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Pediatrics Final Exam > Cardiac > Flashcards

Cardiac Flashcards

1
Q

Preload

Cardiac

A

Amount of fluid in the ventricles at the end of diastole (once the ventricles are fully filled)

  • amount of fluid on board / fluid overload
  • more fluid more pressure / ↑ BP
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2
Q

Afterload

Cardiac

A

Resistance the left ventricle must pump against to push blood into circulation

  • ↑ dilation of vessel = ↓ pressure exerted on vessel to pump blood out into circulation
  • ↓ dilation of vessel = ↑ pressure exerted on vessel to pump blood out into circulation
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3
Q

Contractility

Cardiac

A

How effective the heart is at pumping

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4
Q

Stroke Volume

Cardiac

A

The volume of blood pumped out by a ventricle with each heartbeat

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5
Q

Congenital Heart Disease

Cardiac

A

Defect in the heart or great vessels of a fetal structure

  • critical & non-critical
  • most occur in the first 8 weeks of gestation
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6
Q

Heart Sounds found in Children

KNOW THIS!!!!

Cardiac

A
  • S1
  • S2
  • S3 can be normal in children (related to rapid filling of ventricle)
  • S4 is NOT normally heard in children & can be indicative of CHF
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7
Q

What heart sound in children is abnormal and can indicate CHF?

KNOW THIS!!!!!

Cardiac

A

S4

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8
Q

Categories of Congenital Heart Defects (CHD)

Cardiac

A

1.) Acyanotic (↑ pulmonary blood flow)

2.) Cyanotic (↓ pulmonary blood flow)

3.) Obstructive

4.) Mixed

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9
Q

Acyanotic Congenital Heart Defects

  • what is it?
  • what are the specific heart defects?
  • what are the signs & symptoms?

Cardiac

A

↑ pulmonary blood flow (↑ blood flow into the lungs)

*

1.) PDA (patent ductus arteriosus)
2.) ASD (atrial septal defect)
3.) VSD (ventricular septal defect)

*

Signs & Symptoms:
* tachypnea
* tachycardia
* murmur
* CHF
* poor weight gain
* diaphoresis
* edema

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10
Q

Cyanotic Congenital Heart Defects

  • what is it?
  • what are the specific heart defects?
  • what are the signs & symptoms?

Cardiac

A

↓ pulmonary blood flow (↓ blood flow into the lungs = less blood is oxygenated by the lungs)

*

1.) Tetrology of Fallot
* pulmonary stenosis
* ventricular hypertrophy
* VSD
* aorta displaced over VSD

*

Signs & Symptoms:
* polycythemia (too many RBCs in the body)
* cyanosis
* hypoxic spells
* poor weight gain

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11
Q

Obstructive Congenital Heart Defects

  • what is it?
  • what are the specific heart defects?
  • what are the signs & symptoms?

Cardiac

A

blood flow is obstructed

1.) CoA (Coarctation of the Aorta)
2.) HLHS (Hypoplastic Left Heart Syndrome)

Signs & Symptoms:
* ↓ pulses
* poor color
* delayed capillary refill
* ↓ urine output
* CHF with pulmonary edema

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12
Q

Mixed Congenital Heart Defects

  • what is it?
  • what are the specific heart defects?
  • what are the signs & symptoms?
A

oxygenated and non-oxygenated blood are mixed in the heart

1.) TGA (Transposition of the Great Arteries)

Signs & Symptoms:
* cyanosis
* poor weight gain
* pulmonary congestion

  • survival relies on mixing of systemic & pulmonary
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13
Q

Kawasaki Syndrome

Cardiac

A

Acute febrile, systemic vascular inflammatory disorder that affects small & mid-sized arteries

  • Acute febrile (5 days) disorder that leads to inflammation of arteries, includign the coronary arteries
  • 3 stages
  • unknown etiology

Leading cause of acquired heart disease in children

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14
Q

Signs & Symptoms of Kawasaki Disease

KNOW THESE!!!!

Cardiac

A
  • Strawberry Tongue
  • Fever
  • Cracking Skin
  • Swelling of hands & feet
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15
Q

What should children with Kawasaki Disease be monitored for?

KNOW THIS!!!!

Cardiac

A

Coronary Artery Aneurysms

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16
Q

What is the leading cause of acquired heart disease in children?

KNOW THIS!!!!

Cardiac

A

Kawasaki Disease

17
Q

What are the 3 stages of Kawasaki Disease?

Cardiac

A

1.) Acute Stage
* fever for 5 days (39 C / 102.2 F)
* conjunctival hyperemia (no exudate)
* cervical lymph node enlargement
* strawberry tongue
* rash

2.) Subacute Stage
* Cracking skin, lips, fingers, toes
* coronary artery aneurysms

Convalescent Stage
* asymptomatic stage of kawasaki disease
* occurs 6-8 weeks after symptoms begin

18
Q

Treatment for Kawasaki Disease

Cardiac

A

IV IG (IV immunoglobulin – give highest possible dose) + Aspirin (large dose then small dose)

  • monitor for coronary artery aneurysms (5% chance) = CABG

Nursing: meds, comfort, teaching (bleeding risk)

19
Q

Cardiomyopathy

Cardiac

A

Disease of the heart muscle (making it hard to pump)

  • results inchanges in chamber size, wall thickness, and/or contraction
  • eventually leads to systolic or diastolic dysfunction
20
Q

Dilated Cardiomyopathy

Cardiac

A

Disease of the heart muscle that causes the heart to become enlarged & pump less

  • common in children
  • Increased risk for embolism

*

Signs & Symptoms: fatigue, weakness, exertional dyspnea

*

Tx: Diuretics, digoxin, ACE inhibitors (similar to tx for CHF)

21
Q

Hypertropic Cardiomyopathy

Cardiac

A

Heart muscle becomes enlarged & blocks blood flow

*

Signs & Symptoms: exertional dyspnea, fatigue, dizziness, fainting, & angina-like chest pain

*

Treatment:
* Beta-Blockers (“-olol) (propranolol, metoprolol, etc.)
* Calcium Channel Blockers (“-ipine” (verapamil, amlodipine, nifedipine, etc.)
* Cardioverter / Defibirllator

22
Q

What is Dilated Cardiomyopathy?

KNOW THIS!!!!

Cardiac

A

Disease of the heart muscle that cause the heart to become enlarged & to pump less

23
Q

What are the treatments for Dilated Cardiomyopathy?

KNOW THIS!!!!

Cardiac

A

Diuretics

Digoxin

ACE Inhibitors

24
Q

Side effects of diuretics in kids

Cardiac

A
  • fluid & electrolyte imbalances (hypokalemia, etc.)
  • hypotension
25
Q

Side effects of Digoxin in kids?

Cardiac

A
  • bradycardia
  • vomiting
  • not eating
  • blurred vision
  • digoxin toxicity
26
Q

Side effects of ACE Inhibitors in kids

Cardiac

A
  • hypotension
  • cough
  • hyperkalemia
27
Q

What can dilated cardiomyopathy lead to / cause?

Cardiac

A

Blood clots & increased risk for embolism

28
Q

What is Hypertrophic Cardiomyopathy?

KNOW THIS!!!!

Cardiac

A

heart muscle becomes enlarged & obstructs blood flow

29
Q

What are the treatments for Hypertrophic Cardiomyopathy?

KNOW THIS!!!!

Cardiac

A

Beta Blockers
* propranolol
* metoprolol

Calcium Channel Blockers
* verapamil
* amlodipine
* nifedipine

Cardioverter / Defibrillator

30
Q

What is Hypovolemic Shock

KNOW THIS!!!!

Cardiac

A

inadequate tissue & organ perfusion due to inadequate blood or plasma volume in vascular space

31
Q

What are common causes of Hypovolemic Shock?

KNOW THIS!!!!

Cardiac

A
  • Hemorrhage
  • Burns (plasma loss)
  • Nephrotic Syndrome (plasma loss)
  • Sepsis
32
Q

Signs & Symptoms of Hypovolemic Shock

KNOW THIS!!!!

Cardiac

A
  • Pale
  • Cool extremities
  • Weak / thready pulses
  • Diaphoresis
  • ↓ BP

Mild S/S: mild tachycardia, normal BP, weak pulses, anxious, normal capillary refill, cool, clammy, ↓ urine output

*

Moderate S/S: moderate tachycardia, weak / thready pulses, ↓ BP, confusion, agitation, pallor, >3 capillary refill, cold, dry, sunken eyes, oliguria

*

Severe S/S: extreme tachycardia, hypotension, absent pulses, tachypnea, comatose, pale, cold, no urine output

33
Q

Treatment for Hypovolemic Shock

KNOW THIS!!!!

Cardiac

A
  • IV Fluid Bolus
  • O2
  • transfusions - (20 mL/kg) x3; max of 60 mL

Pediatrics Final Exam (5 decks)

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