Cardiac 1 Flashcards
what are the fetal cardiac structures
foramen ovale: closes within 24 hrs of birth (child should stay at the hospital for 24 hrs after birth to ensure closure)
ductus arteriosus- closes by day 4
pediatric differences in cardiac
- heart lies more horizontal in childre
- apical impulses at the left midclavicular line (4th ICS)
- sinus arrhythmia is normal in children
- child has increased risk of heart failure
why are children at higher risk of heart failure
immature heart is sensitive to volume or pressure overload
muscle fibers are less developed
physical exam
observe, palpate, vital signs(HR for full min, BP on 4 extremities), auscultate chest, abdomen (hepatomegaly)
what are the pulse rates
infants average 120
continues to decrease with age
pulse strength ratings
0 is no pulse 1 is faint, detectable 2 is diminished 3 is normal 4 is bounding
cardiac diagnostic tests
chest x ray, ECG, CBC, ABGs, echocardiography, MRI, cardiac cath
what is a normal pulse ox in children
*pulse ox is a good noninvasive O2 sat level
95% to 98% is normal in children
*<94 in quiet infant is bad
why is cardiac catheterization used
- helps determine what is happening in child’s heart
- may do some corrective procedures
pre procedure of cardiac cath care
- NPO 4-6 hrs before procedure
- age appropriate teaching
- oral sedation
- obtain baseline VS and blood work
- assess skin temp, strength pulse
- complete Hx (ht, wt, allergies)
post procedure of cardiac cath
- monitor for bleeding (pressure dressing 6 hrs)
- vital signs and neuro check (every 15 min for 1 hr, then 30 min for 1 hr until stable)
- maintain bed rest 4-6 hr and keep leg straight
discharge teaching for cardiac cath
- teach signs of complications (bleeding infection)
- quiet play only for 24 hrs
- increase fluid intake to get dye out of system
- this is a defect in the heart or great vessels or persistence of fetal structures after birth
- common birth defect
congenital heart disease
how many CHD are there
> 35
when are CHD most likely to occur
during first 8 wks of gestation
genetic/environmental factors that may affect CHD
- fetal exposure to drugs, alcohol, and secondary to tobacco smoke
- maternal viral infection (rubella)
- maternal metabolic disorder (diabetic)
- increased maternal age
- genetic factors (family hx)
- chromosomal abnormalities (trisomy)
clinical manifestations of congential heart disorder
- *first indication of CHD is HEART MURMUR
- symptoms in newborn as soon as umbilical cord is cut or within first few days of birth
- may remain asymptamatic for a while
- classified by change in blood flow (increase or decreae in pulmonary)
describe what artiral septal defect (ASD) is
- defect from atria allowing blood to flow from LA to RA
- foramen ovale fails to close*** (increased pulmonary BP)
s/s of ASD
dyspnea, fatigue, poor growth, systolic **ejection murmur
what can ASD lead to
congestive heart failure (can go into it)
treatment of ASD
surgical closure with patch or closure device cna be inserted during cardiac cath
describe what patent ductus arteriosus is (PDA)
-failure of fetal ductus arteriossus to close first few weeks of life
what is the fetal ductus arteriosus
- artery connecting aorta and pulmonary artery
- oxygenated blood shunted from aorta into pulmonary artery
s/s of PDA
- *machine like murmur and thrill in pulmonic area
- tachycardia, widened pulse pressure, bounding pulse
