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Pediatrics > ATI 20 - Cardiovascular Disorders > Flashcards

ATI 20 - Cardiovascular Disorders Flashcards

1
Q

Cardiomyopathy

A

disorder of heart’s muscle

  • affects chamber size, wall thickness, or contraction
  • leads to problems w VENTRICULAR systolic or diastolic function
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2
Q

most common form of cardiomyopathy

A

DILATED cardiomyopathy

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3
Q

Dilated Cardiomyopathy

A

ventricular stretches + dilates
» poor pumping

  • genetic (myocarditis or neuromuscular disease)
  • treated for CHF
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4
Q

most common cause of sudden unexpected death

A

HYPERTROPHIC cardiomyopathy

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5
Q

Hypertrophic Cardiomyopathy

A

myocardial cells become enlarged> causes scarring

|&raquo_space;>poor filling fr still walls

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6
Q

Pulmonary Artery HTN

pathophysiology

A
  • blood backs up in lungs» pulmo vasoconstriction
  • rt.vent hypertrophy as RV tries to push past pressure
  • cause inflammtn, hypertrophy of sm. arteries, + fibrosis
  • rt to lft shunt if pressure gets too high
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7
Q

Pulmonary Artery HTN

symptoms

A
  • dyspnea w activity
  • chest pain
  • syncope
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8
Q

Pulmonary Artery HTN is ____ and eventually _____

A

progressive + eventually fatal

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9
Q

Pulmonary Artery HTN

education

A
  • avoid high altitude (hypoxia)

- adhere to med schedule

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10
Q

Congenital Heart Disease

occurrence

A

8-12 per 1,000 live birth

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11
Q

Congenital Heart Disease

genetic + environmental causes

A
  • drug exposure
  • maternl viral infectn
  • maternl metab disorder
  • incr maternl age
  • multifactorial genetc pattern
  • chrmsml abnorm
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12
Q

Congenital Heart Disease

etiology

A

inadequate CO

-hypertrophy followed by failure

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13
Q

Congestive HF

EARLY signs in INFANTS

A
  • wt loss or lack of wt gain
  • tire easily
  • irritable
  • diaphoresis
  • freq resp infectn
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14
Q

Congestive HF

EARLY signs in OLDER CHILDREN

A
  • exercise intolerance
  • dyspnea
  • ab pain or distention
  • periph edema
  • change in skin color
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15
Q

Congestive HF

LATE signs in INFANTS

A
  • tachypnea
  • tachycardia
  • pallor/cyanosis
  • nasal flaring
  • grunting
  • retraction
  • cough
  • crackles
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16
Q

Congestive HF

LATE signs in OLDER CHILDREN

A
  • anorexia
  • cough
  • wheeze
  • crackle
  • fluid vol excess
  • JVD
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17
Q

Congestive HF

nursing mgmt

A
  • I+O
  • serial ab measurment
  • freq dvlpt assessment Q2-3MO
  • admin meds
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18
Q

Congestive HF

medications [6]

A 
1 digoxin (Lanoxin)
2 furosemide (Lasix)
3 thiazide (Diuril)
4 spironolactone (Aldactone)
5 ACEi (-pril)
6 carvedilol (Coreg)
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19
Q

digoxin (Lanoxin)

moa

A
  • slows HR
  • incr filling time
  • incr CO
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20
Q

digoxin (Lanoxin)

nursing mgmt

A

-assess HR for brady (full 1 min)
-withhold if pulse is <90bmp for infants
<70bmp for children
-monitor for digoxin toxicity

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21
Q

withhold digoxin if pulse is ___ for infants; ___ for children

A

<90bmp

<70bmp

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22
Q

furosemide (Lasix)

moa

A
  • rapid diuresis

- blocks reabsorb of Na + H2O in renal tubes

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23
Q

furosemide (Lasix)

nursing mgmt

A
  • monitor pt during rapid diuresis for VS, I+O, fluid + electrolyte balance
  • monitor for hypo-K + hypo-Cl
  • assess digoxin toxicity if hypo-K is present
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24
Q

thiazide (Diuril)

moa

A

maintain diuresis

-decr absorption of Na, H2O, K, Cl, bicarb in renal tubules

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25
Q

thiazide (Diuril)

nursing mgmt

A
  • monitor BP
  • I+O
  • lab for hypo-K
  • assess for digoxin toxicity
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26
Q

spironolactone (Aldactone)

moa

A

K sparing diuresis

27
Q

ACEi (-pril)

moa

A
  • promote vasc relaxtn
  • reduce periph vasc resistance
  • reduce afterload
28
Q

ACEi (-pril)

nursing mgmt

A

-monitor HTN w start of therapy + dosage changes

common SE: cough, hyper-K, worsening renal functn

29
Q

carvedilol (Coreg)

moa

A
  • improve lft.vent function
  • vasodilatn of systmc circltn

-for chronic HF + dilated cardiomyopathy

30
Q

Infective Endocarditis

clinical manifestations

A
  • fever
  • fatigue
  • muscle aches
  • new/change in murmur
  • signs of congestive HF
31
Q

Infective Endocarditis

Tx

A
  • abx, antifungal (2-8wk)
  • Tx congestive HF
  • assess valve damage (surgcl valve replacement)
32
Q

Congenital Heart Condition

nursing care

A
  • limit feeding to 30min unless instructed otherwise
  • careful w fluid + O2
  • breastmilk preferred (possibly pumped, fortifd, or supplmtd)
  • infectn prevention
  • maybe transpyloric, nasogastric, gastronomy tube
33
Q

___ is required before cardiac catheterization

A

baseline assessment

-make sure no allergies to iodine or shellfish bc contrast

34
Q

cardiac catheterization

post op care

A
  • continuous cardiac + pulse ox
  • assess pulse for symmetry
  • assess skin
  • assess insertion site for bleed/hematoma
  • prevent bleeding by keeping extremity in straight position
35
Q

cool extremity that blanches after cardiac catheterization can indicate

A

arterial obstruction

36
Q

sudden sustained incr in pulse/resp + decr in perfusn may indicate…

A

early hemorrhage

37
Q

INCREASED pulmonary BF

clinical manifestations

A
  • tachypnea
  • tachycardia
  • murmur
  • *CHF**
  • poor wt gain
  • diaphoresis
  • periorbital edema
  • freq resp infection
38
Q

DECREASED pulmonary BF

clinical manifestations

A
  • *cyanosis**
  • hypoxic spells
  • poor wt gain
  • polycythemia
39
Q

OBSTRUCTION to systemic BF

clinical manifestation

A
  • *CHF w pulmo edema**
  • diminished pulse
  • poor color
  • delayed cap refill time
  • decr UO
40
Q

MIXED Defects

clinical manifestations

A
  • *cyanosis**
  • *CHF can occur w incr shunting**
  • poor wt gain
  • pulmo congestn
41
Q

Patent Ductus Arteriosus

occurrence

A

common

-5-10% of all infants w congenital heart disease

42
Q

normal ductus arteriosus

A

blood goes fr pulmo artery to aorta

  • closes 10-15 hr after birth
  • complete seal after 10-21 days after birth
43
Q

normal closure of ductus arteriosus is triggered by…

A

high O2 saturation

44
Q

Patent Ductus Arteriosus

pathophysiology

A

at birth, SVR incr + PVR decr

|&raquo_space;reverses flow across ductus arteriosus

45
Q

Patent Ductus Arteriosus

is common in…

A

preterm infants w resp distress syndrome or hypoxemia

46
Q

Arrhythmias

**bradycardia leads to…

A
  • hypothermia
  • hypoxia
  • incr ICP

-hyper-K

47
Q

Arrhythmias

**supraventricular tachycardia for infants

A

> 220bpm
signs poor feed, irritable, pallor
-vagal maneuvers

48
Q

Arrhythmias

**supraventricular tachycardia for children

A

> 180 bpm

-vagal maneuvers

49
Q

Rheumatic Fever

**pathophysiology

A

inflammatory disorder of connective tissue
»autoimmune
***caused by group A beta-hemolytic streptococcus

50
Q

Rheumatic Fever

**etiology/age

A

5-15 yo

51
Q

Rheumatic Fever

**clinical manifestations

A

-begin 2-6wk after untreated or partially treated strep infectn w GABHS

52
Q

**with Rheumatic Fever, a new mrmr may indicate…

A

carditis of mitral or aortic valve

53
Q

Tx for carditis, inflammation in Rheumatic Fever

A

aspirin

54
Q

Kawasaki Disease

**acute (1-2wk) clinical manifestations

A
  • high fever >5dy
  • unresponsive to antipyretics
  • red throat
  • red/chapped lips
  • strawberry tongue
  • swollen limbs
55
Q

Kawasaki Disease

**subacute clinical manifestations

A

subacute is >2wks

  • cardiac disease
  • no fever
  • joint pain
56
Q

Kawasaki Disease

**tx

A

aspirin

  • anti-inflammatory
  • anti-platelet dose after fever decr
57
Q

Shock + types

A

inadequate delivery of O2 to tissues

types: compensated + decompensated

58
Q

Decompensated shock vs compensated shock

A

decomp: hypotension, delayed cap refill, pallor
comp: tachycard, normotensive or HTN

59
Q

hypovolemic shock

*cause

A

loss of volume

60
Q

vasogenic shock

*cause

A

vasodilation

61
Q

cardiogenic shock

*cause

A

pump failure

62
Q

obstructive shock

*cause

A

obstruction to flow

63
Q

Rheumatic fever diagnostics

A

Blood antistreptisin O tiger is elevated

Pediatrics (51 decks)

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