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Pediatrics Nursing - NUR 220 > Cardiac > Flashcards

Cardiac Flashcards

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1
Q

stenosis

A

narrowing causing obstruction to blood flow

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2
Q

Atresia

A

Complete blockage of blood flow

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3
Q

heart murmurs

A

abnormal struture of the heart, making blood travel in an abnormal fashion resulting in noise

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4
Q

Physical indicators of cardiac dysfunction

A

Tachypnea, tachycardia, diaphoresis, crackles, edema, cyanosis, murmur, sternal lift, clubbing of the fingers

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5
Q

Normal heart rate:

  1. Newborn
  2. 3 Years
  3. 10 years
  4. 16 years
A
  1. 120-160
  2. 80-125
  3. 70-120
  4. 55-90
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6
Q

Cardiac catherization

A

Invasive routine and diagnostic procedure using radiopaque catheters placed in peripheral blood vessel and then guided into heart with aid of fluoroscopy

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7
Q

Biggest risks of cardiac cath

A

BLEEDING

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8
Q

Cardiac cath post op care includes:

A

Check pulses

Monitor coolness, blanching

Vitals taken every 15 minutes, HR for full 60 seconds

Hypotension could indicate hemorrhage

Fluid intake, blood glucose levels

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9
Q

What do you do if bleeding occurs after a cardiac cath?

A

Direct continuous pressure is applied 1 inch above the site to localized pressure of the vessel puncture

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10
Q

What do you do before giving digoxin?

A

Check apical pulse for a full 60 seconds prior to administration

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11
Q

What pulse would indicate not to give digoxin?

  • Infants?
  • Older children
A

90 -110 bpm in infants

70 beats/min in older children

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12
Q

Signs of toxicity in digoxin

A

N/V
Anorexia
Bradycardia
Dysrhythmias

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13
Q

Prostaglandins - IMPORTANT TO KNOW!

A

Metabbolizes rapidly - infusion must be continuous and have it’s own IV line

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14
Q

Side effects of prostaglandins

A

Reduced glomerular filtration

Impaired Plt function
Decreased GI blood flow

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15
Q

What is the major cause of death in the first year of life?

A

Congenital Heart Disease

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16
Q

Left to Right Shunting

A

Involves blood flow from the left side(blood that goes to the body) of heart to the right side(blood that goes to the lungs) resulting in increased pulmonary blood flow

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17
Q

Ventricular septal defect(VSD)

A

MOST COMMON

  • Abnormal opening is present in the septum between the two ventricles

Allows blood to shunt L-R

Blood that should go to aorta and out of the body shunts back into pulmonary circulation

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18
Q

VSD assessment upon child

A

occurs when 4-8 years old

Fatigue, loud and harsh murmur

  • SOB, crackles, feeding difficulty, murmur, FTT. respiratory infections, cardiomegaly
  • Fatigue, Harsh murmur(at 4-8 weeks of life) is when shunting starts
19
Q

Treatment of VSD

A

Most close spontaneously by age of 1

Cardiac cath: moderate size

Prophylatic abx 6 mos - prevents endo carditis and other infections before/after surgery

20
Q

When would you perform open heart surgery for a patient with VSD?

A

Over 3mm

-age of 2

21
Q

Nursing interventions of VSD:

A

Monitor feeding - give breaks during

S/S CHF

Monitor WOB

22
Q

Medication for VSD

A

-Diuretic or digoxin - prevent fluid accumulation in lungs

23
Q

Atrial Septal Defect(ASD)

A
  • abnormal opening between the atria that causes an increased flow of oygenated blood into the right side of the heart
  • Blood shifts L to R
  • Most common in girls
24
Q

How will a patient present with ASD?

A

Asymptomatic until infection from recirculating blood occurs

25
Q

Treatment for ASD

A
  • Surgery between 1-3 years old
26
Q

What happens if ASD is not repaired?

A

Emboli formation later in life

Infection - endo carditis, HF

27
Q

S/S of ASD

A

Asymptomatic

  • Harsha systolic murmur over pulmonic area
  • Increased blood volume right side of heart
  • Split second heart sound(lub-dud-dud)
  • Most close spontaneously
28
Q

Patent Ductus Arteriosus(PDDA)

A

Failure of the fetal ductus arteriosus(sjunt connecting the aorta and the oulmonary artery) to close within first weeks of life

29
Q

What would you see in PDA?

A
  • Continuous murmur
  • Shunting blood from aorta to pulmonary artery d/t higher pressure in aorta
  • Same s/s as ASD - wide pulse pressure, murmur, wet bs, tachypnea, poor feeding, sweating w/ feedings
30
Q

Treatment of PDA

A
  • Iv Indomethacin or ibuprofen - PGE inhibitors
  • Cardiac cath - 6mos -1 year

Ductal ligation

31
Q

When should PDA close on its own?

A

Should close hours to days after birth, may take up to 3 months

32
Q

Nursing Interventions for PDA

A

Risk for CHF/endocarditis

  • Decrease WOB, Give rest periods, I&O, Diueretics, Dopamine, Digoxin, Daily weight
33
Q

Pulmonic Stenosis

A

narrowing at the entrance of the pulmonary artery

34
Q

S/S of pulmonic stenosis

A
  • Mild right sided CHF
  • Cyanosis
  • Loud murmur
  • SOB, RV hypertrophy
  • Cardiomegaly
35
Q

Nursing interventions for pulmonic stenosis

A
  • Calm envirnment
  • Monitor BP/O2 sat

-If atresia - Give PGE keep PDA open, IV own line, continuous infusion

36
Q

Treatment for pulmonic stenosis

A
  • Cardiac cath - Balloon angioplasty
  • Normal life span
  • Restenosis may occur
37
Q

Aortic Stenosis

A

narrowing or stricture of the aortic valve, causing resistance to blood flow from the left ventricle into the aorta, causing a decreased cardiac output

38
Q

Symptoms of aortic stenosis

A
  • Murmur(may or may not be present)
  • Faint pulses
  • Hypotension
  • Tachycardia
  • Poor feeding
  • Chest pain
  • Exercise tolerance
39
Q

Treatment of Aortic stenosis

A
  • Stabilization with beta blocker or CCB
  • Balloon valvuloplasty
  • May need valve repalcement
  • Anticoagulation
  • Antiplts
  • Abx
  • Exercise test before competitive sports
40
Q

Coarctation of the aorta

A
  • Localized narrowing near the insertion of the ductus arteriosus
  • Aorta brings blood to the rest of the body
41
Q

What is the only mild symptom that you would see in COA?

A
  • Dec/Absent femoral pulse
    -Cardiomegaly
  • R sided heart failure
  • HTN(headache)
  • SOB, Poor feeding
    Chest xray
42
Q

Nursing interventions for COA

A

Medication - digozin/lasix

  • Mild( wait ti repair) at age 2
  • Cardiac cath dilation(baloon angioplasty)
  • Stent placed
43
Q

What would be done if severe COA?

A

Baloon cath then surgery

44
Q

Decreased pulmonary blood flow:

A

Blood is having a difficult time leaving the right side of the heart via the pulmonary artery

Pediatrics Nursing - NUR 220 (3 decks)

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