bounding Pulse

Lower extremities:
Cool, Low BP & Diminished Pulse

Treatment

Answer 24

COA
Coarctation of Aorta

(Narrowed Aorta)

Treatment
Balloon Angioplasty
Stents

Question 25

Cardiac Catheterization

Before
Assess for alargy to
NPO Status?
Report what?

Answer 25

Iodine. Used as a contrast dye

NPO, Yes 4 - 6 hrs for children
Shorter NPO for infants

Report Diaper Rash.
Can introduce bacteria into blood steam

Question 26

Cardiac Catheterization
After

Priority Assessments
Pulses Distal to cath site.
Which of the following is normal

Weak Pulses
Cool extremities
Pale extremities

Straighten leg (how long)

No baths immediately afterward to prevent infection

Answer 26

Weak Pulse is normal after cardiac Catheterization

Cool, Pale extremities is not

Straighten Leg 4 - 8 hrs

Question 27

After cardiac Catheterization the nurse assesses that the pedal pulse distal to the insertion site is weaker.

Which is the nurses best action

Answer 27

Record data

This is a normal findings

Question 28

After cardiac Catheterization of a child which assessment Findings is most concerning for a nurse

Answer 28

Affected extremity Cool to touch

Question 29

Chest tube monitoring (Infant)

Report to HCP

1hr Over _____ mL/ kg
3 hrs Over ___ mL / kg / hr

Indicates: Severe bleeding & cardiac tamponade

Answer 29

1hr Over 5 - 10 mL/ kg
3 hrs Over 3 mL / kg / hr

Question 30

Surgical repair of a congenital heart defects

Most important for the nurse to include in the post op care plan

Answer 30

Elevate the clients head to reduce respitory effort

Question 31

Can you apply lotion or powder to an incision site after surgery?

Answer 31

No risk for infection