Cardiac Alterations Flashcards
In a fetus, what does the foramen ovale do?
Allows blood to pass from the right to left atrium
What does the ductus venosus do?
Channel blood from the umbilical vein to the inferior vena cava and into the right atrium
When does the foramen ovale close?
When pressure in the left atrium exceeds that of the right atrium
Ductus arteriosus constricts in response to what?
Higher oxygen saturation
What is the leading cause of death excluding prematurity during the first year of life
Congenital defects
Which ventricle is larger?
Right ventricle is initially larger than left
Immature heart is more sensitive to _________ and __________ __________.
Volume or pressure overload
Newborns cardiac output primarily depends on what?
Heart rate
At what age is the heart muscle fully developed?
Five years of age
What is congestive heart failure?
A congenital disorder, cardiac output is inadequate to support bodies circulatory and metabolic needs. There is increased pulmonary bloodflow and obstructed outflow and problems with hard contractility
What are some pathological conditions that lead to congestive heart failure?
Severe anemia, acidosis, respiratory disease
Left-sided heart failure results in what?
Pulmonary edema
What is left-sided heart failure?
The left ventricle is unable to pump blood into systemic circulation. Increased pressure in the left atrium and pulmonary veins
Describe right-sided heart failure.
The inability to pump blood into the pulmonary artery, increased pressure in the right atrium and systemic venous circulation.
What does right-sided heart failure cause?
Causes hepatosplenomegaly and occasional edema
Eventually, heart failure is ___________
Bilateral
Heart failure results in __________ ________ _______
Inadequate cardiac output
Inadequate cardiac output results in what problem with the organs and tissues?
poorly oxygenated organs and tissues
What happens to the kidneys and heart muscle in congestive heart failure?
The kidney stimulate sodium and water reabsorption causing fluid overload. The heart muscle becomes hypertrophied
What are signs and symptoms of congestive heart failure?
Tachycardia, decreased cardiac output: poor perfusion, cold extremities, weak pulses, slow capillary refill, low blood pressure, mottled skin. Pulmonary congestion: tachypnea , dyspnea , retraction, nasal flaring. Diaphoresis: during feeding and at rest. Pulmonary edema, orthopnea, wheezing, cough, gasping and grunting respirations
What is management of CHF?
Improve cardiac function: digitalis glycosides (digoxin), angiotensin converting enzyme inhibitors (captopril). Remove accumulate fluid and sodium: Lasix for Rappa diuresis, diurnal for maintenance diuresis. Decreased cardiac commands. Improve tissue oxygenation
What should be done prior to the administration of digoxin?
Apical pulse should be counted for one minute prior to administration
What are signs of digitalis toxicity?
Bradycardia, vomiting , neurological or visual disturbances
What needs to be monitored carefully when administering digoxin?
Serum k levels