Cardiac Flashcards
circulatory changes at birth
triggered by first breath, PA pressure drops–> ductus arteriosus closes, RA pressure drops –> foramen ovals closes, vascoconstriction –> ductus venosus closes
assessment concerns
cyanosis, sob, dob, tachypnea, clubbing, trouble eating, FTT, edema, jaundice
assess
AI, CRT, liver, HR, BP on lower and upper extremities
making a diagnosis
holter monitor, ECG, xray, echo, arteriogram, prenatal ultrasound, catheter
congenital examples
tetralogy of fallout, tricuspid atresia, atrial septal defect, atrioventricular canal defect, patent ductus arteriosus, patent ductus arteriosus
acquired examples
HF, endocarditis, cardiomyopathy, HTN, rheumatic fever, Kawasaki disease, hyperlipidemia
diseases w decreased pulmonary blood flow
tetralogy of fallout, tricuspid atresia
diseases with increased pulmonary blood flow
ASD, VSD, AV canal, PDA
obstructive diseases
aortic stenosis, pulmonary stenosis, coarctation of the aorta
mixed diseases
transposition of the great vessels, anomalous pulmonary vein connection, trunks arteriosus, hypo plastic left heart syndrome
tetralogy of fallot
decreased, 4 defects; right vent hypertrophy, overriding aorta, pulmonary stenosis, VSD (run Olivia punched Vanessa)
cyanosis - knee to chest, o2, morphine, IV fluids
tricuspid atresia
decreased, tricuspid valve doesn’t develop in utero, deoxygenated blood goes through atrial septum PFO, blood mixing @ pulmonary artery & aorta
atrial septal defect
increased, hole between left and right atria, asymptomatic
sob, fatigue, FTT
ventricular septal defect
increased, how between L and R ventricles
asymptomatic if small, shunt,
loud harsh murmur, PHTN, HF, FTT
atrioventricular canal
increased, tricuspid and mitral valves, ASD, VSD, shunting, pulmonary edema
Patent Ductus Arteriosus
increased, aorta and pulmonary artery connected, second most common congenital, premies, high altitudes, to accommodate right to left shunting diseases such as artioventircular canal and ventricular septal defect,
coarct
obstructive, BP in all 4; higher in uppers
aortic stenosis
obstructive, restricted blood flow between L vent and aorta, asymptomatic; FTT, faint pulses, easy fatigue, chest pain
pulmonary stenosis
obstructive, R vent to pulmonary artery, asymptomatic; FTT, faint pulses, easy fatigue, cheat pain
transposition of the great vessels
mixed, PA and aorta switched, accompanied by ASD or VSD, surgical intervention; switch, balloon partial septostomy, PGE
total anomalous pulmonary vein connection
mixed, pulmonary veins dont connect to L atrium; connect to r atrium/s vena cava, PFO/ASD present
trances arteriosus
mixed, decreased, single large vessel, surgery
hypo plastic left heart syndrome
mixed, small L vent, small aorta, prenatal, several surgeries, transplant
CHD management
semi fowlers, sparingly o2, weigh frequently, high calorie, infection prevention
HF
6 mo, reduced output, hypertrophy
sweating during feeds, poor feeds, increase WOB, decrease UOP, low BP, tachycardia, mottled pale skin, edema, crackles
infective endocarditis
bacteria/fungi, CHD, prosthetic valves, central lines
flu-like, fatigue, anorexia/weight loss
antibiotics/anti-fungal 4-6 weeks
cardiomyopathy
myocardium can’t contract, leads to HF and transplant
monitor for clots, diuretics, promote rest and some activity
HTN
overweight/obesity, growth retardation,
loose wright, diet, excercise
post op
temp, output, tamponade/arrythmia, f/e balance, hemorrhage,
cardiac tamponade
abrupt lack of chest tube drainage, hypotension, muffled heart sounds, decreased perfusion, narrowing pulse pressures, widening mediastinum on X-ray, increased R and L atrial pressures
HF goals
save energy, decrease metabolic demands, fluid removal, positioning, nutrition, ***sparing o2, pulmonary vasodilator
HF rx
furosemide, spironolactone, digoxin, vasodilators
