Cardiac

Question 1

s/s of CHD in infants

Answer 1

dyspnea & diaphoresis when straining & feeding, fatigue, hypotonia, feeding difficulties, URIs, mottling, slow cap refill

Question 2

s/s of CHD in children

Answer 2

activity intolerance, headache, dyspnea, clubbing, mottling, polycythemia, slow cap refill

Question 3

order of resp de-escalation

Answer 3

vent - CPAP - Hi-Flow - NC

Question 4

ideal output

Answer 4

1mg/kg/hour

Question 5

purpose of digoxin

Answer 5

lower HR & increase contractility to increase CO

Question 6

digoxin parameters

Answer 6

no for HR <70 in children, 90 in infants

Question 7

s/s of digoxin toxicity

Answer 7

anorexia, n/v

Question 8

purpose of aspirin

Answer 8

antiplatelet, post stent/valve placement; also used for Kawasaki’s

Question 9

enalapril

Answer 9

ace inhibitor

Question 10

propranolol

Answer 10

beta blocker

Question 11

s/s of Kawasaki’s disease

Answer 11

fever >39 for 5+ days and conjunctivitis, rash, adenopathy, strawberry tongue, reddened hands & feet

Question 12

acute phase of Kawasaki’s

Answer 12

abrupt onset of high fever, joint pain, child is irritable

Question 13

subacute phase of Kawasaki’s

Answer 13

10 days later - high platelets, skin peels on hands & feet

Question 14

meds for Kawasaki’s

Answer 14

IVIG, aspirin

Question 15

aspirin for Kawasaki’s

Answer 15

high dose during acute phase & fever, continued for life if coronaries are harmed

Question 16

mgmt of sickle cell

Answer 16

pain meds, fluids, blood, warm compresses, oxygen, check BPs, encourage vax

Question 17

PDA treatment

Answer 17

indomethacin, cath lab/open litigation

Question 18

PDA s/s

Answer 18

L sided HF - crackles/rales, dyspnea, FTT, diaphoresis

Question 19

mgmt of PDA

Answer 19

furosemide, digoxin for HF, increase calories, I&Os, daily weight, low Na diet

Question 20

PDA

Answer 20

opening between aorta & pulmonary artery - L to R shunting of blood, increased pulmonary blood flow

Question 21

TGA

Answer 21

aorta & pulmonary artery are switched, PDA & ASD needed to live -cyanotic defect

Question 22

TGA s/s

Answer 22

70-85% sat, R sided HF

Question 23

TGA mgmt

Answer 23

digoxin, furosemide

Question 24

TGA tx

Answer 24

prostaglandins, arterial switch surgery

Question 25

prostaglandins side effect

Answer 25

apnea - may need ventilated

Question 26

s/s of coarc

Answer 26

upper extremities - +4 pulses lowers - hypoTN, +1 pulses, cool may not be walking, dizziness, headache, epistaxis

Question 27

mgmt of coarc

Answer 27

furosemide, digoxin - monitor all 4 BPs, hold if too low

Question 28

tx of coarc

Answer 28

stent, aortic dilation

Question 29

s/s of re-coarc

Answer 29

headache, dizziness, chest pain, epistaxis

Question 30

tetralogy of fallot

Answer 30

VSD, overriding aorta, pulmonic stenosis, R ventricular hypertrophy

Question 31

s/s of tet

Answer 31

cyanosis, clubbing, polycythemia, hypoxic seizure risk

Question 32

tet spell

Answer 32

periods of hypoxia while feeding or pooping --> tachypneic, blue, cool extremities

Question 33

blue tet

Answer 33

severe pulmonic stenosis - need surgery soon

Question 34

pink tet

Answer 34

mild pulmonic stenosis - can wait a little longer for surgery

Question 35

mgmt of tet spells

Answer 35

bring knees to chest - pressure increases venous return to increase pulmonary flow

Question 36

mgmt of tet

Answer 36

furosemide, digoxin, restrict allotted time for PO feeds to conserve energy, can give O2 & morphine

Question 37

tx of tet

Answer 37

BT shunt until ready for open repair, then close VSD & widen pulm artery

Question 38

aortic stenosis

Answer 38

narrowed aortic valve causing L ventricular hypertrophy --> coronary arteries may not be perfused

Question 39

s/s of AS

Answer 39

L sided HF, dyspnea, activity intolerance, may faint or arrest w/ strenuous activity

Question 40

mgmt of AS

Answer 40

furosemide, digoxin, beta blockers

Question 41

AS tx

Answer 41

dilation, stent placement

Question 42

HLHS

Answer 42

no left ventricle - PDA & ASD needed to live

Question 43

s/s of HLHS

Answer 43

sats 70-85%, cyanosis

Question 44

what should you do if a HLHS infant has +4 pedal pulses, headache, satting 63%?

Answer 44

give O2, may need to vent

Question 45

what should you do if an HLHS infant has cool, pale feet, cap refill of 5 seconds, crackles, satting 91%?

Answer 45

give antihypertensives

Question 46

HLHS tx

Answer 46

prostaglandins, artificial ASD, BT shunt, will eventually need a transplant

Question 47

HLHS mgmt

Answer 47

balance pulm & circulatory flow

Question 48

ASD

Answer 48

opening between atria, L to R shunt --> increased pulmonary flow

Question 49

ASD s/s

Answer 49

L sided HF, crackles, tachypnea, diaphoresis

Question 50

ASD mgmt

Answer 50

lasix, digoxin, rest, increase calories

Question 51

ASD tx

Answer 51

cath lab/open closure

Question 52

VSD

Answer 52

opening between ventricles, L to R shunt, can eventually go R to L

Question 53

VSD s/s

Answer 53

L&R sided HF, crackles, fatigue, edema, lethargy

Question 54

VSD tx

Answer 54

cath lab/open closure

Question 55

VSD mgmt

Answer 55

lasix, digoxin, antihypertensives