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Flashcards in Exam 3: Cardiac Deck (25):

what are some Pediatric Indicators of Cardiac Dysfunction

Poor feeding
Tachypnea, tachycardia
Failure to thrive, poor weight gain, activity intolerance
Developmental delays
Positive prenatal history
Positive family history of cardiac disease


what are the two types of cardiac defects?

congenital or acquired


congenital cardiac defect?

anatomic, resulting in abnormal function (since birth)


acquired cardiac defect?

Disease process: infection, autoimmune response, environmental response, familial tendencies


what are some maternal/environmental causes of CHD?

if mother has rubella in the first 7 wks, chance of CHD is 50%


what is the major cause of infant death?



what is the most common anomaly of CHD?

ventricular septal defect


blood flows form higher pressure on the left side ot lower pressure on

right side


shunting from left side of heart

to right side --> through defect. which causes CHF


what can be done for kids who have atrial septal defect?

surgical patch & cardiac cath & open heart surgery


ventricular septal defect? what can be done for kids?

most common CHD. rt atrium can enlarge, HF, shunting is left to right, can be asymptomatic, daychron patch, systolic murmur is heard at left sternal border
large VSD: SOB, poor feeds,fatigue, and resp. infections. surgical open heart surgery
risk for: bacterial endocarditis or issues in pulmonary obstructive vascular disease.


patent ductus arterious?

failure for ductus to close in first week of life. left aorta to right pulmonary artery. widened pulse pressure
PDA: machinery like murmur at left subclavicular margin. (hallmark sign) frequent colds, RSV,
-prostoglandin inhibitor (indomethocin)
-coils in ducts to keep it closed


what are the three main obstructive defects?

Coarctation of the aorta

Aortic stenosis

Pulmonic stenosis

***blood exits heart, and meets area of narrowing or stenosis, causes blood flow obstruction. decrease in cardiac output

S/S of HF


coarctation of aorta?

coarc- small narrowing on top. increase pressure in head and upper extremeties compared to lower.

S/S: high blood pressure and bounding pulses in arms, cool extremeties, lower extremeties BP is 10 less than upper extremeties. give digoxin.

-nonsurgical repair (angioplasty or stent) not permanent
-surgical (thoracotomy)


aortic stenosis

-narrowing of aortic valve. left ventricular hypertrophy. hypertension. left vent.
chest pain, fatigue, exercise intolerance, dizziness when standing

-balloon angioplasty is best fix
bacterial endocarditis is risk for kids suffering from this


pulmonic stenosis

narrowing at entrance to pulmonary artery. rt. vent. hypertrophy. may cause reopening of foramen ovale (which is good)
newborns: cyanosis, loud systolic murmur at SB, dyspnea at exercise, fever

-balloon angioplasty (risk for bacterial endocarditis)
-shunt blood from aorta to lungs


decreased pulmonary flow defects types

Tetralogy of Fallot

Tricuspid Atresia

(there's a pumonary issue AND anatomic issue (such as asd or vsd. increase pressure on rt. side of heart, due to diffcicuty of blood exiting. shunting is right to left!

hypoxia and cyanosis


tetralogy of fallot

vsd, overriding aorta, pulm stenosis, and rt. vent hypertrophy. most common cyanotic defect.


shunting with tetralogy of fallot

dependent on resistance between pulmonic or systemic.
if pulmonic is more resistant than systemic, shunting is right to left.
if systemic is more resistant then pumonic, then we're shunting left to right

-left side of heart gets less oxygen
-cyanosis and hypoxia with crying, relief with squatting (tet spells)
systolic murmur
-seen more in morning. space out activities to prevent tet spells.
-risk for embolotic seizures
-surgery, close vsd, reset pulm. stenosis


tricuspid atresia

tricuspid valve fails to develop
-no movement of blood
complete mixing of deox and oxy blood in left side
-severe cyanosis, dyspnea, tachycardia, clubbing of fingers
-prostoglandin E given to get blood circulating
-surgery--> shunt, anastomoses


final group: mixed defects

fully saturated systemic blood mixes with desaturated pulm blood. resulting in desat. systemic blood flow. cyanosis and HF


transposition of arteries

wrong side, backwards. no connection between systemic and pulmonary. blood does not mix.
cyanosis, poor feeds, tachy,


truncus arteriosus

single vessel which overrides vessels. blood from right and left ventricle enter same vessel.

desat and hypoxemia


total anomolous venous connection

pulm. blood flow from rt. atrium instead of left. atrium. enlargement, ASD, (rare)


hypoplastic left heart syndrome

giant right ventricle. fatal if not fixed. small or none left ventricle (which pumps)