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Peds > Acquired Cardiac > Flashcards

Acquired Cardiac Flashcards

1
Q

what is bacterial endocarditis

A

an inflammatory process resulting from infection of the valves and the inner lining of the heart

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2
Q

describe the pathophysiology of bacterial endocarditis

A

organisms enter bloodstream from an area of localized infection and grow on the endocardium -> vegetations, fibrin deposits, and platelet thrombi form -> lesions may invade adjacent tissues or break off and embolize

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3
Q

what are CM of bacterial endocarditis

A

Low grade intermittent fever
Anorexia
Malaise
Weight loss
Joint pain
Positive blood culture
New heart murmur or change in existing murmur
Petechiae of mucous membranes
Janeway spots
Osler nodes
splinter hemorrhages under nail

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4
Q

what are janeway spots

A

painless hemorrhaging spots on hands and feet

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5
Q

what are osler nodes

A

painful red intradermal nodes with white centers on fingers and toes

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6
Q

what is the typical therapeutic management of bacterial endocarditis

A

IV antibiotics for up to 2-8 weeks
surgical removal of significant emboli and / or valve replacement

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7
Q

how can bacterial endocarditis be prevented in the hospital

A

prophylactic antibiotic 1 hour before a risky procedure

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8
Q

what are some high risk patients for bacterial endocarditis

A

artificial heart valve, CHD, repaired defects, heart transplant

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9
Q

what is rheumatic fever

A

a systemic inflammatory disease that follows a group A beta hemolytic streptococcus infection - autoimmune reaction to step antibodies

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10
Q

the primary concern with rheumatic fever is that it may develop into what

A

rheumatic heart disease which causes damage to the mitral valve = weakened valve that allows a back flow of blood

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11
Q

what age group is most likely to develop rheumatic fever

A

school age

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12
Q

what may be present 2-6 weeks prior to symptoms developing for rheumatic fever

A

upper respiratory infection

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13
Q

are males or females more at risk of developing rheumatic fever

A

males

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14
Q

what are the 5 major CM of rheumatic fever

A

polyarthritis
carditis
chorea (involuntary, sudden facial movements)
erythema marginatum (rash)
subcutaneous nodules

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15
Q

what are the 4 minor CM of rheumatic fever

A

arthralgia
low grade fever
elevated ASO titer
abdominal pain

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16
Q

how to prevent cardiac damage and relieve symptoms of rheumatic fever

A

salicylate therapy - 2 weeks for inflammation
steroids to decrease inflammation
bed rest

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17
Q

how to prevent recurrence of rheumatic fever and endocarditis

A

prophylactic antibiotics

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18
Q

is Kawasaki disease contagious

A

no

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19
Q

what are the acute symptoms of kawasaki disease

A

bacterial conjunctivitis without exudate
oral mucosa changes
enlarged lymph nodes
patchy rash
fever that doesn’t respond to tylenol or ibuprofen
dry, red, cracked lips
strawberry tongue
erythema and swelling of palms and soles

20
Q

how long is the acute phase of kawasaki disease

A

8-10 days

21
Q

when is the subacute phase of kawasaki disease

A

10-35 days

22
Q

what are the CM of the subacute phase of kawasaki disease

A

vasculitis
desquamation of toes, feet, fingers, and palms
thrombocytosis
arthritis

23
Q

how long can the convalescent period be for kawasaki disease

A

up to 10 weeks

24
Q

what is the most dangerous phase of kawasaki disease and why

A

recovery / convalescent phase because there is an increased amount of platelets in the blood and that can contribute to the development of a heart attacj

25
Q

what are the s/s you may see for a patient you suspect to be having an MI due to the convalescent phase of kawasaki disease

A

abdominal pain
vomiting
restlessness
inconsolable crying
pallor
shock

26
Q

in the case of kawasaki disease what needs to be given within 10 days of fever to assist in avoiding the long lasting cardiac problems

A

high dose IV gamma globulin

27
Q

high dose aspirin is started on children with kawasaki diseased until when

A

they are afebrile for 48-72 hours

28
Q

why does a child need aspirin long term if they are diagnosed with kawasaki disease

A

for the anti-platelet effects

29
Q

what nursing considerations are important when administering gamma globulin to a child with kawasaki disease

A

know that this is a blood product - need to stay with patient and do a ton of monitoring
monitor for pulmonary congestion, respiratory distress, or fluid volume overload

30
Q

after a child has kawasaki disease they should be instructed to not get any live vaccines for how long

A

11 months

31
Q

what is the initial use and long term use of aspirin in children that have kawasaki disease

A

initial is anti-inflammatory and long term is for anti-platelet

32
Q

what can cause hypertension in only the upper extremities of children

A

coarctation of the aorta

33
Q

a total cholesterol under what is considered acceptable for children

A

< 170

34
Q

should fat intake be controlled between birth - 2 years

A

nope

35
Q

what is supraventricular tachycardia

A

rapid, regular heart rate 200-300 bpm

36
Q

what are the 2 potential treatments of SVT

A

vagal maneuvers, valsalva maneuver

37
Q

what does adenosine

A

impairs AV conduction = converts dysrhythmia to normal rhythm

38
Q

what two common things can send patients into SVT

A

psuedophed and caffeine

39
Q

a sinus arrthymia is noted in a school age child what should you do

A

know this is normal, have them hold their breath and see if it fixes after that

40
Q

what is cardiomyopathy

A

myocardial abnormalities which impair the cardiac muscles ability to contract

41
Q

what are the 3 types of cardiomyopathy

A

dilated
hypertrophic
restrictive

42
Q

what is dilated cardiomyopathy

A

ventricular dilation with greatly decreased contractility leading to CHF

43
Q

what is hypertrophic cardiomyopathy

A

increase in heart muscle mass without an increase in cavity size

44
Q

what is restrictive cardiomyopathy

A

restriction to ventricular filling

45
Q

what are the 4 CM of cardiomyopathy

A

CHF
dysrhythmia
syncope
sudden death

46
Q

what is digoxin for

A

to increase the contractility of the heart but not speed it up

Peds (12 decks)

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