Cardiac Disorders in Children

Question 1

polycythemia (bone marrow produce more RBC) found in

Answer 1

decreased pulmonary blood flow / tetralogy of fallot b/c body senses reduced oxy blood so compensates by producing more RBC

Question 2

TET spells/episodes

Answer 2

rapid drop in oxy in blood, choking, gasping for air, dyspnea

Question 3

screen for congenital heart defects

Answer 3

pulse ox, preductal right hand, post ductal either foot

Question 4

pulse ox for newborn s/b

Answer 4

> 95%

Question 5

radial pulse bounding, femoral pulse weak or absent

Answer 5

coarctation of aorta, obstructive congenital heart defect

Question 6

upper extremity hypertension, low BP lower extremities

Answer 6

coarctation of aorta

Question 7

common screening for newborns

Answer 7

APGAR appearance- skin color
pulse- heart rate
grimace- reflex response
activity- muscle tone
respiration- breathing rate and effort

Question 8

murmur found with

Answer 8

vsd, ventricular septal defect, asd and patent ductus arteriosis

Question 9

congenital heart defects causes

Answer 9

genetic, family hx, trisomy 13, down syndrome

mother- diabetes, rubella, toxins, alcohol (fetal alcohol syndrome), over 40 yo

Question 10

acquired heart defect causes

Answer 10

hypertension, kawasaki (inflammation of blood vessels throughout body), heart failure, infection, cardiomyopathy

Question 11

4 types of cardiac disorders in children

Answer 11

1. increased pulmonary blood flow- single structural problem
2. decreased pulmonary blood flow - fallot, multiple structural problems
3. obstructive- narrowing, stricture, coarctation of the aorta
4. mixed

Question 12

diagnostic test shows blood flow in heart

Answer 12

echocardiogram

Question 13

diagnostic test shows size and location of heart

Answer 13

chest x-ray

Question 14

congenital heart defect- too much blood flow to lungs

Answer 14

increased pulmonary blood flow, oxy blood reenters pulmonary circulation

Question 15

increased pulmonary blood flow pulse ox saturation is?

Answer 15

lower, b/c less oxy blood to body

Question 16

ssnri- selective serotonin norepi reuptake inhibitor, 2 types anti-depressants

Answer 16

1. effexor- increase norepi, higher HR, BP, don’t give cardiac problems
2. cymbalta- for pain, fibromyalgia, depression hurts

Question 17

increased pulmonary blood flow s/s

Answer 17

tachycardia, tachypnea, right side ventricular hypertrophy (inc pressure and workload on right side)

Question 18

increased pulmonary blood flow deoxy blood mix with oxy blood, True or False?

Answer 18

true

Question 19

3 reasons increased pulmonary blood flow in child heart

Answer 19

1. vsd- ventricular septal defect
2. asd- atrial septal defect
3. pda- patent ductus ateriorosis

Question 20

pulmonary hypertension risk for which condition?

Answer 20

increased pulmonary blood flow

Question 21

right to left shunting of blood in heart

Answer 21

decreased pulmonary blood flow, pressure in right side higher than left so deoxy blood moves to left ventricle and out aorta into circulation, result deoxy blood in body

Question 22

keep ductus arteriosis open and give prostaglandins

Answer 22

tetralogy of fallot, decreased pulmonary blood flow

Question 23

infant tachypnea rate?

Answer 23

greater than 80 breath per minute, indication of blood backing up in heart

Question 24

blue color around lips and nose

Answer 24

central cyanosis

Question 25

infant tachycardia rate

Answer 25

over 160 bpm

Question 26

back up of blood and fluids into lungs, causes

Answer 26

left sided heart failure, left ventricle filled with blood (rales and crackles)

Question 27

backup of blood and fluids into liver and veins causes

Answer 27

right sided heart failure (edema)

Question 28

decreased perfusion of blood throughout body affect on heart

Answer 28

heart work harder, hypertrophy risk

Question 29

lower blood perfusion/heart failure s/s

Answer 29

fatigue, pallor, change in skin temperature, poor appetite, weight loss

Question 30

heart failure in infant leads to fluid retention - s/s

Answer 30

periorbital edema, enlarged liver/hepatomegaly, weight gain b/c fluid retain, cough/congestion fluid in lungs

Question 31

hypoxemia s/s

Answer 31

clubbing of fingers, polycythemia

Question 32

nursing intervention standard precautions: newborn vulnerable to infection b/c

Answer 32

upper respiratory infection b/c fluid in lungs, decreased blood flow, low energy, infections increase workload of heart

Question 33

drug given for heart failure or cardiac arrhythmia

Answer 33

digoxin to slow and increase heart contract/strength, controls rhythm of heartbeat

Question 34

given with digoxin

Answer 34

furosemide (loop diuretic), potassium (electrolyte to replace K+ loss from diuretic)

Question 35

potassium levels

Answer 35

3.5-5

Question 36

propranolol

Answer 36

beta-blocker, reduce oxy demands, lowers pulse, influence HR and BP, apical pulse for 1 minute, don't give if HR too low

Question 37

ace inhibitor, enalapril

Answer 37

lowers afterload to dilate vessels, no effect HR, lowers BP, check BP b/c too low don't give, give ARB if cough

Question 38

K+ sparing diuretic

Answer 38

spironolactone- allows potassium to remain in body

Question 39

tetralogy of fallot four multiple problems

Answer 39

occur at same time

Question 40

digoxin with food?

Answer 40

1 hour before or 2 hours after

Question 41

digoxin oral care

Answer 41

brush or rinse mouth if no teeth, do not give another dose if child vomits

Question 42

digoxin how often?

Answer 42

q12, po, ng tube, iv if held 2x call HCP, 2 nurses check dosage prior to administration

Question 43

digoxin missed dose

Answer 43

if missed and more than 4 hours elapsed skip dose

Question 44

digoxin toxicity s/s

Answer 44

anorexia or weight loss b/c child doesn't eat, bradycardia (lower HR is goal), dysrhythmia

Question 45

systematic vasculitis aka

Answer 45

kawasaki disease

Question 46

kawasaki disease problem

Answer 46

inflamed inside of arteries, veins, capillaries can lead to scarring

Question 47

kawasaki s/s

Answer 47

fever 5+ days, conjunctival/eyes inflammation, oral mucosa red and dry

Question 48

kawasaki care

Answer 48

I/O and daily weight (all cardiac problems), oral care, cool blanket,/clothes