Exam 4 Cardio

Question 1

Most common way to diagnose CHD?

Answer 1

Echo, can be done in utero

Question 2

Cardiac Cath

Answer 2

Invasive, cath is guided with fluoroscopy to the heart, dye is injected and the path through the heart is followed

Question 3

Complications of Catheterization

Answer 3

Hemorrhage, fever, n/v, loss of pulse in cathed extremity, transient dysrhythmias

Question 4

Pre op cath

Answer 4

Sedation, NPO, check allergies, locate and mark pulses

Question 5

Post op cath

Answer 5

ECG monitor rath and rhythm, BP, pulse ox, frequent monitoring of extremity (pulse, color, temp) I&O

Question 6

What do you do if bleeding occurs at cath insertion site?

Answer 6

Do not remove dressing. Hold direct pressure 1 in above site, lay child flat, call doc

Question 7

Leg position after cath

Answer 7

Keep straight for 4-8 hrs

Question 8

Cath insertion post op care

Answer 8

Keep free from infection (apply diapers) keep clean and dry, pt may shower only. Avoid strenuous exercise, but may attend school

Question 9

Two types of congenital heart dz

Answer 9

Congestive heart failure and Hypoxemia

Question 10

Normal pressure flow of heart

Answer 10

Left side has a higher pressure than right side.

Question 11

Normal resistance of circulation

Answer 11

Pulmonary circulation has less resistance than systemic circulation

Question 12

Increased pulmonary blood flow leads to what

Answer 12

Congestive heart failure, acyanotic

Question 13

Decreased pulmonary blood flow leads to what

Answer 13

Cyanosis

Question 14

Obstruction to blood flow out of the heart leads to what

Answer 14

Congestive heart failure, acyanotic

Question 15

Mixed blood flow leads to what

Answer 15

Cyanosis, varied s/s

Question 16

The inability of the heart to pump an adequate amount of blood to the systemic circulation

Answer 16

Congestive heart failure

Question 17

When does CHF occur in children?

Answer 17

Secondary to structural problems that cause increased blood volume and pressure in the heart

Question 18

Right sided heart failure

Answer 18

Right ventricle can’t pump effectively into pulmonary artery

Question 19

Left sided heart failure

Answer 19

Left ventricle can’t pump effectively into systemic circulation

Question 20

Right sided heart failure causes increased pressure where?

Answer 20

In the right atrium and systemic venous circulation

Question 21

Left sided heart failure causes increased pressure where?

Answer 21

In the left atrium and pulmonary veins

Question 22

Manifestations of right sided heart failure

Answer 22

HTN, hypatosplenomegaly, edema

Question 23

Manifestations of left sided heart failure

Answer 23

Lungs become congested causing pulmonary edema

Question 24

Polycythemia

Answer 24

Increased number of RBC to increase the oxygen carrying capacity of blood. Increases blood viscosity and increases risk for clots

Question 25

Polycythemia occurs with what?

Answer 25

Hypoxia

Question 26

Abnormal opening between the atria which allows blood from the high pressure LA to shut into the RA

Answer 26

Atrial septal defect

Question 27

Abnormal opening between the right and left ventricle which causes left to right shunting

Answer 27

Ventricular septal defect

Question 28

A low atrial septal defect and high ventricular septal defect, clefts of the mitral and tricuspid valves causing blood to flow between all chambers of the heart

Answer 28

AV canal defect

Question 29

Failure of the fetal ductus arteriosus to close within the first few weeks of life, causing blood to flow from high pressure aorta to low pressure pulmonary artery

Answer 29

PDA

Question 30

Narrowing near the insertion of the ductus arteriosus leading to increased pressure to the hear and upper extremities and decreased pressure to the body and lower extremities

Answer 30

Coarctation of the aorta

Question 31

Narrowing of the aortic valve causing resistance to blood flow out of the LV, decreased CO, LV hypertrophy, and pulmonary vascular congestion

Answer 31

Aortic stenosis

Question 32

Narrowing at the entrance to the pulmonary artery causing RV hypertrophy and decreased pulmonary blood flow

Answer 32

Pulmonic stenosis

Question 33

VSD, pulmonic stenosis, overriding aorta, RV hypertrophy

Answer 33

Tetralogy of Fallot

Question 34

Tricuspid valve fails to develop resulting in no flow from RA to RV. Blood flows from an ASD or PFO to the left side of the heart. Blood flows through a VSD to the right side and to the lungs. Results in complete mixing of unoxygenated blood and oxygenated blood which leads to systemic desaturation. Varying amounts of pulmonary obstruction leads to decreased pulmonary blood flow

Answer 34

Tricuspid Atresia

Question 35

Pulmonary artery leaves the left ventricle and the aorta exits from the RV> no communication between systemic and pulmonary circulation. Need an associated defect (septal, PDA) in order for blood to mix

Answer 35

Transposition of the great vessels

Question 36

Underdevelopment of the left side of the heart leading to hypoplastic LV and aortic atresia. Blood flows from LA through a PFO to the RA>RV>PA. A PDA allows blood to flow to systemic circulation

Answer 36

Hypoplastic left heart syndrome

Question 37

An infection of the valves or lining of the heart

Answer 37

Bacterial Endocarditis

Question 38

Inflammatory dz that occurs after a strep infection. Self-limited illness that involves joints, skin, brain, and heart.

Answer 38

Rheumatic Fever

Question 39

What is the complication of RF?

Answer 39

Cardiac valve damage (Rheumatic heart dz, usually mitral valve)

Question 40

Acute systemic vasculitis of unknown cause. Self-limited but without intervention have 15-25% developing aneurysms. Extensive inflammation of arterioles, venues, capillaries. Segmental damage to muscular arteries leads to coronary aneurysms

Answer 40

Kawasaki Dz

Question 41

Acute stage of Kawasaki Dz

Answer 41

Abrupt onset of high fever, unresponsive to antipretics and abx, then gets other s/s, very irritable

Question 42

Subacute stage of Kawasaki Dz

Answer 42

Resolution of fever and lasts until all s/s have disappeared

Question 43

Convalescent phase of Kawasaki Dz

Answer 43

All s/s resolved but labs (ESRW) remain elevated, lasts until all are normal (6-8 weeks after onset)

Question 44

In which stage of Kawasaki Dz is the pt at risk for aneurysms?

Answer 44

Subacute. Monitor serial echo