Cardiovascular

Question 1

Congenital Heart Disease

Answer 1

-Anatomic Abnormalities present at birth
-6 to 13 per 1000 live births

Question 2

Symptoms of cardiac dysfunction

Answer 2

-poor feeding
-tachypnea, tachycardia
-failure to thrive, poor weight gain, activity intolerance
-developmental delays
-positive prenatal history
-poisitve family history of cardiac disease

Question 3

Inotropes

Answer 3

-Common vasoactive drugs include:
Dopamine
Dobutamine
Epinephrine
-Use Blood pressure, and cap refill: to increase measure cardiac output
-Dosed by minutes (per kg/min)

Question 4

Physical Characteristics of Cardiac Defects

Answer 4

-Pink and blue babies: It’s all about the duct

Question 5

Atrial Septal Defect (ASD)

Answer 5

-Heart murmur
-Few symptoms in children
-Shortness of breath
-Poor growth
-Treatment: surgical closure, which may increase pulmonary hypertension, closure with cardiac catheterization, follow up with a cardiologist

Question 6

Ventricular Septal Defect

Answer 6

-Murmur
-CHF: depending on the size of VSD, failure to thrive
-Treatment: observation (cardiologist, medical management with Digoxin), surgical repair

Question 7

Ventricular Septal Defect

Answer 7

-Murmur
-CHF: depending on the size of VSD, failure to thrive
-Treatment: observation (cardiologist, medical management with Digoxin), surgical repair

Question 8

Tetralogy of Fallot

Answer 8

-4 separate defects within one syndrome
-Ventricular septal defects
-pulmonary stenosis
-Secondary thickening of the right ventricle
-Aorta lies directly over VSD

Question 9

Tet Spells

Answer 9

-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

Question 10

Cause of Tet Spells

Answer 10

-crying
-defecation
-feeding
-awakening from naps
-fever
-dehydration
-tachycardia (deceased filling time leads to reduced end-diastolic volume)
-Medications (ACE inhibitors)

Question 10

Cause of Tet Spells

Answer 10

-crying
-defecation
-feeding
-awakening from naps
-fever
-dehydration
-tachycardia (deceased filling time leads to reduced end-diastolic volume)
-Medications (ACE inhibitors)

Question 11

Nursing Care for Tet Spells

Answer 11

-place an infant in a knee-chest position
-administer 100% oxygen
-admin morphine
-use a calm approach
-IV fluid replacement for blood volume expansion

Question 12

Treatment CHF

Answer 12

-correct cardiac defect
-enhancing cardiac contractility (digoxin)
-reduce afterload (lasix)
-improve oxygen delivery
-enhance nutrition

Question 13

Rheumatic Fever

Answer 13

-a systemic immune disease that affects the joints, skin, heart, blood, vessels, and brain
-may develop after strep throat or scarlet fever
-very rare in the U.S.
-prevented by prompt diagnosis, antibiotics, and anti-inflammatory med

Question 14

Symptoms of PHTN

Answer 14

-Progressive shortness of breath (especially with activity)
-Hyperventilation
-Fatigue
-Pink frothy sputum
-Progressive cyanosis
-Right sided heart failure
–Distension of veins in the neck
–Swelling of the legs and hands due to fluid retention
–Enlarged liver

Question 15

Treatment PHTN

Answer 15

1. Improve alveolar oxygenation
2. Minimize pulmonary vasoconstriction
3. Maintain systemic blood pressure and perfusion
4. Treatments do not restore normal life expectancy
   All treatment is palliative.
   Currently, there is no cure

Question 16

Nursing Care of CHD

Answer 16

Decrease Cardiac Workload
1. provide rest periods
2. consolidate care
3. respond to crying
4. monitor tolerance to feedings