Cardiac Flashcards
1 indicator of heart dysfunction
murmur
hemodynamic characteristics of CHD
increased pulmonary blood flow
decreased pulmonary blood flow
obstruction of blood flow out of the heart
mixed blood flow
increased pulmonary blood flow defects
abnormal connection between septums
increased blood to the right side of the heart
decreased systemic blood flow, increased blood to lungs
risk for right sided heart failure
includes..
atrial septal defect
ventricular septal defect
atrioventricular septal defect
patent ductus arteriosus
gold standard diagnosis for heart stuff
echocardiogram
atrial septal defect
a form of increased pulm blood flow
hole between left and right atria
can be asymptomatic or have a murmur with atrial dysrythmia
ventricular septal defect
a form of increased pulm blood flow
hole between left and right ventricles
atrioventricular septal defect
a form of increased pulm blood flow
most common with Downs
blood mixing in all chambers
cyanosis!
patent ductus arteriosus (PDA)
form of increased pulm blood flow
ovale of pulmonary artery and aorta never closes
machine murmur will be present, bounding pulses, wide pulse pressure
give NSAIDs to inhibit prostaglandins and make it close
obstructive heart defects
causes decreased cardiac output
includes…
coarctation of aorta
aortic stenosis
pulmonic stenosis
coarctation of aorta
narrowing of aorta
CM: increased head and neck pressure, HA, JVD, HTN in arms, bounding pulses in arms, hypotension in legs, faint pulses in legs
aortic stenosis
narrowing of aortic valve causing left ventricular enlargement and decreased CO
CM: faint pulses, cyanosis, tachycardia, poor feeding
pulmonic stenosis
narrowing of pulmonic valve
heart failure symptoms
decreased pulmonary blood flow
blood has a hard time leaving right side of the heart via the pulmonary artery
CM: cyanosis and hypoxemia
includes…
tetralogy of fallot
tricuspid artresia
tetralogy of fallot
form of decreased pulm blood flow
pulmonic stenosis,
overriding aorta,
ventricular septal defect,
right ventricular hypertrophy
CM: episodic cyanosis (tet spells), lack of O2 improvement after birth
RN interv: calm pt down, encourage knees to chest and lean forward
tricuspid atreseia
form of decreased pulm blood flow
narrowing of tricuspid valve, blocking blood flow from right to left ventricle
CM: tachycardia, dyspnea, clubbing
mixed defects
oxygenated and deoxygenated blood mix, leading to decreased O2 saturation in systemic blood
includes…
transposition of the great arteries
hypoplastic left-sided heart syndrome
transposition of the great arteries
form of mixed defect
pulmonary artery and aorta are switched
CM: extreme cyanosis, heart enlargement
need emergency surgery
give prostaglandins to keep ductus arteriosus open
hypoplastic left sided heart syndrome
form of mixed defect
left ventricle is underdeveloped
CM: cyanosis, heart failure symptoms
need surgery w/in few weeks
give prostaglandins to keep ovale open
impaired myocardial function
decreased CO
CM: tachycardia, fatigue, weakness, decreased urine output, hypotension, pale cool extremities
pulmonary congestion
heart cant pump out all blood, fluid leaking
CM: tachypnea, dyspnea, cyanosis, exercise intolerance, resp distress
systemic venous congestion
blood backed up
CM: JVD, peripheral and periorbital edema, weight gain, ascites, hepatomegaly
diagnoses
echocardiogram
chest xray
cardiac cath
pre-cardiac cath
assess and mark pulses
baseline O2 sats
NPO
assess for iodine or shellfish allergy
post-cardiac cath
check pulses distal to site
lay flat with pressure on site
vitals Q15 min
monitor I+O
monitor blood glucose
monitor dressing for bleeding and hematoma
monitor color and temp of extremities
digoxin
improves contractility
give 1 hr before meals
give at same time every day
hold for less than 60bpm
digoxin toxicity
N/V
poor appetite
diuretics
decrease blood and fluid volume
may need to replace K (NOT with potassium sparing diuretics)
ace inhibitors
vasodilate and reduce stenosis
monitor for cough
bacterial endocarditis
bacterial infection of inner lining of heart
caused by strep, staph, fungus
often w valve replacements
can lead to bacteremia
endocarditis
CM: new murmur, low grade fever, malaise, weight loss, anorexia
draw blood cultures
treat w abx or antifungals
rheumatic fever
inflammatory disease caused by GABHS
2-4 weeks after start of strep infection
CM: swelling of skin and joints
rheumatic heart disease
damage to valves from RF
dx by jones criteria (must have + strep test or rising ASO test, 2 major and 1 minor)
treat: penicillin G IM x1, penicillin V PO x10 days, sulfa PO for 10 days
kawasaki disease
autoimmune response affecting skin, lymph nodes, and heart
most common under age 5
3 phases:
acute- sudden high fever above 103, unresponsive to abx and antipyretics
subacute- end of fever thru end of all signs
convalescent- signs resolved but labs still abnormal, takes about 6-8 weeks for labs to be normal
dx of kawaski
MUST have fever for 5+ days and four of below symptoms..
-erythema of palms and soles, peeling of hands and feet
-rash
-1+ swollen lymph nodes
-oral conjunctivitis
-strawberry tongue, mouth erythema, lip peeling
Kawasaki treatment
IVIG (IV immunoglobulin)
daily low dose aspirin for a few months then 3-5mg/kg/day antiplatelet (to prevent coronary artery clot)
followup echos
hyperlipidemia treatment
restrict cholesterol and fat intake
increase whole grains, fruits, veggies
exercise 60min a day for 5 days/week
meds: colestipol or cholestyramine
systemic hypertension
essential- idiopathic
secondary- usually to renal disease, CVD, or endocrine or neurologic disorders
treat: beta blockers, diuretics, Ca channel blockers, ACE inhibitors, angiotensin receptor blockers
