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NY-Pediatric Nurse Practitioner > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

cardiac abnormalities associated with tetralogy of fallot

A

Pulmonary stenosis (ULSB), VSD at LLSB, overriding aorta, right ventricular hypertrophy

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2
Q

most common cause of congestive heart failure in the first year of life is?

A

VSD

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3
Q

s/s of Congestive EARLY heart failure in a 2-month old are?

A

Tachycardia and tachypnea

hepatomegaly, edema is initially noted in the eyes (can be subtle) about 10% wt increase.

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4
Q

what is the recommended sub acute bacterial endocarditis prophylaxis?

A

AHA recommends prophylaxis for children within 6 months of a surgical repair or catheterization procedure that left a closure device

OR (EASIER) children with repaired congenital heart disease with a residual effect.

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5
Q

URSB heard best when sitting, decreases with a change in head position, generally when turning ipsilaterally?

A

Venus Hum

```
ipsilateral= same side
(contralateral= opp. side)
~~~

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6
Q

heard best at ULSB, axilla, and back

A

Peripheral Pulmonary stenosis

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7
Q

Recommendations for children (2-8) with increased BMI and family risk factors

A

perform 2 lipid profiles and avg results

limit saturate fats <7%

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8
Q

t/f standard of care for high cholesterol for peds is statins

A

false, NO stating under 10 yrs

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9
Q

Murmur heard at URSB where is the problem likely coming from?

A

Aortic valve or Vessel

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10
Q

Murmur heard at ULSB where is the problem likely coming from?

A

pulmonic valve

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11
Q

pathologic murmur heard at LLSB where is the problem likely coming from? what else might you consider?

A

VSD or Tricuspid valve (even though tricuspid is on the RIGHT side of the heart, murmur is heard at Lower Left Sternal border)

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12
Q

grade 2 to 3/4 systolic ejection murmur heard at the ULSB concern for what kind of condition?

A

ASD

can be confused for pulmonary valve/artery problem but the question asked for systolic ejection NOT systolic ejection CLICK which is heard in stenosis

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13
Q

holosystolic murmur, sometimes associated with a thrill heard at the LLSB concern for what condition?

A

VSD

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14
Q

holosystolic murmur head at ULSB with a machinery sound concern for what condition

A

PDA

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15
Q

loud systolic ejection click at mid/ULSB concern for what condition?

A

TOF

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16
Q

hypercapnic hypercyanotic episodes are called? r/t what disorder?

A

TET spells

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17
Q

Prolonged PR interval on ECG with evidence of group A beta hemolytic strep is suspicious for?

A

Rheumatic fever

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18
Q

list some of the major Jones criteria for diagnosing rheumatic fever?(5) What are some of the minor? (4)

what is the diagnostic criteria?

A

major: subcataneous nodules, carditis, chorea, polyarthritis, erythema marginatum (erythema multiforme like rash, or lyme disease like rash)
minor: fever>102.2, elev CRP/sed rate, arthralgia, prolonger PR interval ECG with evidence of strep infection.

2 minor 1 major, or 2 minor 1 major

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19
Q

Venous hum decreases or disappears what two ways?

A

when turning head ipsilateral (right side), and when supine

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20
Q

what valve is most affected with rheumatic fever? which side is it?

A

Mitral- left side

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21
Q

which syndrome has coarctation of the aorta, bicuspid aortic valve

A

Turner syndrome

22
Q

which syndrome has aortic regurgitation and mitral valve prolapse?

A

Marfan syndrome

23
Q

Which syndrome is at risk for aortic dissection?

A

Marfan syndrome

24
Q

acyanotic heart diseases?
cyanotic heart diseases?
obstructive heart diseases?

A

A- VSD, ASD, PDA
C- Tran of greater arteries, TOF
O- pulm stenosis, aortic stenosis, coarc

A=  (think holes in heart)
C= more extensive conditions TGA, TOF
O= obstruction of valves
25
Q

expected sounds and locations for TOF

A

LOUD systolic ejection CLICK @ mid and ULSB

pulm stenosis @ULSB

26
Q

which condition has an ejection click at the apex and URSB if bicuspid valve is involved?

A

Coarctation

27
Q

What do you expect to see for blood pressures in the 4 limbs of kids with a coarc?

A

higher pressure in upper

Lower pressure in bottom

28
Q

TGA often has the same sounding murmur as what other condition?

A

VSD

29
Q

which condition has a machine like quality? where do you hear this?

A

PDA at the ULSB

30
Q

Where and what would you hear to make you suspect pulmonary stenosis?

A

ULSB, systolic ejection CLICK
also thrill at the ULSB radiating to back and side (PPS)
(click = think stenosis or narrow)

31
Q

Where and what would you hear to make you suspect aortic stenosis?

A

systolic thrill at URSB, systolic ejection click.

click = think stenosis or narrow

32
Q

What is the most common innocent murmur? where is it heard what does it sound like?

A

Stills murmur, between LLSB and apex

sounds musical, VIBRATORY

33
Q

Venous hum is heard best at? sounds like?

A

URSB, continuous humming murmur

34
Q

What is the flow of blood through the heart?

A

Sup vena cava, RA, Tricuspid valve, RV, Pulmonic valve, pulmonary artery, lungs, Pulm vein, LA, bicuspid/ mitral valve, LV, aortic valve, aorta, body= DONE :)

give yourself a hug that one is rough

35
Q

S1 is the closure of?

A

Mitral and tricuspid valves (AV valves think atrioventricular as they separate the atrium and ventricles)

36
Q

S2 is the closure of?

A

aortic/ pulmonic valves

37
Q

Systole is the period between?

A

S1 and S2

38
Q

diastole is the period between?

A

S2 and S1

39
Q

describe the S/S for Kawasakis?

tx?

A 
Fiery CRASH
Fiery= Fever for 5days or more
C= conjunctiva injected No exudate
R= rash, appears polymorphic/ morbiliform, 
A= cervical lymphadenopathy
S= Strawberry tongue
H= hands, fingers edematous/ swollen then desquamation
Tx: high dose ASA, IGG
40
Q

Rib notching, cardiomegaly, grade 2-3 systolic ejection murmur, possible ejection click at URSB, what condition is this?

A

Coarctation of the Aorta

41
Q

What are some red flags that concern you a patient is having chest pain related to cardiac symptoms?

A

Abrupt onset with no prodromal symptoms
frequent pain associated with activity or exertion
radiating pain, associated nausea, dizziness, fatigue

42
Q

what are some signs and symptoms of chest pain that are likely not cardiac in origin?

A

sharp, stabbing pains along two or more costochondral joints, occurs at rest, short duration (seconds to few minutes)

43
Q

what cholesterol level is considered hyperlipidemia?Borderline?

A 
200= hyper
170-199 = borderline
44
Q

what is the most useful test for eval of suspected rheum fever?

  • ASO titer
  • CRP
  • EKG
  • UA
A

ASO titer because it is important to evaluate for current or recent infection

45
Q

Wolff-Parkinson white syndrome is associated with what cardiac disorder?

A

SVT

46
Q

loud systolic ejection murmur heard at ULSB, holosystolic ejection murmur heard at LLSB with thrill. What condition are you concerned for?

A

TOF

47
Q

Turner syndrome has what cardiac anomalies?

A

coarctation of the aorta and bicuspid aortic valve

48
Q

Marfan syndrome has what cardiac anomalies?

A

mitral valve prolapse, aortic regurgitation and risk for aortic dissection

49
Q

down syndrome often has what cardiac anomalie?

A

ASD/ VSD

50
Q

List the 5 major jones criteria for diagnosis of rheumatic fever
(think P.E.C.C.S)

A 
polyarthritis
erythema marginatum
carditis
chorea
subcutaneous nodules

NY-Pediatric Nurse Practitioner (12 decks)

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