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Cardiac Disorders (Gas#5) Flashcards

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
Disorders with obstructive blood flow
Coarctation, Pulmonary Stenosis, Aortic Stenosis
26
Disorders of decreased pulmonary blood flow (cyanotic)
Tetralogy of Fallot, Pulmonary atresia, Tricuspid Atresia
27
Tetralogy of Fallot is what kind of heart disorder
Decreased Pulmonary blood flow (cyanotic) because of all 4 anomalies
28
s/s & lab findings of Tetralogy of Fallot
enlarged heart on echo & EKG, clubbing of fingers, Polycethemia, Increased hemoglobin, increased hematocrit, increased RBCs, decreased O2
29
What interventions do you do with Tetralogy of Fallot
Give O2, Inderal or Morphine can be given to bronchodilate
30
What symptoms do parents need to call their doctor when they see their child who has Tetralogy of Fallot exhibiting
Rapid breathing, Retractions, Edema (peripheral edema is a late sign), Too tired to eat, persistent vomiting
31
What position will children get into with Tetralogy of Fallot?
a squatting, knee-like position
32
what are tet spells
happen with children with Tetralogy of Fallot. They become hypercapnic and may have syncope because of decreased blood/oxygen going to brain
33
What is a Blalock-Taussing procedure used in kids with Tetralogy of Fallot
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
34
What type of disorder is a Complete Transposition of great arteries (TGA)
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
35
What do you give for Complete Transposition of great arteries?
Prostaglandin in order to keep patent ductus open. surgery is done 1 wk- 3 months
36
What disorder is Truncus Arteriosus and why
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
37
Most common symptoms of CHF in kids. whats a late sign?
Tachycardia & tachypenia. late sign:Edema
38
When do you hold Digoxin in an infant and older child
infant: <79
39
Causes of heart failure
congenital defect, rheumatic fever, kawasaki (viral infec) Severe anemia, hypocalcemia, myocarditis
40
other s/s of chf besides the most common, tachycardia/tachypenia?
enlarged liver, sweating, fatigue, poor growth, rales, periorbital edema (infants)
41
What does heart failure mean?
the heart is unable to pump and circulate enough blood to supply oxygen and nutrients to body cells
42
what are two common symptoms of CHF in infants?
enlarged liver & periorbital edema
43
kids with CHF are at high risk for? and what kind of meds do you put them on to prevent this?
reacurrent respiratory infections, hypoxemia, fever, dehyration, endocarditis (inflammation of the endocardium valves); put them on low dose antibiotics
44
Failure to thrive
eight more than height, hypermetabolism
45
Rheumatic fever
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
Major Rheumatic symptoms that kid gets after 2-3 weeks (inital symptom & others)
Polyarthritis (joint pain) (inital symptoms), Erthema marginatum (Rash), Chorea (moving around), subcutaneous nodules, Carditits,
47
What is a good indicator of improvement in a kid with Rheumatic fever?
Pulse rate
48
Rheumatic fever Treatment
Penicillin, Aspirin, NSAIDS, corticosteriods (to decrease inflammation in kids who dont respond to Ibprofen)
49
What things can increase your chance of getting Rheumatic fever?
living in crowded living spaces, Malnutrition, Immunodeficiency, Poor access to healthcare
50
Rheumatic fever occurs between which ages
5-15 yrs old
51
Rheumatic fever is a major cause of what disorder?
mitral & aortic valve disorder
52
Rheumatic fever patient education
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
Which lab values do you look at with Rheumatic fever
ESR (SED rate), CRP (C-reactivve Protein), ASO titer (Antibody Antistreptococcal titer), CBC, Throat culture
54
Endocarditis
inflammation & infection of the endocardium valves
55
Who is exposed to Endocarditits/Carditis
Rheumatic fever, Congenital anomalies, Immunosupp. Agents, IV devices/Open heart surgery
56
Carditis s/s
Chest pain, Tachycardia, Pericardial Friction Rub, Evidence of heart failure
57
Acute Endocarditis s/s
rapid valve destruction, general malaise, joint pain, heart murmur, Petechiae, splinter hemorrhages, enlarged spleen , spiking fever
58
Subacute Endocarditits s/s
Cough, Dyspnea, fever, pretty much the sam symptoms for acute Endocarditits
59
Which organism is responsible for acute endocarditis?
Staph aureus
60
Which organism is responsible for subacute endocarditis
Strept. Viridans & Enterococci, fungi, yeast
61
Treatment of Endocarditits
A penicillinase-resistant penicillin is given= Nafcillin (Unipen), valve replacement
62
Stenosis
valve doesn't open properly
63
Regurgitation
valve doesn't close properly
64
Mitral valve regurgitation & what is a common cause of this
allows blood back into the left atrium during systole; Rheumatic fever is a common cause of this
65
Severe mitral valve regurgitation symptoms
left sided heart failure symptoms because blood is going back into the left atrium and not going to the body
66
Where are Mitral valve regurgitations heard
apex
67
Aortic Regurgitation (insufficiency)
allows blood to flow back into the left ventricle from the aorta
68
where are aortic regurgitations heard?
3rd left intercostal space
69
Aortic regurgitation causes what?
increased preload & more forceful contractions causing hypertrophy
70
Mitral Stenosis & Tricuspid Stenosis both cause what side heart failure
right
71
Tricuspid regurgitation occurs secondary to..
right ventricular dilation because stretching distorts the valve
72
Where is Tricuspid regurgitation heard
xyphoid process
73
Pulmonic vavle Stenosis is secondary to
Rheumatic heart disease, congenital disease
74
Pulmonic regurgitation is a complication of what?
pulmonary hypertension
75
what can pulmonic regurgitation eventually lead to what side heart failure?
right sided heart failure
76
Can a echocardiography be done at the bed side?
yes, no prep
77
Annuloplasty
repairs a narrowed or enlarged valve annulus, basically its a prosthetic ring that is used to resize the opening
78
disadvantage of mechanical tissue valves
youll be on anticoagulants for life
79
advantage of mechanical tissue valves
they are durable
80
cardiomyopathy
enlargement of the heart
81
Dilated cardiomyopthy is due to
cocanie use, pregnancy, chemo drugs, systemic htn
82
hypertrophic cardiomyopathy
decreased compliance of left ventricle & hypertophy of the ventricle muscle
83
when do symptoms occur with hypertrophic cardiomyopathy?
when increased oxygen demand causes increased ventricular contractility; common cause of sudden death in athletes
84
Restrictive cardiomyopathy
basically the ventricle heart walls are thick causing small spaces for ventricles
85
s/s of restrictive cardiomyopthy
JVD, decreased tissue perfusion
86
Dissecting aneurysm
passage of blood thru a tear; its starting to rupture
87
Dissecting aneurysm s/s
BP may be different in arms, syncope, pain, diminished or absent pulses
88
what is the key to not increasing the size of an aneurysm
BP
89
Abdominal Aortic Aneurysm s/s
pulsative mass, peripheral pulses
90
s/s of aortic aneurysm
mid abdomen or lower back pain, pulsating mass, a bruit over mass, pain may be indicative to a rupture
91
Nursing care for an aneurysm
maintain bedrest, calm environment, beta blockers, antihypertensives, use matter-of fact honesty
92
Broken heart syndrome
portion of heart enlarges due to stress
93
Broken heart syndrome s/s and why do you need to call 911
chest pain, irregular heartbeat, generalized weakness. Call 911 because it could progress to an MI
94
Males or females more at risk for broken heart syndrome
female over 50

Nursing IV (20 decks)

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