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Nursing IV > Cardiac Disorders (Gas#5) > Flashcards

Cardiac Disorders (Gas#5) Flashcards

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1
Q

saccular aneurysm

A

projects from one side of the vessel only

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2
Q

Fusiform aneurysm

A

entire arterial segment is dilated

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3
Q

mycotic aneurysm

A

small aneurysm due to localized infection

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4
Q

when do most heart defects occur in gestation?

A

4-7

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5
Q

Acyanotic heart disease

A

blood is going from the left side of the heart back to the right side& bypassing the aorta to go to the body. Basically oxygenated to deoxygenated

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6
Q

Increased Pulmonary Blood Flow (Acyanotic) heart disorders

A

Ventricular septal defect (VSD), Atrial Septal Defect (ASD), Atrioventricular canal (AVC) and patent ductus arteriosus (PDA)

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7
Q

Ventricular Septal defect(VSD) is what type of heart disorder and why

A

acyanotic. There is an opening between the two ventricles which causes blood to be shunted back into the right ventricle instead of going to the aorta and to the body

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8
Q

What side of the heart gets bigger as a result of Ventricular Septal Defect (VSD)?

A

right ventricular hypertrophy and increased pressure in the pulmonary artery

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9
Q

Ventricular Septal Defect (VSD) is heard where? what does it sound like and when can you hear it (time frame)

A

its heard at the left sternal border 3rd &4th intercostal space. Sounds like a harsh murmmur at 4-8 weeks of age

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10
Q

Atrial Septal Defect (ASD) is what type of heart disorder and why?

A

Acyanotic. The Framen ovally does not close resulting in an opening between the two atrials which causes blood to be shunted back into the right antrial instead of going to the aorta and to the body.

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11
Q

What is a result of Atrial Septal Defect (ASD)

A

right ventricular hypertrophy and increased pressure in the pulmonary artery (same as VSD) Right sided heart failure=peripheral edema

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12
Q

Atrial Septal Defect (ASD) is heard where? and what does it sound like

A

It is heard at the pulmonic area-2nd-3rd intercostal space and it sounds like a harsh murmur

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13
Q

Why is a Atrial Septal Defect (ASD) dangerous if not fixed when young?

A

you could form a clot that is trying to close the defect which can actually end up releasing and becoming a PE

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14
Q

Atrial Septal Defect (ASD) is more common in girls or boys?

A

girls

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15
Q

Patent Ductus Arterious (PDA) is what type of heart disorder and why

A

acyanotic. The patent Ductus didnt close causing blood to go from the left ventricle into the aorta and instead of going out to the body some go through the ductus which goes into the pulmonary artery and to the lungs and back into the left ventricle

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16
Q

Patent Ductus Arterious (PDA) takes how long to close after birth?

A

3 months

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17
Q

Patent Ductus Arterious (PDA) sounds like what?

A

a machinery murmur

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18
Q

Patent Ductus Arterious (PDA) is more common in girls or boys?

A

girls

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19
Q

what can be given in order to close Patent Ductus with the Patent Ductus Arterious (PDA) disorder & what does the medication inhibit?

A

Indomethacin (Indocin) or Ibprofen because they inbit prostaglandin synthesis which keeps the ductus open

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20
Q

AV-Atrioventriculaar Septal Defect

A

hole in heart; can lead a normal life after surgery

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21
Q

Coarctation of the Aorta is what kind of heart disorder and why

A

Obstructive blood disorder because it is a constricted segment on aorta.

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22
Q

s/s of coarctation of the aorta and is it more common in girls or boys?

A

High bp in upper reign of body, low bp in extremities, ha, epistaxis and vertigo, decreased peripheral pulses. more common in boys

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23
Q

Coarctation of the aorta treatment

A

Digoxin, diuretics or can have surgery, ballon catheter or narrowed portion of aorta is removed and the new ends are anastomosed

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24
Q

Which four anomilies consist a Tetralogy of Fallot

A

pulmonary stenosis (narrowing of the pulmonary artery), Ventricular septal defect (VSD), overriding aorta & hypertrophy of rt ventricle

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25
Q

Disorders with obstructive blood flow

A

Coarctation, Pulmonary Stenosis, Aortic Stenosis

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26
Q

Disorders of decreased pulmonary blood flow (cyanotic)

A

Tetralogy of Fallot, Pulmonary atresia, Tricuspid Atresia

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27
Q

Tetralogy of Fallot is what kind of heart disorder

A

Decreased Pulmonary blood flow (cyanotic) because of all 4 anomalies

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28
Q

s/s & lab findings of Tetralogy of Fallot

A

enlarged heart on echo & EKG, clubbing of fingers, Polycethemia, Increased hemoglobin, increased hematocrit, increased RBCs, decreased O2

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29
Q

What interventions do you do with Tetralogy of Fallot

A

Give O2, Inderal or Morphine can be given to bronchodilate

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30
Q

What symptoms do parents need to call their doctor when they see their child who has Tetralogy of Fallot exhibiting

A

Rapid breathing, Retractions, Edema (peripheral edema is a late sign), Too tired to eat, persistent vomiting

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31
Q

What position will children get into with Tetralogy of Fallot?

A

a squatting, knee-like position

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32
Q

what are tet spells

A

happen with children with Tetralogy of Fallot. They become hypercapnic and may have syncope because of decreased blood/oxygen going to brain

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33
Q

What is a Blalock-Taussing procedure used in kids with Tetralogy of Fallot

A

It creates a shunt using the subclavin artery to provide a ductus arteriosus (shunt between the aorta & the pulmonary artery) that will allow blood to leave the aorta and enter the pulmonary artery, oxygenate in the lungs, return to the left side of the heart & leave through the aorta and into the body

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34
Q

What type of disorder is a Complete Transposition of great arteries (TGA)

A

Mixed blood heart disorder, The aorta stems from the rt ventricle instead of the left & the pulmonary artery stems from the left ventricle instead of the right so deoxygenated blood is circulated thru body

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35
Q

What do you give for Complete Transposition of great arteries?

A

Prostaglandin in order to keep patent ductus open. surgery is done 1 wk- 3 months

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36
Q

What disorder is Truncus Arteriosus and why

A

mixed blood disorder, the aorta & pulmonary are not separate. May has have a VSD. Receives blood from both ventricles. Surgery is needed to separate the two

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37
Q

Most common symptoms of CHF in kids. whats a late sign?

A

Tachycardia & tachypenia. late sign:Edema

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38
Q

When do you hold Digoxin in an infant and older child

A

infant: <79

39
Q

Causes of heart failure

A

congenital defect, rheumatic fever, kawasaki (viral infec) Severe anemia, hypocalcemia, myocarditis

40
Q

other s/s of chf besides the most common, tachycardia/tachypenia?

A

enlarged liver, sweating, fatigue, poor growth, rales, periorbital edema (infants)

41
Q

What does heart failure mean?

A

the heart is unable to pump and circulate enough blood to supply oxygen and nutrients to body cells

42
Q

what are two common symptoms of CHF in infants?

A

enlarged liver & periorbital edema

43
Q

kids with CHF are at high risk for? and what kind of meds do you put them on to prevent this?

A

reacurrent respiratory infections, hypoxemia, fever, dehyration, endocarditis (inflammation of the endocardium valves); put them on low dose antibiotics

44
Q

Failure to thrive

A

eight more than height, hypermetabolism

45
Q

Rheumatic fever

A

systemic inflammatory disease where kid basically gets strep throat which can go away(with or without antibiotics) then appear 2-3 wks later with a fever & rheumatic symptoms. Can effect all layer of the heart

46
Q

Major Rheumatic symptoms that kid gets after 2-3 weeks (inital symptom & others)

A

Polyarthritis (joint pain) (inital symptoms), Erthema marginatum (Rash), Chorea (moving around), subcutaneous nodules, Carditits,

47
Q

What is a good indicator of improvement in a kid with Rheumatic fever?

A

Pulse rate

48
Q

Rheumatic fever Treatment

A

Penicillin, Aspirin, NSAIDS, corticosteriods (to decrease inflammation in kids who dont respond to Ibprofen)

49
Q

What things can increase your chance of getting Rheumatic fever?

A

living in crowded living spaces, Malnutrition, Immunodeficiency, Poor access to healthcare

50
Q

Rheumatic fever occurs between which ages

A

5-15 yrs old

51
Q

Rheumatic fever is a major cause of what disorder?

A

mitral & aortic valve disorder

52
Q

Rheumatic fever patient education

A

encourage regular follow up visits, avoid people with URIs, gradual activity progression as their condition improves, reinforce activity limitations to reduce the workload of the heart

53
Q

Which lab values do you look at with Rheumatic fever

A

ESR (SED rate), CRP (C-reactivve Protein), ASO titer (Antibody Antistreptococcal titer), CBC, Throat culture

54
Q

Endocarditis

A

inflammation & infection of the endocardium valves

55
Q

Who is exposed to Endocarditits/Carditis

A

Rheumatic fever, Congenital anomalies, Immunosupp. Agents, IV devices/Open heart surgery

56
Q

Carditis s/s

A

Chest pain, Tachycardia, Pericardial Friction Rub, Evidence of heart failure

57
Q

Acute Endocarditis s/s

A

rapid valve destruction, general malaise, joint pain, heart murmur, Petechiae, splinter hemorrhages, enlarged spleen , spiking fever

58
Q

Subacute Endocarditits s/s

A

Cough, Dyspnea, fever, pretty much the sam symptoms for acute Endocarditits

59
Q

Which organism is responsible for acute endocarditis?

A

Staph aureus

60
Q

Which organism is responsible for subacute endocarditis

A

Strept. Viridans & Enterococci, fungi, yeast

61
Q

Treatment of Endocarditits

A

A penicillinase-resistant penicillin is given= Nafcillin (Unipen), valve replacement

62
Q

Stenosis

A

valve doesn’t open properly

63
Q

Regurgitation

A

valve doesn’t close properly

64
Q

Mitral valve regurgitation & what is a common cause of this

A

allows blood back into the left atrium during systole; Rheumatic fever is a common cause of this

65
Q

Severe mitral valve regurgitation symptoms

A

left sided heart failure symptoms because blood is going back into the left atrium and not going to the body

66
Q

Where are Mitral valve regurgitations heard

A

apex

67
Q

Aortic Regurgitation (insufficiency)

A

allows blood to flow back into the left ventricle from the aorta

68
Q

where are aortic regurgitations heard?

A

3rd left intercostal space

69
Q

Aortic regurgitation causes what?

A

increased preload & more forceful contractions causing hypertrophy

70
Q

Mitral Stenosis & Tricuspid Stenosis both cause what side heart failure

A

right

71
Q

Tricuspid regurgitation occurs secondary to..

A

right ventricular dilation because stretching distorts the valve

72
Q

Where is Tricuspid regurgitation heard

A

xyphoid process

73
Q

Pulmonic vavle Stenosis is secondary to

A

Rheumatic heart disease, congenital disease

74
Q

Pulmonic regurgitation is a complication of what?

A

pulmonary hypertension

75
Q

what can pulmonic regurgitation eventually lead to what side heart failure?

A

right sided heart failure

76
Q

Can a echocardiography be done at the bed side?

A

yes, no prep

77
Q

Annuloplasty

A

repairs a narrowed or enlarged valve annulus, basically its a prosthetic ring that is used to resize the opening

78
Q

disadvantage of mechanical tissue valves

A

youll be on anticoagulants for life

79
Q

advantage of mechanical tissue valves

A

they are durable

80
Q

cardiomyopathy

A

enlargement of the heart

81
Q

Dilated cardiomyopthy is due to

A

cocanie use, pregnancy, chemo drugs, systemic htn

82
Q

hypertrophic cardiomyopathy

A

decreased compliance of left ventricle & hypertophy of the ventricle muscle

83
Q

when do symptoms occur with hypertrophic cardiomyopathy?

A

when increased oxygen demand causes increased ventricular contractility; common cause of sudden death in athletes

84
Q

Restrictive cardiomyopathy

A

basically the ventricle heart walls are thick causing small spaces for ventricles

85
Q

s/s of restrictive cardiomyopthy

A

JVD, decreased tissue perfusion

86
Q

Dissecting aneurysm

A

passage of blood thru a tear; its starting to rupture

87
Q

Dissecting aneurysm s/s

A

BP may be different in arms, syncope, pain, diminished or absent pulses

88
Q

what is the key to not increasing the size of an aneurysm

A

BP

89
Q

Abdominal Aortic Aneurysm s/s

A

pulsative mass, peripheral pulses

90
Q

s/s of aortic aneurysm

A

mid abdomen or lower back pain, pulsating mass, a bruit over mass, pain may be indicative to a rupture

91
Q

Nursing care for an aneurysm

A

maintain bedrest, calm environment, beta blockers, antihypertensives, use matter-of fact honesty

92
Q

Broken heart syndrome

A

portion of heart enlarges due to stress

93
Q

Broken heart syndrome s/s and why do you need to call 911

A

chest pain, irregular heartbeat, generalized weakness. Call 911 because it could progress to an MI

94
Q

Males or females more at risk for broken heart syndrome

A

female over 50

Nursing IV (20 decks)

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