Cardiac

Question 1

Preload

Cardiac

Answer 1

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

Question 2

Afterload

Cardiac

Answer 2

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

Question 3

Contractility

Cardiac

Answer 3

How effective the heart is at pumping

Question 4

Stroke Volume

Cardiac

Answer 4

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

Question 5

Congenital Heart Disease

Cardiac

Answer 5

Defect in the heart or great vessels of a fetal structure

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

Question 6

Heart Sounds found in Children

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Cardiac

Answer 6

• 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

Question 7

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

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Cardiac

Answer 7

S4

Question 8

Categories of Congenital Heart Defects (CHD)

Cardiac

Answer 8

1.) Acyanotic (↑ pulmonary blood flow)

2.) Cyanotic (↓ pulmonary blood flow)

3.) Obstructive

4.) Mixed

Question 9

Acyanotic Congenital Heart Defects

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

Cardiac

Answer 9

↑ 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

Question 10

Cyanotic Congenital Heart Defects

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

Cardiac

Answer 10

↓ 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

Question 11

Obstructive Congenital Heart Defects

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

Cardiac

Answer 11

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

Question 12

Mixed Congenital Heart Defects

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

Answer 12

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

Question 13

Kawasaki Syndrome

Cardiac

Answer 13

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

Question 14

Signs & Symptoms of Kawasaki Disease

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Cardiac

Answer 14

• Strawberry Tongue
• Fever
• Cracking Skin
• Swelling of hands & feet

Question 15

What should children with Kawasaki Disease be monitored for?

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Cardiac

Answer 15

Coronary Artery Aneurysms

Question 16

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

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Cardiac

Answer 16

Kawasaki Disease

Question 17

What are the 3 stages of Kawasaki Disease?

Cardiac

Answer 17

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

Question 18

Treatment for Kawasaki Disease

Cardiac

Answer 18

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)

Question 19

Cardiomyopathy

Cardiac

Answer 19

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

Question 20

Dilated Cardiomyopathy

Cardiac

Answer 20

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)

Question 21

Hypertropic Cardiomyopathy

Cardiac

Answer 21

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

Question 22

What is Dilated Cardiomyopathy?

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Cardiac

Answer 22

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

Question 23

What are the treatments for Dilated Cardiomyopathy?

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Cardiac

Answer 23

Diuretics

Digoxin

ACE Inhibitors

Question 24

Side effects of diuretics in kids

Cardiac

Answer 24

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

Question 25

**Side effects of Digoxin in kids?** ## Footnote **Cardiac**

Answer 25

* **bradycardia** * **vomiting** * **not eating** * **blurred vision** * digoxin toxicity

Question 26

**Side effects of ACE Inhibitors in kids** ## Footnote **Cardiac**

Answer 26

* **hypotension** * **cough** * **hyperkalemia**

Question 27

**What can dilated cardiomyopathy lead to / cause?** ## Footnote **Cardiac**

Answer 27

**Blood clots & increased risk for embolism**

Question 28

**What is Hypertrophic Cardiomyopathy?** | **KNOW THIS!!!!** ## Footnote **Cardiac**

Answer 28

**heart muscle becomes enlarged & obstructs blood flow**

Question 29

**What are the treatments for Hypertrophic Cardiomyopathy?** | **KNOW THIS!!!!** ## Footnote **Cardiac**

Answer 29

**Beta Blockers** * propranolol * metoprolol **Calcium Channel Blockers** * verapamil * amlodipine * nifedipine **Cardioverter / Defibrillator**

Question 30

**What is Hypovolemic Shock** | **KNOW THIS!!!!** ## Footnote **Cardiac**

Answer 30

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

Question 31

**What are common causes of Hypovolemic Shock?** | **KNOW THIS!!!!** ## Footnote **Cardiac**

Answer 31

* **Hemorrhage** * **Burns** (plasma loss) * **Nephrotic Syndrome** (plasma loss) * **Sepsis**

Question 32

**Signs & Symptoms of Hypovolemic Shock** | **KNOW THIS!!!!** ## Footnote **Cardiac**

Answer 32

* **Pale** * **Cool extremities** * **Weak / thready pulses** * **Diaphoresis** * **↓ BP** ## Footnote **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

Question 33

**Treatment for Hypovolemic Shock** | **KNOW THIS!!!!** ## Footnote **Cardiac**

Answer 33

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