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PEDS > Cardio > Flashcards

Cardio Flashcards

0
Q

Valve btwn right atrium and right ventricle?

A

Tricuspid valve

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1
Q

Deoxygenated blood enters heart where?

A

Thru superior/inferior vena to right atrium

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2
Q

Valve between right ventricle and pulmonic arteries?

A

Pulmonic valve

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3
Q

Oxygenated blood enters heart where?

A

From lungs to pulmonic veins into left atrium

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4
Q

Valve btwn left atrium and left ventricle is…?

A

Mitral valve

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5
Q

Oxygenated blood leaves heart where?

A

From left ventricle thru aortic valve into aortic arch

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6
Q

In what order do you listen for heart sounds?

A

AP(E)TM (“apt m/ape to man”)

Aortic, Pulmonic, Erb’s, tricuspid, mitral

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7
Q

Describe the physical route of auscultating heart sounds.

A

Right left down down over

➡️⬅️⬇️⬇️?

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8
Q

Watch YouTube video of heart auscultation

A

URL here

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9
Q

Which cardiac issues are cyanotic?

A

TOF & TGA

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10
Q

TOF stands for …?

A

Tetralogy of Fallot

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11
Q

TGA stands for …?

A

Transportation of Greater Arteries

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12
Q

PDA stands for …?

A

Patent ductus arteriosus

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13
Q

COA stands for…?

A

Coarctation of aorta

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14
Q

VSD stands for…?

A

Ventricular septal defect

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15
Q

ASD stands for…?

A

Atrial Septal Defect

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16
Q

What is the main defect of ASD?

A

Hole btwn RA & LA.

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17
Q

What happens with ASD?

A

Hole btwn atria causes oxygenated blood in left atrium to flow back into right atrium, increasing the workload of the right side, leading to right ventricular hype trophy and eventual HF.

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18
Q

Would increased pulmonary blood flow be associated with cyanotic or acyanotic conditions?

A

Acyanotic

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19
Q

Trace blood from vena cava to aorta

A

VC ➡️ RA ➡️ TRICUSPID ➡️ RV ➡️ PULMONIC ➡️ PULM ART ➡️ LUNGS ➡️ PULM VEINS ➡️ LA ➡️ MITRAL ➡️ LV ➡️ AORTIC ➡️ AORTA

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20
Q

Which clinical symptom presents with a small ASD?

A

Loud murmur

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21
Q

Which is worse in septal defects: loud sounds or soft sounds?

A

Soft bc loud indicates higher pressure, smaller opening.

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22
Q

What is the #1 congenital cardiac defect?

A

VSD

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23
Q

Pathology of VSD?

A

Hole btwn ventricles causes leak of oxygenated blood back into right side➡️Right sided hypertrophy➡️Heart failure

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24
Q

What condition is nicknamed turtle heart?

A

Severe VSD (common ventricle)

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25
Q

Teaching priorities and referrals for VSD parents?

A

S/S infection, CHF, support group, formula assistance, know what milestones to watch for, how to reach EI

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26
Q

Feeding concerns for VSD?

A

Small frequent high calorie feedings, mix formula carefully

27
Q

4 things to assess for with VSD?

A

Tachypnea, dyspnea, poor growth, low formula intake

28
Q

COA pathology

A

Narrowing of the aorta, increasing pressure in left side of heart and leading to left sided CHF

29
Q

Which defects cause increased pulmonary blood flow?

A

ASD, VSD, PDA

30
Q

Clinical manifestations of mild or moderate COA?

A

High BP, bounding pulse in arms
Low BP in legs, absent femoral pulse
Cool legs
Dizziness, syncopy

31
Q

Clinical manifestations of severe COA?

A

Acidosis and hypotension, requiring intubation and BP support

32
Q

What happens with PDA?

A

Ductus arteriosis (btwn aorta and pulmonary arteries) never closes, increasing pressure in the left ventricle and causing right ventricular hypertrophy from blood backing up through pulmonary artery

33
Q

TGA: wha happen?

A

Pulmonary arteries leave from left ventricle, aorta from right ventricle, no mixing of systemic and pulmonary circulation.

34
Q

Is TGA improved or worsened by coexisting defects?

A

Improved bc holes allow blood to mix

35
Q

List interventions for TGA immediately at birth (5)

A 
Intubate
Paralyze to conserve energy
Prostaglandin to keep PDA open
100% oxygen
Correct metabolic acidosis
36
Q

Why are cyanotic defects associated with metabolic acidosis?

A

The body is cold and overproduces lactic acid

37
Q

What are 4 priority interventions for a post op TGA patient?

A

Observing for leaking around sutures
Arrhythmias
Hemorrhage
Left ventricle dysfunction

38
Q

Describe 4 components of TOF.

A
  1. Pulmonic stenosis
  2. Backup into right ventricle➡️hypertrophy
  3. Overriding aorta (moves to be closer to pulmonic artery
  4. VSD because valve prevents ventricular septum from closing
39
Q

MONA is an acronym for how we treat tet spells. What do the letters stand for?

A

Morphine
Oxygen
Nitrate
Aspirin

40
Q

4 things that cause tet spells?

A

Crying, cold, defection, feeding

41
Q

Intervention for older unprepared patients with tet spells?

A

Squatting to of help push blood out to extremities

42
Q

Why is morphine used for TOF?

A

As a vasodilator

43
Q

Clinical manifestations of TOF? (7)

A 
Clubbing of fingers and toes
Polycythemia (elevated RBCs)
Metabolic acidosis
FTT
activity intolerance
Cyanosis
O2 sat 50-70%
44
Q

Discuss effects of prostaglandin and indomethacin

A

Prostaglandin keeps ductus arteriosis open
Indomethacin CIA prostaglandin inhibitor, closes ductus artiosis
Both have very serious side effects and require 1:1 nursing care

45
Q

Top five nursing priorities for CHF patients?

A 
Oxygen
Nutrition
Assisting to cope
Preventing infection
Pre-op & post op care
46
Q

Is acute rheumatic fever congenital?

A

No; acquired.

47
Q

Describe what happens with acute rheumatic fever.

A

Immune reaction to strep throat that presents weeks after pharyngitis. It is self-limiting but can cause permanent valve damage.

48
Q

List and describe 5 major jones criteria for rheumatic fever.

A

Carditis - tachycardia, cardiomegaly
Poly arthritis - swollen hot red joints
Erythema marginatum - macular rash
Chorea / St Vitus Dance - sudden movements
Subcutaneous Nodules - over bony prominences

49
Q

Three main things nurses can do to prevent rheumatic fever.

A

Perform complete throat cultures, not just quick tests
Full course antibiotics teaching
Always check siblings

50
Q

Five treatments for rheumatic fever?

A 
Bed rest
NSAID/ibuprofen for joint pain
Steroids for carditis
Penicillin/erythromycin
Penicillin prophylaxis (Bicillin) monthly for 10 yrs to lessen damage to valves
51
Q

Which valves are most damaged by rheumatic fever?

A

Left sided: mitral and aortic

52
Q

List and describe 6 dx criteria for Kawasakis disease

A
  1. Changes in palms and soles; erythema and peeling
  2. Bilateral conjunctivitis w/o exudate
  3. Reddening of oral membrane / strawberry tongue
  4. Polymorphous rash
  5. Cervical lymphadenopathy
  6. High fever for more than 5 days (unresponsive to antipyretic)
53
Q

3 phases of Kawasaki

A

Acute: fever, irritability
Subacute: resolution of fever, ends when all clinical symptoms disappear
Convalescent: symptoms gone but lab values still off

54
Q

Duration of Kawasaki?

A

6-8 weeks

55
Q

What is the only thing you give aspirin to a child for?

A

Kawasaki during acute phase

56
Q

Nonpharmacologic treatments for CHF in babies?

A 
Warm environment
Low stress/stimuli
Skin care
Let sleep
Give oxygen
High cal, low volume feedings
Parent teaching
57
Q

S/s of CHF in babies?

A

Tachycardia at rest
Diaphoresis during feeds
Anorexia
Poor perfusion to extremities

58
Q

Pharmacological treatment for babies with CHF?

A 
Digoxin
Lasix
Ace inhibitors
Synegis
K+ supplements
59
Q

How many doses is a Dig loading dose made up of?

A

3

60
Q

How often give Dig?

A

At least 8 hours apart

61
Q

More dangerous to give Dig before or after slated time?

A

Before bco risk of overdose

62
Q

How is loading dose of dig split?

A

1st dose: 2x

2nd: x
3rd: x

63
Q

Signs of dig toxicity?

A

Nausea and vomiting

64
Q

What do we monitor for dig patients?

A

Heart rate, blood pressure, potassium

PEDS (2 decks)

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