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cardiac PEDS Flashcards

1
Q

When does fetal hear begin to beat?

A

end of 3 weeks gestation

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2
Q

What compensates for nonfunctional lungs?

A

fetal circulation

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3
Q

Where does oxygenation occur?

A

the placenta

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4
Q

Which side of the heart is arterial blood returned to?

A

right

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5
Q

What is the pathway of oxygenated blood?

A
  • 2/3 is shunted through the foramen oval
  • into the left side of the heart
  • pumped through the aorta
  • 1/3 is pumped by the right side of the heart
  • out through the pulmonary artery
  • detoured through ductus arterioles
  • to aorta
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6
Q

Which ventricle is thicker?

A

both are equal in weight and muscle wall thickness

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7
Q

When is the blood oxygenated through the lungs?

A

birth

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8
Q

When does the foramen ovale close?

A

within 1st hour

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9
Q

When does the ductus arteriosus close?

A

within 10-15 hours after birth

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10
Q

by 1 year old what is the ratio of left ventricle to right ventricle?

A

2:1

same as adult

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11
Q

What is the heart’s position in an infant?

A
  • more horizontal

- apex is higher (4th left intercostal space)

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12
Q

When does the heart reach adult position?

A

7 years old

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13
Q

What history for infants should you obtain about mother’s health during pregnancy?

A
  • unexplained fever
  • rubella in 1st trimester
  • infection
  • hypertension
  • drugs
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14
Q

When do fetal shunts usually close?

A

within 10-15 hours may take up to 48 hours

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15
Q

When do you assess the cardiovascular system on an infant?

A

-During the first 24 hours of life and then again in 2-3 days

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16
Q

What are the signs of heart failure in infants?

A
  • persistent tachycardia
  • tachypnea
  • liver enlargement
  • engorged veins
  • gallop veins
  • pulsus alternans
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17
Q

What is the purpose of palpating the apical pulse?

A

to determine size and position of heart

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18
Q

How is the infant heart different from the adult heart?

A

more horizontal and 4th intercostal space

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19
Q

What happens to the apex with cardiac enlargement?

A

shifts to left

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20
Q

What happens to the apex with pneumothorax?

A

shifts away from affected side

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21
Q

What happens to the apex with diaphragmatic hernia?

A

shifts to right b/c hernia is usually on left

22
Q

What happens to the apex with dextrocardia?

A

shifts to right

23
Q

What is the normal HR for infant?

A
  • 100-180 bpm immediately after birth
  • then 120-140 bpm after
  • > 170 bpm with crying
  • 70-90 bpm with sleeping
24
Q

What is tachycardia for an infant?

A
  • > 200 bpm in newborns

- >150 bpm in infants

25
What is bradycardia for an infant?
- <90 bpm in newborn | - <60 in infants or children
26
What is sinus arrhythmia?
Phasic speeding up or slowing down with the respiratory cycle
27
What makes it difficult to evaluate the heart sounds?
Rapid rates
28
Is the heart louder in infants or adult? why?
- infants | - thinner chest wall
29
When is the splitting of S2 common?
after height of inspiration a few hours after birth
30
Compare S1 to S2 in an infant?
S2 is higher pitch and sharper
31
Are murmurs common? when? why? what are they normally graded?
- yes - first 2-3 days - b/c fetal shunt closure - grade 1 or 2
32
What is infant PDA?
continuous machinery and disappears within 2-3 days
33
Signs that may indicate heart disease in children?
- Poor weight gain - Developmental delay - Persistent tachycardia - Tachypnea - Dyspnea on exertion - Cyanosis
34
How does clubbing affect the fingers and toes of a child?
usually doesn’t appear until late in first year even with severe cyanotic defects
35
When is the apical pulse visible in children?
when the child has a thin chest wall
36
where is the precordial bulge located? why?
- left of sternum | - the cartilaginous rib is more compliant
37
where would yo palpate the apical pulse on a child < 4? 4-6? >7?
- 4th intercostal space left of mid-clavicular space - 4th intercostal space - 5th intercostal space
38
What is a thrill?
a palpable vibration
39
What is a physiologic S3?
- early in diastole - just after S2 - due soft sound that is best heard at the apex
40
What causes the venous hum? where do you listen for it?
- due to turbulence off blood flow in jugular venous system | - supraclavicular fossa at eh medial third of the clavicle, especially on the right, or over the upper anterior chest
41
when might a venous hum sound louder in a children?
when a child stands
42
how do you differentiate between venous hum and other cardiac murmurs?
- occulting the jugular vein with your fingers | - obliterates the venous hums
43
Characteristics of innocent murmurs?
- soft - relatively short - early or mid systolic ejection murmur - medium pitch
44
when does lymphoid tissue reach adult size?
6 years
45
what happens to the lymphatic system by puberty?
surpasses adult size and slowly atrophies
46
are superficial lymph nodes often palpable in child even when healthy?
yes
47
what does enlarged tonsils indicate?
respiratory infections
48
what causes abdominal pain in children?
- excessive lymphoid response | - upper respiratory infection
49
what causes a weak pulse?
vasoconstriction of diminished cardiac output
50
what does diminished or absent femoral pulses while upper extremity pulses are normal indicate?
coarctation of aorta
51
what do vaccines produce?
local lymphadenopathy

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