Heart Disorders

Question 1

3 defects that increase pulmonary blood flow

Answer 1

Ventricular septum defect vsd
Atrial septal defect asd
Patent ductus arteriosus

Question 2

Hole in septum between right and left ventricle that results in increased pulmonary blood flow flow (left to right shunt)

Answer 2

Ventricular septal defect

Question 3

A hole in septum between right and left atria that results in increased pulmonary blood flow

Answer 3

Atrial septal defect

Question 4

Condition where normal fetal circulation conduit between pulmonary artery and aorta fails to close causing increased pulmonary blood flow (left to right shunt)

( The fetal duct between the pulmonary artery and the aorta does not close)

Answer 4

Patent ductus arteriosus

**common in premies

Question 5

Do vsd require surgery or close on their own?

Answer 5

Close

On their own

Question 6

Loud hard murmur, heart failure, closes on it own early in life

Answer 6

Ventricular septal defect

Question 7

Loud hard murmur with fixed split second heart sound, heart failure, asxs sometimes

Answer 7

Atrial septal defect

Question 8

Machine him systolic murmur, wide pulse pressure, bounding pulse, asxs sometimes, heart failure, rales

Answer 8

Patent ductus arteriosus

Question 9

3 types of obstructive defects

Answer 9

Pulmonary stenosis
Aortic stenosis
Coarctation of aorta

Question 10

Type of heart defect where blood flow exiting the heart meets an area of narrowing (stenosis) which causes obstruction of blood flow resulting in decreased cardiac output

Answer 10

Obstructive defects

Question 11

Narrowing of pulmonary valve or pulmonary artery that result in obstruction of blood flow from ventricles

Answer 11

Pulmonary stenosis

Question 12

Systolic ejection murmur, asxs sometimes, cyanosis with worsening narrowing, cardiomegaly, heart failure

Answer 12

Pulmonary stenosis

Question 13

Narrowing of aortic valve

Answer 13

Aortic stenosis

Question 14

Aortic stenosis in infants vs children

Answer 14

Infant- faint pulse, hypotension, tachycardia, poor feeding

Children- intolerance to exercise, dizziness, chest pain, possible ejection murmur

Question 15

Narrowing of lumen of aorta, usually at or near the ductus arteriosus that results In Obstruction of blood flow from aorta

Answer 15

Coarctation of aorta

Question 16

Elevated bp in arms, bounding pulse in upper extremities, decreased bp in lower extremities + weak absent pulses lower, heart failure in infants, dizziness, headache, fainting, nosebleeds

Answer 16

Coarctation of aorta

Question 17

2 heart defect that decrease pulmonary blood flow

Answer 17

Tricuspid atresia

Tetralogy of fallot

Question 18

These type of defects have hypercyanotic spells

Answer 18

Defects that decrease pulmonary Bld flow - tricuspid atresia and tetralogy of fallot

Question 19

Complete closure of tricuspid valve resulting in mixed blood flow. + atrial septal opening defect that allows blood to enter left atrium

(Tricuspid valve is closed and septal defect )

Answer 19

Tricuspid atresia

Question 20

Infants va children sxs tricuspid atresia

Answer 20

Infants: cyanosis, dyspnea, tachycardia

Children: hypoxemia, clubbing of fingers

Question 21

4 defects of tetralogy of fallot

Answer 21

Pulmonary stenosis
Ventricular septal defect
Overriding aorta
Right ventricular hypertrophy

Question 22

What does your heart sound like with tetralogy of fallot

Answer 22

Systolic murmur

Question 23

3 types of mixed defect

Answer 23

Transposition of great arteries
Truncus arteriosus
Hypoplastic left heart syndrome

Question 24

Digoxin hold parameters infant vs child

Answer 24

Infant <90

Child < 70

Question 25

Antidote for digoxin

Answer 25

Digoxin immune fag

Question 26

Sxs of digoxin toxicity

Answer 26

Bradycardia, dysthymia, n/v, anorexia, visual disturbances

Question 27

What class of drugs are catopril and enalapril ? Why use them for heart stuff?

Answer 27

Ace inhibitor Reduce after load by causing vasodilation

Question 28

Nursing actions for furosemide

Answer 28

Potassium wasting diuretic High k diet I/O Monitor hypokalemia, nausea, vomitting, dizziness Daily weight

Question 29

Where do triglycerides come from?

Answer 29

Made by body from carbohydrates | End product of fat ingestion

Question 30

What is HDL?

Answer 30

Good! | Low level cholesterol/triglyceride and high protein

Question 31

What is LDL?

Answer 31

Bad! | High level cholesterol, low level triglycerides, moderate protein

Question 32

2 treatments for all 3 Increased Pulmonary Blood Flow heart defects + 1 special for PDA

Answer 32

ASD, VSD, PDA: may close spontaneously, cardiac cath | PDA- indomethacin

Question 33

treatment for Obstruction to blood flow heart conditions? (2)

Answer 33

* cardiac cath | * balloon angioplasty = opens narrow area

Question 34

these type of defects result in dexoygenated blood entering the body circulation

Answer 34

Decreased pulmonary blood flow * Tetralogy of Fallot * Tricuspid atresia

Question 35

symptoms of tetraology of fallot

Answer 35

* TET spells * Murmur * Client blue with crying, feeding, play * Chronic hypoxia (clubbing)

Question 36

type of defect where ◦ aorta connected to right ventricle ◦ pulmonary artery connected to left ventricle

Answer 36

Transposition of the great arteries :Mixed Blood Flow Defect

Question 37

defect where Failure of septum to form

Answer 37

Truncus arteriosus :: Mixed Blood Flow Defect

Question 38

defect with Underdeveloped left side of heart

Answer 38

Hypoplastic left heart syndrome: Mixed Blood Flow Defects

Question 39

how do you do a Critical Congenital Heart Screening? | what do we do if results are abnormal?

Answer 39

pulse ox on newborn on right hand and both feet. Look for differences- want <3% • need to be above 90% on the hand • repeat if difference >3% - if difference persists --> refer to specialty care

Question 40

S/S of congestive heart failure (7)

Answer 40

* Tachycardia * Tachypnea * Weight gain * Poor Feeding/Growth * Fatigue * Decreased output * Orthopnea

Question 41

considerations for feeding CHF babes?

Answer 41

* Feed every 3 hours * Polycose to add calories * cluster care- not feeding every hour

Question 42

when do we hold digoxin in an adult?

Answer 42

<60 / min

Question 43

patient/ parent education for digoxin?

Answer 43

◦ make sure parents can check radial or apical pulse before discharge

Question 44

The disease causes Weakening of the walls of blood vessels due to acute systemic vasculitis/ inflammation

Answer 44

Kawasaki Disease

Question 45

3 phases of kawaski disease

Answer 45

acute, subacute, convalescent

Question 46

tell me what happen in the acute phases of kawaski

Answer 46

• acute- high fever unresponsive to antipyretics, eyes red (no drainage), bright red chapped lips, strawberry tongue with red bumps, irritability inflammation in throat, swelling in hands and feet, palms and soles red, non-blistering rash, joint pain bilaterally, myocarditis, LV function decreased, pericardial effusion

Question 47

tell me what happen in subacute phase of kawaski

Answer 47

• subacute- fever will break, subsiding of other s/s, irritability, peeling of skin around nails/palms/soles

Question 48

how long can sxs of kawaski persist?

Answer 48

sxs 8 weeks

Question 49

will labs be normal during convalescent phase of kawaski?

Answer 49

no- altered for 6-8 week

Question 50

2 treatments for kawaski

Answer 50

aspirin high dose | iv immunoglobulin

Question 51

how do we handle administering IV immunogobblins

Answer 51

◦ treat as blood administration ◦ potential for infusion reaction ◦ want immunoglobulin to be clear- not cloudy- discard if cloudy! ◦ exp date/ lot # recorded

Question 52

when is it most effective to admin IV immunogobblins for kawaski?

Answer 52

w/in 1st 10 days of illness onset

Question 53

if you immunogobblin is cloudy can you give it?

Answer 53

NO- needs to be clear

Question 54

monitor for infusion _______ with IV immunogobblins

Answer 54

reaction