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Pediatrics > ATI 20 - Congenital Heart Disease - INCR PULMO BF > Flashcards

ATI 20 - Congenital Heart Disease - INCR PULMO BF Flashcards

1
Q

Congenital Heart Disease

occurrence

A

8-12 per 1,000 live birth

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2
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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3
Q

Congenital Heart Disease

etiology

A

inadequate CO

-hypertrophy followed by failure

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4
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
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5
Q

___ is required before cardiac catheterization

A

baseline assessment

-make sure no allergies to iodine or shellfish bc contrast

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6
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
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7
Q

cool extremity that blanches after cardiac catheterization can indicate

A

arterial obstruction

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8
Q

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

A

early hemorrhage

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9
Q

INCREASED pulmonary BF

clinical manifestations

A
  • tachypnea
  • tachycardia
  • murmur
  • *CHF**
  • poor wt gain
  • diaphoresis
  • periorbital edema
  • freq resp infection
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10
Q

DECREASED pulmonary BF

clinical manifestations

A
  • *cyanosis**
  • hypoxic spells
  • poor wt gain
  • polycythemia
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11
Q

OBSTRUCTION to systemic BF

clinical manifestation

A
  • *CHF w pulmo edema**
  • diminished pulse
  • poor color
  • delayed cap refill time
  • decr UO
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12
Q

MIXED Defects

clinical manifestations

A
  • *cyanosis**
  • *CHF can occur w incr shunting**
  • poor wt gain
  • pulmo congestn
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13
Q

Patent Ductus Arteriosus

occurrence

A

common

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

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14
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
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15
Q

normal closure of ductus arteriosus is triggered by…

A

high O2 saturation

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16
Q

Patent Ductus Arteriosus

pathophysiology

A

at birth, SVR incr + PVR decr

|&raquo_space;reverses flow across ductus arteriosus

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17
Q

Patent Ductus Arteriosus

is common in…

A

preterm infants w resp distress syndrome or hypoxemia

18
Q

Patent Ductus Arteriosus

clinical manifestations

A
  • *continuous machinery murmur during sys + dias**
  • *thrill in pulmonic area**
  • full, bounding pulse
  • widened pulse pressure
  • if CO is low, hypotension
  • CHF
19
Q

Patent Ductus Arteriosus are at a high risk for…

A

freq rsp infectn

PNA

20
Q

Patent Ductus Arteriosus

therapy fr least to most invasive

A
  • wait + monitor
  • medication
  • cardiac catheter to insert coils + occlude PDA
  • thoracoscopic repair (ligate vessels)
21
Q

Patent Ductus Arteriosus

medications

A

-prostaglandin inhibitor
-ibuprofen
-indomethacin
(helps w closure)

22
Q

Normal foramen ovale

A

blood moves fr RT atrium to LFT atrium

23
Q

Atrial Septal Defect

A

opening bw atrium septum remain open

|&raquo_space;allows left-to-right shunting

24
Q

small vs large Atrial Septal Defect

A

small: patent foramel ovale
large: completely absent septum

25
Q

small - mod Atrial Septal Defect in infants + young children

clinical manifestations

A

usually asymptomatic

26
Q

LARGE Atrial Septal Defect

clinical manifestations

A
  • may cause CHF
  • easily tired + poor growth
  • loud harsh murmur w dixed split second heart sound
27
Q

adults w uncorrected small to mod Atrial Septal Defect are at an incr risk for..

A

stroke

28
Q

ATRIAL SEPTAL DEFECT

therapy fr least to most invasive

A
  • wait + monitor
  • cardiac catheter, septal occluder
  • patch closure if CHF is present
29
Q

cardiac catheter, septal occluder

post care

A

aspirin at 81mg/day for 6 months

30
Q

VENTRICULAR SEPTAL DEFECT

pathophysiology

A

opening in ventricular septum
»incr pulmo blood flow
»blood is shunted fr LFT.VNTRCL to RT.VNTRCL to PULMO ARTERY

31
Q

most common congenital heart defect

A

VENTRICULAR SEPTAL DEFECT

32
Q

SMALL VENTRICULAR SEPTAL DEFECT

clinical manifestations

A

may have no symptoms

-may close spontaneously early in life

33
Q

MOD - LARGE VENTRICULAR SEPTAL DEFECT

clinical manifestations

A
  • may be assoc w CHF, poor growth, + decr exercise tolerance
  • loud harsh murmur at left sternal border
  • thrill may be present
34
Q

VENTRICULAR SEPTAL DEFECT

least to most invasive therapy

A
  • wait + monitor
  • cardiac catheter closure
  • surgery after 1yo
35
Q

surgery for VENTRICULAR SEPTAL DEFECT

teaching re age

A

best after 1yo

  • if CHF s/s cannot be medically managed, then w/in first 6 mo
  • highest risk in first 2 mo
  • good prognosis post op
36
Q

ATRIOVENTRICULAR CANAL DEFECT

pathophysiology

A

-one AV valve + large septal defect bw both ATRIA + VENTRICLES

37
Q

*ATRIOVENTRICULAR CANAL DEFECT

etiology

A

occurs in 2% of congenital heart defect cases

70% of these kids have DOWN SYNDROME

38
Q

ATRIOVENTRICULAR CANAL DEFECT

clinical manifestation

A

-infants often develop CHF, tachypnea, avoidant/restrictv food intake disorder (failure to thrive), recurrent respiratory, infections, and repeated resp failure
S1 accentuated, S2 split
-holosystolic murmur
-thrill

39
Q

ATRIOVENTRICULAR CANAL DEFECT

holosystolic murmur can be heard at…

A

left lower sternal border

-may be transmitted to left axilla when mitral regurg is present

40
Q

ATRIOVENTRICULAR CANAL DEFECT

clinical therapy

A
  • *CHF is treated
  • *surgery bw 2-4mo to prevent pulmo vasc disease
  • patch septal defect
  • mitral valve replacemt
  • infective endocarditis prophylaxis for 6 mo

Pediatrics (51 decks)

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