Cardiovascular Flashcards
congenital heart disease
how are they categorized and what are the consequences
- Anatomic Abnormalities present at birth
- Cardiac defects prevent normal blood flow to the pulmonary and/or systemic stem.
- Defects are categorized by blood flow patterns in the heart.
- Clinical consequences are CHF and Hypoxemia
Inotropes
helps pump heart strength of contractibility - dopamine - dobutamine - epinephrine
PGE
- Also known as alprostadil
Vasodilator - Maintains patency of ductus arteriosus in neonates with ductal – dependent congenital heart lesions until surgery can be done.
- Improve shunting after balloon septostomy has failed to improve oxygenation.
- alprostadil
tetralogy of fallot
4 defects
- Ventricular septal defect
- Pulmonary stenosis
- Secondary thickening of right ventricle
- Aorta lies directly over VSD
tet spells
- Increased resistance of blood flow to the lungs with increased flow of desaturated blood to the body.
- Sudden cyanosis, progressive cyanosis over first year of life
- Syncope
- Hypoxic brain injury
- Death.
what causes a tet spells
- Crying
- Defecation
- Feeding
- Awakening from naps
- Fevers
- Dehydration
- Tachycardia (decreased filling time leads to reduced end diastolic volume)
- Medications (ACE inhibitors)
tetraology of fallot symptoms
3
Audible Murmur
Cyanosis
Tachypnea
tetralogy of fallot interventions
PGE Gtt
Surgical Repair
nursing care for tet spells
- Place Infant in Knee Chest Position
- Administer 100% Oxygen
- Administer Morphine
- Use a Calm Approach
- IV Fluid replacement for Blood - Volume Expansion
- Knee-Chest Position (increases Preload and increases SVR)
- Can even compress abdominal aorta to increase SVR more.
- Oxygen
- Oxygen will help decrease PVR.
- Morphine (calms, decreased tachypnea, and also decreases PVR)
congestive heart failure
caused by:
Failure of the heart to pump blood with normal efficiency out of either left or right ventricle caused by:
Excessive work load
Normal workload with damaged myocardium
CHF causes
Congenital heart Defects
Acute rheumatic fever
Myocarditis
Endocarditis
chf symtoms
3
impaired myocardial function
pulmonary congestion
systemici venous congestion
chf: impaired myocardial function s/s
Tachycardia, fatigue, weakness, restlessness, pale, cool extremities, decreased blood pressure, decreased urinary output
chf: pulmonary congestion s/s
Tachypnea, dyspnea, respiratory distress, exercise intolerance, cyanosis
chf: systemic venous congestion s/s
Peripheral and periorbital edema, weight gain, ascites, hepatomegaly, neck vein distention
treatment chf
Correct Cardiac Defect
Enhancing cardiac contractility
-Digoxin
Reduce afterload
-Lasix
Improve oxygen delivery
Enhance nutrition
A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect?
(select all that apply.)
Bradycardia Cool extremities Peripheral edema Increased urinary output Nasal flaring
b
c
e
assessment of heart disease in children
History
Physical assessment
General appearance
Pulse, blood pressure, & respirations
nursing care of chd
decrease cardiac workload
- provide rest periods
- consolidate care
- respond to crying
- monitor tolerance to feedings
nutritonal management
small frequent high calorie formulas
- use a large holed nipple
- monitor cardiac tolerance: tachycardia, tachkypnea, desaturation
You caring for an infant with a congenital heart defect. The baby’s pulse is 158 and the respiratory rate is 74. What is the best position for the baby to be in?
A. Side-lying with a blanket roll at the back
B. Supine with the legs slightly elevated
C. Prone position with the head elevated
D. Upright in an infant seat
d
where is ductus arteriolsis located
pulmonary artery
aorta
CHF nursing care
- know weight bc fluid retention
- work of breathing
- level of edema
- diaphoretic
- perfusion assessment
- vital signs, hr, bp, caprefill, weight
