Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PEDs Exam 2 > Cardiac > Flashcards

Cardiac Flashcards

1
Q

What are the four structures of fetal circulation?

A
  • umbilical vein, umbilical arteries
  • foramen ovale
  • ductus arteriosus
  • ductus venosus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

True or false: lungs are used in utero.

A

false; lungs are like deflated balloons until the newborn takes its first breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what important thing happens when a newborn takes its first breath?

A

the lungs expand and all the fetal circulation structures that were used in utero should be closed or begin to close

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

The ductus venosus does what important job?

A

connects umbilical vein to inferior vena cava causing blood to bypass the liver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Which fetal circulation structure is permanently closed when the clamp is placed on the umbilical cord?

A

ductus venosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is an early sign to look for in an infant that would indicate cardiac dysfunction?

A

poor feeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are some other pediatric indicators of cardiac dysfunction?

A
  • poor feeding: infant
  • tachypnea
  • tachycardia
  • failure to thrive, poor weight gain
  • activity intolerance: older kiddos
  • developmental delays especially gross motor
  • positive family history of cardiac disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are some common gross motor milestones that may be delayed if cardiac dysfunction is indicated?

A
  • crawling: infant
  • walking: toddler and preschool
  • exercise: toddler and preschool
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are some important family history questions consider with cardiac disease/dysfunction?

A
  • prenatal care
  • delivery process (was it traumatic?)
  • substance abuse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the key thing we’re listening for in an infant or child who we suspect has some type of cardiac dysfunction?

A

murmurs; however, they are hard to detect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what are some key assessments of cardiac function?

A
  • history: prenatal and postnatal
  • color
  • auscultation
  • pulses
  • blood pressure (in all 4 extremities)
  • capillary refill
  • abdomen (distention)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

with which cardiac condition is it imperative to check BP in all four extremities and why?

A

coarctation of the aorta because lower extremities will have a lower BP than upper extremities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what are some types of diagnostic testing that is done to detect cardiac issues?

A
  • chest X Ray
  • ECG
  • echocardiography
  • cardiac catheterization
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are some potential complications that can occur during a cardiac catheterization?

A
  • hemorrhage (#1)
  • arrhythmias
  • vascular damage
  • vasospasms
  • thrombus
  • embolus
  • infection
  • catheter perforation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what are some primary nursing care skills that should be done for cardiac catheterization?

A
  • mark distal pulses before procedure
  • check insertion site dressing Q 15 minutes for the first 2 hours
  • monitor heart rate, vitals, and pulses Q 15 minutes initially (pt will be on tele)
  • maintain affected extremity in straight, flat position
  • keep the patient on bed rest (typically 6 hours)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the number one thing that should be monitored after a patient has a cardiac catheterization, and if this particular thing occurs what should be done?

A
  • monitor for bleeding and arrhythmias
  • oozing, swelling , check under the patient
  • if bleeding occurs, apply pressure, and call for help (cardiologist)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Cardiac catheterization emergency management of bleeding from the site is to apply pressure ____ inch(es) above the insertion site.

A

1 inch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what are some post cardiac catheterization teaching highlights?

A
  • for a parent of a child who recently had a cardiac catheterization should include monitoring the site
  • the child should avoid strenuous exercise, but may return to school
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the two types of cardiac defects?

A
  • congenital

- acquired

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what are the types of congenital cardiac defects?

A

anatomic , resulting in abnormal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the causes of acquired cardiac defects?

A 
-disease process:
\+infection 
\+autoimmune response
\+environmental factors 
\+familial tendencies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what are the hemodynamic characteristics and classifications of congenital heart disease? (4)

A
  • increased pulmonary blood flow
  • decreased pulmonary blood flow
  • obstruction of blood flow out of the heart
  • mixed blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Increased pulmonary blood flow defects have left to right shunting lesions and cause what?

A
  • increase blood volume on right side a heart
  • increased pulmonary blood flow
  • decrease systemic blood flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what is 1 cause of increased pulmonary blood flow defects (left to right shunting)

A
  • abnormal connection between two sides of the heart

- either the septum or the great vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are the three types of increased pulmonary blood flow defects?

A
  • atrial septal defect (ASD)
  • ventricle septal defect (VSD)
  • patent ductus arteriosus (PAD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

where does atrio septal defect occur and what are the common characteristics?

A
  • foreman ovalle
  • two times more common in females
  • can be asymptomatic until dyspnea and fatigue occur on exertion
  • may have a murmur
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what are the common characteristics of ventricle septal defect?

A
  • this is the most common congenital lesion

- majority of these close spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what are the characteristics of Patent ductus arteriosus?

A
  • this is most common in pre-term infants

- acyanotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

when do we want the patent ductus arteriosus to be closed?

A

1 hour after birth; however, no longer than six hours after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what happens if the atrial septal defect is not asymptomatic or does not close on its own?

A
  • chronic increased pulmonary blood flow leads to pulmonary vascular obstructive disease
  • atrial dysrhythmias caused by atrial enlargement
  • surgery or non-surgical cardiac catheterization is done to prevent pulmonary vascular obstructive disease as an adult
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

what are the three types of decreased pulmonary blood flow defects (right to left shunting)?

A
  • Tetralogy of Fallot
  • tricuspid atresia
  • transposition of the great vessels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Decreased pulmonary blood flow defects carry _____________ blood to the body causing cyanosis.

A

non-oxygenated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

what are the four things the categorize a defect as Tetralogy of Fallot?

A
  • pulmonic stenosis
  • right ventricular hypertrophy
  • overriding aorta
  • ventricular septal defect
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

True or false: a patient with Tetralogy of Fallot will be extremely cyanotic so giving them oxygen will help.

A

false; oxygen will not help because hemodynamics of this patient differ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

what are common characteristics of Tetralogy of Fallot?

A
  • most frequent cyanotic lesion
  • boot shaped heart
  • may need prostaglandin aid to keep PDA open
  • clubbing
  • cyanotic spells - Tet spells or hyper-cyanotic spells
  • polycythemia (keep hydrated)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How do we treat cyanotic spells that occur in patients with Tetralogy of Fallot?

A

put the patient in a needed chest baby position or have the patient squat during Tet spells because this increases the blood flow to the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what is a patient who has Tetralogy of Fallot most at risk for?

A
  • clots/embolus
  • seizures
  • sudden death
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the three types of obstructed defects?

A
  • coarctation of the aorta
  • aortic stenosis
  • pulmonic stenosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

what happens in a patient who has coarctation of the aorta?

A
  • there is a decreased blood flow to the lower part of the body
  • BP in upper extremities will be higher than in the lower extremities (check BP in all 4 extremities)
40
Q

What are the two types of congestive heart failure in children?

A
  • Pulmonary congestion (left sided)

- systemic venous congestion (right sided)

41
Q

What are some signs and symptoms of pulmonary congestion (left sided)?

A
  • tachypnea
  • dyspnea
  • respiratory distress (increased RR)
  • exercise intolerance
  • cyanosis
  • crackles
42
Q

what are some signs and symptoms of systemic venous congestion (right sided)?

A
  • peripheral and periorbital edema
  • weight gain
  • ascites (abdominal distention)
  • hepatomegaly
  • neck vein distention
43
Q

what are signs and symptoms of impaired myocardial function?

A
  • tachycardia (#1- even at rest)
  • gallop rhythm
  • fatigue
  • weakness
  • restlessness
  • pale
  • cold extremities
  • decrease BP
  • decreased UOP
44
Q

the earliest sign of heart failure is __________ which is defined as an infant having a sleeping heart rate of greater than ____ bpm.

A

tachycardia

>160 bpm

45
Q

what are some overall signs and symptoms of congestive heart failure in children?

A
  • all infants energy is used to maintain heart rate and breathing
  • poor weight gain
  • tired easily during feedings
  • developmental delay
46
Q

what are the four types of medications used to treat congestive heart failure in children and enhance myocardial function?

A
  • oral positive inotropic agents -digoxin -improve contractility
  • ace inhibitors -reduce after load on the heart
  • beta blockers
  • diuretics
47
Q

Nursing interventions to increase cardiac output and what to monitor for.

A
  • administer digoxin as prescribed
  • monitor serum potassium levels
  • monitor pulse
  • maintain neutral thermal environment
  • plan frequent rest periods
  • cluster care/activities to allow for uninterrupted sleep
48
Q

nursing interventions pertaining to what to monitor for with the oxygenation

A
  • monitor respiratory rate and lung sounds
  • monitor oxygen saturation
  • provide oxygen in the humidification if prescribed
  • observed for diaphoresis, a sign of increase respiratory effort
  • position and semi-Fowler to relieve orthopnea
49
Q

What are some nursing interventions to assess fluid volume?

A
  • strict I&Os
  • daily weight
  • measure abdominal girth daily
  • observe for peripheral edema
  • administer diuretics as ordered
  • monitor electrolytes
50
Q

what are some nursing interventions to assess nutrition?

A
  • maintain nutritional status with small, frequent, high caloric feeds
  • 20 Cal increase to 24 Cal/oz
  • limit feedings to 20-30 minutes
  • infant may require tube feedings to conserve energy
  • provide pacifier for sucking needs if tube feeding
51
Q

What are the three types of cardiac arrhythmias in children ?

A
  • sinus tachycardia
  • supra ventricular tachycardia
  • bradycardia
52
Q

what are some nursing considerations for sinus tachycardia?

A
  • fever
  • stress
  • pain
  • agitation
  • hypovolemia (shock)
  • congestive heart failure
53
Q

what is the management for sinus tachycardia?

A

identify and treat underlying cause

54
Q

what is the abnormal heart rate associated with sinus tachycardia for both infants and children?

A 
infant = <220 BPM 
child= <180 BPM
55
Q

what is the abnormal heart rate associated with super ventricular tachycardia for both infants and children?

A 
infant = >220 BPM 
child = >180 BPM
56
Q

what are nursing considerations for stable supra ventricular tachycardia?

A
  • initiate vagal response ( ice to face, have patient bear down , have patient blow through straw)
  • suction the nasopharynx
57
Q

what medication is administered for stable super ventricular tachycardia?

A
  • adenosine 0.1mg/kg double dose after first dose (Max first dose of 6mg)
  • give IV as a slam technique( push in adenosine and immediately push in normal Saline after)
58
Q

what are some common causes of bradycardia in a neonate?

A
  • suctioning
  • reflux
  • apnea of prematurity
59
Q

what are some other common causes of bradycardia (besides suctioning, reflux, and apnea of prematurity)?

A
  • hypoxemia (give O2 first)
  • hypothermia
  • head injury
  • heart block
  • heart transplant
  • toxins\ poisons\ drugs
  • increased vagal tone
  • central line in right atrium
60
Q

What do we do if cardiogenic shock is caused by bradycardia or tachycardia?

A

manage arrhythmias per algorithms

61
Q

what do we do if cardiogenic shock is caused by congenital heart disease or heart surgery?

A
  • administer 5-10mL NS/LR bolus and repeat as necessary after listening to the lungs
  • vasoactive infusion
62
Q

What are some signs and symptoms to assess low cardiac output?

A
  • poor neurological status
  • acidosis
  • high lactate
  • poor perfusion (long capillary refill time)
  • modeled skin
  • weak\ thready pulses
  • hands and feet cool to touch
  • poor UOP
63
Q

What are the common causes of infective (bacterial) endocarditis?

A
  • streptococcal
  • staphylococcal
  • fungal infections
64
Q

how do patients often present if they have infective endocarditis?

A

with insidious, low grade fever

65
Q

what do we give prophylactically before dental work and before surgeries to decrease the risk of infective endocarditis from happening?

A

prophylactic antibiotics

66
Q

what is rheumatic fever?

A

inflammatory disease that occurs after Group A B-haemolytic streptococcal pharyngitis (strep throat)

67
Q

what are some major things throughout the body that can be affected by rheumatic fever?

A
  • joints
  • skin
  • brain
  • heart
  • serous surfaces
68
Q

What is the most common complication of rheumatic fever if there is significant damage to the heart valves?

A

rheumatic heart disease

69
Q

what are some clinical manifestations of rheumatic fever?

A
  • carditis (chest pain, SOB)
  • fever
  • tachycardia (even during sleep)
  • polyarthritis (migratory large-joint pain)
  • erythema marginatum ( rash started trunk)
  • subcutaneous nodules over Bony prominences
  • Chorea (irregular involuntary movements)
70
Q

what are some lab findings that are associated with rheumatic fever?

A
  • elevated erythrocyte sedimentation rate

- elevated ASO (antistreptolysin O) titer -rise and titers begins about seven days post onset of infection

71
Q

What is Kawasaki Disease?

A

In acute systemic vasculitis of unknown cause

72
Q

what is the most common adverse result in coronary artery disease that occurs in 75% of cases in children less than five years old?

A

Kawasaki disease

73
Q

what are the three phases of Kawasaki Disease?

A
  • acute
  • subacute
  • convalescent
74
Q

what is the acute phase of Kawasaki disease?

A

abrupt onset of high fever, lasting at least five days, unresponsive to antipyretics and antibiotics

75
Q

what is the sub-acute phase of Kawasaki disease?

A

resolution of fever through end of all KD clinical signs

76
Q

what is the convalescent phase of Kawasaki disease?

A

clinical signs resolved, but laboratory values not returned to normal; Completed with normal values ( 6 to 8 weeks)

77
Q

what are some clinical manifestations during the acute phase of Kawasaki disease?

A
  • cervical lymphadenopathy
  • red, cracked lips
  • strawberry tongue
  • erythematous palms
  • reddened, dry eyes
  • hands and feet edematous
  • palms and soles erythematous
  • very irritable and inconsolable
  • arthritis in small joints
78
Q

what inflammatory markers on labs are elevated during the acute phase of Kawasaki disease?

A

C-reactive protein , erythrocyte sedimentation rate

79
Q

What are the clinical manifestations during the sub-acute phase of Kawasaki disease?

A
  • begins with the resolution of fever
  • risk of coronary thrombosis
  • Pilling of hands and feet
  • arthritis in large weight bearing joints
  • irritability persisting
80
Q

what are the clinical manifestations during the convalescent phase of Kawasaki disease?

A
  • clinical signs resolve
  • may still have elevated sed rate and CRP
  • may still have arthritis
81
Q

what is the treatment for Kawasaki disease?

A
  • high dose IVIG (decreases inflammation and prevents arrhythmias)
  • high dose aspirin (prevent arrhythmias and clotting)
82
Q

What is some priority nursing care that needs to be done for a child who has Kawasaki disease?

A

-management of risk for fluid imbalance
-assess for signs of heart failure
+decrease UOP
+gallop rhythm
+tachycardia
+respiratory distress
-provide quiet, restful environment (decrease stimuli and cluster care)
-mouth care-lubricating ointments for lips
-ROM in bath for arthritis pain
-acetaminophen for fever
-clear liquid’s/soft foods
-cool cloths
-gentle lotions

83
Q

What is some education that needs to be provided to the family of a child who has Kawasaki disease?

A
  • irritability may persist for two months or more
  • take temperature daily after discharge
  • continue passive range of motion during bath to ease arthritis pain
  • avoid live vaccines for 11 months post administration of IVIG
  • avoid children with viral illness (Reye’s syndrome) related to use of aspirin
  • know signs of aspirin toxicity if given
84
Q

In pediatrics, hypertension is generally secondary to structural abnormalities or underlying pathogenic conditions such as?

A
  • renal disease (most common)
  • cardiovascular disease
  • endocrine or neurological disorders
85
Q

at what age should blood pressure screenings begin?

A

three years of age

86
Q

what are some labs to draw if a child has hypertension ?

A
  • CBC
  • BMP
  • urinalysis/culture
  • drug screen
  • renal ultrasound
  • EKG
  • sleep study (sleep apnea, lack of sleep)
87
Q

what are some treatment options for hypertension?

A
  • non-pharmacological intervention first (start with diet and exercise)
  • pharmacological (ace inhibitors and betablockers)
88
Q

what is the major adverse reaction of ace inhibitors, and is the reason we need to monitor female adolescents closely?

A

Teratogenic

89
Q

what are some adverse reactions of beta blockers?

A
  • mood disturbances
  • depression
  • lipid abnormalities
90
Q

children ____ years of age and older should be screened for hyperlipidemia if they have any risk factors that indicate the need for a lipid profile.

A

2 years

91
Q

what are the four common risk factors indicating a need for a lipid profile (hyperlipidemia)?

A
  • obesity (BMI in 95th percentile or higher)
  • hypertension
  • a parent or grandparent with a cholesterol level of 240mg/dL or higher
  • early cardiovascular disease in a first or second degree relative
92
Q

what are the numbers that indicate an elevated cholesterol in children (total and LDL)?

A
  • total cholesterol >200mg/dL

- LDL >130mg/dL

93
Q

when should a full lipid profile be drawn in children?

A

after a 12 hour fast

94
Q

do not do a lipid panel within ___ weeks of a febrile illness.

A

3 weeks

95
Q

what is the first line treatment for hyperlipidemia?

A

dietary (restrict intake of cholesterol and fats)

96
Q

if there is no response to diet changes for hyperlipidemia, what two medications should be considered?

A
  • lovastatin

- cholestyramine

PEDs Exam 2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions