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Pediatrics > Cardiovascular Book > Flashcards

Cardiovascular Book Flashcards

1
Q

** what is preload
afterload
how do these two things work with contractility in terms of stroke volume

A

preload: end diastolic volume
afterload: amount of resistant the heart must overcome
the volume of blood ejected by the ventricle with each contraction

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2
Q

** how do we do a cardiac assessment in chikldren? what are we looking for? what should we be hearing?what shouldnt we see or hear? how do we evaulate overall work status in infants? what would you notice in a patient with cardiac failure if the were an infant? what if they were an older child

A

skin color, cap refill, heart rate/rhythm, BP, working of breathing
hearing S1 S2 S3
- S3 is normal in children related to rapid filling
should not see thril or S4 abnormal, heard late in diastole or early systole
CCHD: 95-98% with less than 3% change, R hand is preductal, either foot is postudctal
poor feeding, failure to thrive, tachpnea, tachycardia, poor wt gain, activity intolerance, developmental delayed

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3
Q

** what causes congetintal heart defects

A

drugs, age, chromosomal

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4
Q

**ASD

A

left to right atria,soft ejection murmur with fixed wide splitting of O2

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5
Q

** VSD

A

left to right ventricle, systolic murmur (3rd-4th intercostal) at sternal border, thrill may be present

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6
Q

** PDA

A

aorta to pulmonary artery, mcahnery murmr during systole and diastole, thrill over pulmonic artery

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7
Q

**TOF

A

pulmonary stenosis, right ventriclar hypertrophy, VSD, aortic overriding, tet spells (knee to chest morphine), boot shaped heart

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8
Q

**CoA

A

narrowing of descending aorta increase in BP in arms/neck decreasd BP in legs, PGE to keep PDA open

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9
Q

**HLHS

A

mitral and aortic valves are absent or stenosed with abnormally small left ventricle and small aorta, no murmur, PGE to keep PDA open

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10
Q

** TGA

A

aorta and pulmonary swtiched, egg shaped heart, cyanosis dosent improved with O2 PGE to keep PDA open

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11
Q

** are there specific nursing consdeirations for the disorder

A

PDA may give PGE and may not give O2 as itcan close
tet spell wants knees to chest

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12
Q

** understand what Kawasaki disease is, hoe does it present, what are the complications, what do you anticipate for nursing considerations and how is it treated?

A

acute stage: fever (5 days) >39, conjuctival hyperermia, cervivallymphode enlargement, strawberry tongue, cracker lips, rash on trunk
subacute: cracking skin (lips, fingers, toes) cornary artery anerysm
convalsecnt: 6-8 weeks after onset of s/s

monitor fever and CV status
IVIG 2g/kg for 18hrs

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13
Q

** how does hypovolemic shock occur? What are the stages of hypovolemic shock? is BP a good indicator of the Childs status? How to assess the patient for adequate tissue perfusion? what is the nursing management of shock? what would you anticipate for fluid replacement in shock?

A

hemorrhage, plasma loss from burns, nephrotic syndrome, sepsis, decrease fluids

no BP not good indicator, early comp is a normal BP, moderate decomposition is lowered systolic

urine output

IV fluid bolus, keep child warm

isotonic fluid

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14
Q

**review how you would care for a patient who is returning from cardiac Cath

A

vital signs, bleeding, infection, pressure dressing

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15
Q

why do infants have greater risk of heart failure than older children

A

due to sensitivity to volume or pressure overload

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16
Q

less compliance of the heart muscle means

A

stroke volume cannot increase substantially

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17
Q

how do kids increase CO

A

increase HR

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18
Q

polycythemia

A

increase RBC response to chronic hypoxemia

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19
Q

children respond to severe hypoxemia with

A

bradycardia

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20
Q

PDA

A

aorta to pulmonary artery

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21
Q

s/s of PDA

A

dyspnea
tachycardia
CHF
machinery murmur
thrill in pulmonic area

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22
Q

ASD

A

left to right atrium

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23
Q

ASD s/s

A

CHF
easy tiring
soft systolic ejection murmur

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24
Q

VSD

A

left to right ventricle

25
Q

VSD s/s

A

CHF
systolic murmur
thrill

26
Q

TOF

A

pul stenosis, RV hyperthropy, VSD, overriding of aorta

27
Q

TOF s/s

A

polycythemia
m acid
knee to chest
systolic murmur
thrill

28
Q

TOF radiology

A

boot shaped

29
Q

TGA

A

pulmonary artery and aorta switch

30
Q

s/s of TGA

A

cyanosis soon after birth and doesn’t improve with O2
rapid resp rate
systolic murmur
- S2 is louder

31
Q

TGA radiology

A

egg on a string

32
Q

CoA

A

narrowing of the descending aorta which obstructs the systemic flow

33
Q

s/s of CoA

A

decrease BP in legs
bounding pulse in UE
weak pulse in LE
poor feeding
CHF
loud S2
systolic ejection murmur

34
Q

HLHS

A

mitral or aortic valves are missing or stenosised with a abnormally small left ventricle and small aorta

35
Q

S/S of HLHS

A

progressive cyanosis and CHF
- reiterations, and decrease perierpal pulses
pulmonary edema
no murmur
acidosis

36
Q

HLHS murmur

A

none

37
Q

most common cardiomegaly

A

dilated

38
Q

what is occurring in dilated cardiomegaly

A

4 chambers dialate and systolic contraction is weakened

39
Q

dilated cardiomeg s/s

A

weakness
external dyspnea

40
Q

dilated cardiomeg treatment

A

diuretics, dig, ACEI

41
Q

what cardiomegaly is most common cause of sudden unexpected cardiac death in young athletes

A

hypertrophic

42
Q

what is occurring in hypertrophic cardiomeg

A

enlargement of left ventricle and ventricle septum
diastolic filling is affected

43
Q

s/s of hypertrophic cardiomeg

A

dizziness
chest pain

44
Q

hypertrophic cardiomeg meds

A

beta blockers
ca blockers

45
Q

what is Kawasaki disease

A

acute febrile systematic vascular inflammation disorders

46
Q

why is Kawasaki disease thought to occur

A

caused by infectious agent

47
Q

3 stages of Kawasaki

A

acute
subacute
convalescent

48
Q

Kawasaki acute stage time frame

A

1-2 weeks

49
Q

Kawasaki acute stage s/s

A

high fever for 5 days
hyperemic conjuct
red throat
swollen hands and feet
maculopapular erythema multiform like rash on trunk and peri area

50
Q

Kawasaki sub acte time frame

A

2+ weeks

51
Q

Kawasaki subacute s/s

A

no fever
cracking lips
joint pain
desquamation of skin on tips of fingers and toes

52
Q

Kawasaki convalescent time frame

A

6-8 weeks after disease onset

53
Q

Kawasaki convalescent s/s

A

lingering s/s of inflammation
deep transverse lines may appear across nails on hands and feet

54
Q

Kawasaki treatment

A

single high dose IVIG (2g/kg) over 10-12 hours

55
Q

hypovolemic shock

A

inadequate tissue and organ perfusion resulting from inadequate blood or plasma volume in vascular space

56
Q

s/s of hypovolemic shock

A

nonspecific for early
sustained tachycardia
increased resp effort
weak peripheral pulses
pallor
cold extremities
decrease urine output

57
Q

hypovolemic shock treatment

A

20mL/kg over 5 mins

58
Q
A

Pediatrics (51 decks)

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