Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

54/64 Unit 3 > Peds Cardiac > Flashcards

Peds Cardiac Flashcards

1
Q

Changes that occur with baby’s first breath of air

A

Arterioles dilate significantly, high pressure system becomes low pressure system, shunts close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the two types of cardiac defects?

A

Congenital (CHD) and acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Characteristics of acquired cardiac defects

A

Disease or infection-related, autoimmune response, environmental factors, familial tendencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Most common cause of congenital heart defect

A

Complex interaction between genetics and environmental factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Prenatal risk factors for congenital heart defect

A

Chronic disease, alcohol/illicit drugs, infection, IUGR or macrosomia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Prenatal chronic diseases that increase risk of heart disease in infants

A

Autoimmune, lupus, diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Prenatal infections that increase risk for fetal cardiac anomalies

A

Rubella, toxoplasmosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Genetic risk factors for congenital heart defect

A

Marfan, hypertrophic cardiomyopathy, frequent loss or SIDS, Down syndrome or Turner syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Causes of CHF

A

Volume overload, pressure overload, decreased contractility, high cardiac demands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HF characterized by elevated CVP and venous engorgement

A

Right-sided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

HF characterized by increased pressure in pulmonary veins and LA, increased pulmonary pressures due to lungs congested with blood, and pulmonary edema

A

Left-sided

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Cardiac and circulatory manifestations of CHF

A

Tachycardia during rest (compensatory mechanism), gallop rhythm, weak pulses, slow cap refill, low BP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Integumentary manifestations of CHF

A

Diaphoresis, mottled skin, cold extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Respiratory manifestation of CHF

A

Poor exercise tolerance (“unable to keep up with peers”)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Neurological manifestations of CHF

A

Fatigue and irritability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

S/S of left sided heart failure (pulmonary congestion)

A

Tachypnea, dyspnea, hypoxemia, bronchial edema and coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

S/S of right-sided heart failure (systemic venous congestion)

A

Hepatomegaly, weight gain, gravity dependent swelling, visually distended veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CHF management: improving cardiac function

A

Digoxin, ACE inhibitors, vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

CHF management: removing accumulated fluid

A

Lasix

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

CHF management: decreasing cardiac demands

A

Neutral-thermic (newborns), treat infections, semi-fowlers, sedation/rest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

CHF management: improving oxygenation

A

O2 supplementation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Pediatric weights that are concerning

A

Major changes in weight percentiles, 5% or lower, 95th or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Non-specific CHF manifestations

A

Poor feeding, respiratory difficulty (tachypnea/tachycardia), FTT, developmental delays, non-cardiac congenital defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Cardiac-specific manifestations of CHF

A

Clubbing of fingers, circumoral cyanosis, hypercyanotic/tet spells, sweating, polycythemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Hypercyanotic spells or “tet” spells are most often associated with

A

Tetralogy of Fallot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Interventions for tet spells

A

Stay calm, knee-chest position, morphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Screening performed on newborns 4 hours after life that is highly effective at detecting congenital heart defects

A

Critical Congenital Heart Defect Screening (CCHD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

CCHD is highly effective at detecting what 7 congenital heart defects?

A

Hypoplastic left heart syndrome, pulmonary atresia, tetralogy of fallot, total anomalous pulmonary venous return, transposition of the great arteries, tricuspid atresia, and truncus arteriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe CCHD screening

A

Non-invasive and quick, pulse ox placed on foot and hand comparing oxygenation on different parts of body to help catch defects early

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

An infant would pass the CCHD screening of pulse ox is greater than ___% in RH or F AND a difference of ___% or less between RH and F

A

95; 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

An infant would fail CCHD screening if pulse ox is ___% or lower in RH or foot

A

89

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

If an infant’s pulse ox is between ___ and ___% in RH or F OR a difference of ___% or higher between RH and F, then repeat the CCHD screen in 1 hour

A

90-94; 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What should be done If an infant reads the same pulse ox after repeating CCHD screening?

A

Repeat screen in 1 hour again; if no change, the infant fails the CCHD screen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Diagnostic that assesses the electrical conduction within the heart

A

ECG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Diagnostic that looks for signs of HF by assessing changes in size and position of organs

A

Chest X-Ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Diagnostic that assesses/measures valves, chambers, and EF; may be ordered if CHF screening is failed

A

Echocardiography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Nursing considerations for CHF

A

Patients at risk for neurologic complications, developmental delays (cognitive and motor), thrombotic events, and bacterial endocarditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Examples of increased pulmonary blood flow defects

A

Arterial septal defect, ventricular septal defect, and patent ductus arteriosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Characteristics of atrial septal defect

A

Blood flow from left atria (high pressure) to right side (low pressure), right atrial/ventricular enlargement BUT HF is rare, pulmonary vasculature changes only occur after decades

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

S/S of atrial septal defect

A

Asymptomatic, HF after 3 or 4 decades, murmur, risk for atrial dysrhythmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Increased pulmonary blood flow defects result from an abnormal connection between the two sides of the heart being either the _________ or the _____ _______

A

Septum; great vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Increased pulmonary blood flow defects lead to _________ blood volume on the right side of the heart, _________ pulmonary blood flow, _________ systemic blood flow, and symptoms of _____.

A

Increased; increased; decreased, HF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Treatment for patent ductus arteriosis

A

Indomethacin (Indocin)

44
Q

Examples of obstructive defects

A

Coarction of the aorta, pulmonary stenosis

45
Q

With coarction of the aorta, increased blood flow to the head and upper extremities causes _________ and _________ due to narrowing and high pressures

A

Headaches; epistaxis

46
Q

Coarction of the aorta S/S

A

High pressure in arms and bounding pulses in upper extremities, low pressure, cool skin, and weak pulses in lower extremities, weak or absent femoral pulse, HF in infants

47
Q

Obstructive defect by which less blood flows to lungs, causing blood to back up into body and venous system

A

Pulmonic valvar stenosis

48
Q

Example of decreased pulmonary blood flow defect

A

Tetralogy of fallot

49
Q

Decreased pulmonary blood flow defects, like Tetrology of Fallot, are characterized by ___ blood oxygen levels

A

Low

50
Q

S/S of Tetrology of Fallot (related to low blood oxygen levels)

A

Circumoral cyanosis, tachypnea, systolic murmur, no edema, TET spells or acute cyanosis

51
Q

Defect by which overriding aorta causes mixing of oxygenated and deoxygenated blood

A

Tetrology of fallot

52
Q

With Tetrology of fallot, surgical repair is done within _____ _____ of life based on developmental hypercyanotic spells or “tet”

A

First year

53
Q

Tetrology of fallot long-term complications

A

Chronic pulmonary regurge, R ventricular enlargement, valve replacements, aortic root dilation, sudden cardiac death

54
Q

Example of mixed defect

A

Transposition of the great vessels

55
Q

Defect in which cardiac structure are in the wrong place. The aorta connects to the right side and pulmonary artery connects to the left side preventing blood from going where it needs to go

A

Transposition of the great arteries

56
Q

Operation for treatment of transposition of the great vessels

A

Arterial switch operation

57
Q

Heart sounds that reflect turbulent blood flow through the heart, especially related to valves

A

Murmurs

58
Q

Defects that are more likely to have a murmur

A

PDA, pulmonary stenosis

59
Q

Surgical interventions for cardiac defects

A

Open or closed heart surgery

60
Q

Incision is made in _________ for open-heart surgery

A

Breastbone

61
Q

Cardiopulmonary bypass machine provides

A

Temporary oxygenated blood

62
Q

Postoperative complications

A

HF, decreased CO syndrome, decreased peripheral perfusion, dysrhythmias, pulmonary complications, neuro complications, infection

63
Q

Infection of the inner lining of the heart

A

Bacterial (infective) endocarditis (IE)

64
Q

Children with cardiac anomalies are at risk for

A

Infective endocarditis (IE)

65
Q

The most significant complication of Acute Rheumatic Fever (ARF) which caused permanent valve damage

A

Rheumatic heart disease

66
Q

Abnormal inflammatory response causing inflammation of connective tissues

A

Acute Rheumatic Fever (ARF)

67
Q

Infective endocarditis risk factors

A

Children with CHD, artificial heart valves, recent strep, staph infections elsewhere

68
Q

Manifestations of infective endocarditis

A

Low-grade fever, myalgias, arthralgias, weight loss, new murmur or change in previous, splenomegaly, splinter hemorrhages, osler nodes, janeway spots, petechiae

69
Q

IE in newborns S/S

A

Non-specific: S/S sepsis, S/S HF, feeding intolerance, respiratory distress, tachycardia, hypotension

70
Q

S/S of respiratory distress in newborns

A

Grunting, retractions, flaring

71
Q

Children with ARF and rheumatic heart disease are at risk for

A

Recurrent infections and ARF

72
Q

ARF and RHD assessment

A

History of strep throat infection within the past 2-6 weeks that may or may not have been treated

73
Q

Clinical findings of rheumatic fever/heart disease

A

Carditis, polyarthritis, chorea, subcutaneous nodules, erythema marginatum

74
Q

Pre-procedure goals for invasive procedures

A

Reduce anxiety, enhance coping and cooperation, improve trust

75
Q

General invasive procedure nursing care

A

Meet pre-procedure goals, tours (cath lab/OR,ICU), EDUCATION! (Discharge planning & post-op)

76
Q

Surgical explanation/education for school age and adolescents

A

Basic description and chronological explanation

77
Q

Nursing management for cardiac catheter and surgery

A

Sedation, NPO, accurate weight and height, baseline vitals with bilateral pedal pulses

78
Q

Cardiac catheterization post-procedural care

A

Monitor vitals every 15 min (assess HR and RR for full minute), maintain straight leg for 4-8 hours to prevent bleeding, limit activity for 24 hrs, monitor for bleeding and hypoglycemia

79
Q

Patients who are intubated following cardiac surgery should not be suctioned for more than

A

5 seconds

80
Q

Chest tube nursing care following cardiac surgery

A

Maintain water-seal, patency, sterility

81
Q

Cardiac surgery complications

A

Dysrhythmias, cardiac tamponade, pulmonary changes, neurologic changes, hematologic changes, infection, postpericardiotomy syndrome

82
Q

S/S of postpericardiotomy syndrome

A

Fever, leukocytosis, pericardia friction rub, pericardial or pleural effusion

83
Q

Chest tubes that may be placed after cardiac surgery

A

Pleural or pericardial tubes

84
Q

Following cardiac surgery, chest tube drainage should be monitored _____ for color and quantity

A

Hourly

85
Q

Immediately post-op CT drainage should be

A

Bright red, but becomes serous within hours

86
Q

CT drainage that requires nurse to notify surgeon

A

> 3 mL/kg/hr x 3 consecutive hrs OR 5-10 mL/kg in any 1 hour

87
Q

Best predictor of kidney perfusion

A

Urine output

88
Q

Desired urinary output in children

A

1 mL/kg/hr (report if <1 mL/kg/hr = kidney failure!)

89
Q

Inotropic medication that increases cardiac contractility

A

Digoxin (lanoxin)

90
Q

Digoxin nursing considerations

A

Narrow therapeutic range (monitor for toxicity), take apical pulse prior to administration

91
Q

Hold digoxin if HR < ___ in infants or < ___ for older child

A

90; 70

92
Q

Digoxin toxicity S/S

A

Arrythmias, palpitations, N/V, visual changes

93
Q

Diuretics given for venous congestion/R-sided HF

A

Furosemide (Lasix) or Chlorthiazide (Diuril)

94
Q

Furosemide (Lasix) nursing considerations

A

Wastes K+ (monitor for signs of low K+)

95
Q

Medications that reduce afterload

A

ACE inhibitors like captopril (Captopen) and enalapril (Vasotec)

96
Q

Prostaglandin give to keep open PDA when there is transposition of the great vessels

A

Alprostadil (Prostin PR)

97
Q

General nursing care of children with CHD

A

Conserve child’s energy, promote normalcy (nutrition, developmental milestones, family integration)

98
Q

Rheumatic Heart Disease prevention

A

Early referral for throat cultures (Group A Strep), educate full completion of antibiotic regimen

99
Q

Rheumatic heart disease management

A

Antibiotics, anti-inflammatories, management of HF, supportive care

100
Q

Rheumatic heart disease supportive care

A

Rest, good nutrition, oxygen

101
Q

Rheumatic heart disease lab monitoring

A

ASO titer, elevated CRP and ESR

102
Q

Prophylactic antibiotic therapy for Rheumatic heart disease

A

Penicillin G q28 days; may be on long-term antibiotic therapy for 5, 10, or 40+ years

103
Q

What is a common, serious complication of rheumatic fever?

A

Cardiac valve damage

104
Q

Infective endocarditis patient education

A

Stress importance of follow-up visits, early diagnosis for future infections, and COMPLETION of antibiotic regimen (2-8 weeks likely with PICC line)

105
Q

Infective endocarditis prophylaxis

A

Antibiotics prior to dental and surgical procedures; meticulous mouth care

54/64 Unit 3 (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions