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Cardiovascular Disorder Flashcards

1
Q

When are the four chambers of the heart and arteries formed during gestation?

A

Weeks 2-8

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2
Q

Digoxin

A

Antiarrhythmic agent, cardiac glycoside

-increases contractility of the heart muscle by decreasing conduction and increasing force

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3
Q

What is Digoxin used for?

A
  • heart failure
  • atrial fibrillation
  • atrial flutter
  • supraventricular tachycardia
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4
Q

What must be done prior to administering Digoxin?

A

Count apical pulse for 1 full minute
Hold for adolescent if pulse is < 60
Hold for infant if pulse is < 90

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5
Q

Administering Digoxin

A
  • monitor serum levels
  • note signs of toxicity
  • avoid rapid IV administration
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6
Q

S/S of Toxicity w/ Digoxin

A
  • n/v
  • diarrhea
  • lethargy
  • bradycardia
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7
Q

Heparin

A
  • anticoagulant
  • interferes w/ conversion of prothrombin to thrombin
  • prevents clot formation
  • administer SQ
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8
Q

What should be done when administering Heparin?

A
  • Dose may need adjusted according to coagulation test results
  • monitor for bleeding
  • monitor platelet count
  • ensure antidote is available
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9
Q

What is the antidote for Heparin?

A

Protamine Sulfate

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10
Q

What is characteristic of ventricular heart failure in older children?

A

Edema in the lower extremities

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11
Q

Where does peripheral edema develop first in the infants?

A

Face

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12
Q

S/S of Cardiac Disorder

A
  • cyanosis
  • edema
  • clubbing
  • fever
  • retractions
  • prominence of precordial chest wall
  • visible engorged or abnormal pulsations
  • abdominal distention
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13
Q

Cardiac Catherization

A
  • definitive study of the heart
  • routine diagnostic procedure
  • may be outpatient procedure
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14
Q

What should be done before Cardiac Catherization

A
  • ask about allergies to iodine and shellfish
  • review meds; may need to withhold anticoagulants
  • pay particular attention to pedal pulses
  • NPO 4-6 hrs prior
  • get consent
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15
Q

What to do AFTER Cardiac Catherization

A
  • vitals
  • neurovascular checks of lower extremities
  • check pressure dressing q 15 mins for first hour the q 30 mins for 1 hour
  • don’t change dressing until day after
  • must remain in straight position 4-8 hours
  • no strenuous activity for 3 days
  • no tub baths
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16
Q

What to do if bleeding occurs after Cardiac Catherization

A

Apply pressure 1 inch above the site to create pressure over vessel and reduce blood flow

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17
Q

Congenital Heart Disease

A
  • structural anomalies that are present at birth

- CHD accounts for the largest percentage of all birth defects

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18
Q

Acquired Heart Disease

A
  • occur after birth

- develops from wide range of causes or can occur as complication or long term effect of CHD

19
Q

Disorders w/ DECREASED Pulmonary Blood Flow

A
  • tetralogy of fallot

- tricuspid atresia

20
Q

Disorders w/ INCREASED Pulmonary Blood Flow

A
  • patent ductus arteriosus (PDA)
  • atrial septal defect
  • ventricular septal defect
21
Q

Obstructive Disorders

A
  • Coarctation of the Aorta
  • Aortic stenosis
  • Pulmonary stenosis
22
Q

Mixed disorders

A
  • Transposition of the Great Vessels
  • Total Anomalous pulmonary venous return
  • Truncus arteriosus
  • Hypoplastic Left Heart Syndrome
23
Q

Tetralogy of Fallot

A

mixing of oxygenated and poorly oxygenated blood and then pumped to systemic circulation

  • child will look cyanotic
  • surgical intervention w/in first year
24
Q

Why is Tetralogy of Fallot usually diagnosed early?

A

B/c infant has a LOUD HARSH murmur and is cyanotic

25
S/S of Tetralogy of Fallot
- Hypercyanotic spells - Infant will get in fetal position - Toddlers will squat - Infants may become unresponsive
26
AFTER Blalock-Taussig Surgery for Tetralogy of Fallot
- no BP in affected arm | - pulse is not palpable in arm b/c subclavian artery has been used for shunt
27
What are the 4 heart defects that come w/ Tetralogy of Fallot?
- pulmonary stenosis - VSD - overriding aorta - right ventricular hypertrophy
28
Atrial Septal Defect
- a hole in the wall (septum) that divides the RA from the LA - will spontaneously close w/in first 18 months - most asymptomatic - fixed split second heart sound - systolic ejection murmur best heard in pulmonic valve area
29
If Atrial Septal Defect does not close by age 3 what happens?
surgery
30
Ventricular Septal Defect
- opening b/t the RV and LV - can spontaneously close by age 2 - Holosystolic HARSH murmur along the left sternal border
31
Moderate VSD can result in what?
- Heart failure by 4-8 weeks - infant tires easily - does not eat well
32
Atrioventricular Canal Defect
- endocardial cushion fails to fuse - necessary to separate the central parts of the heart near the tricuspid and mitral valves - creates large left to right shunt - 45% of children w/ Down Syndrome
33
Patent Ductus Arteriosus
- failure of the ductus arteriosus to close w/in first few weeks of life - causes a connection b/t aorta and pulmonary artery - increases workload of left side of heart - most frequent in premies
34
What type of murmur is heard with Ductus Arteriosus?
Harsh continuous machine like murmur under left clavicle at the 1st and 2nd intercostal space
35
What would a chest x-ray show for Ductus Arteriosus?
Cardiomegaly-large heart
36
Hypoplastic Left Heart Syndrome
- structures on left side of the heart are severely underdeveloped - left side is unable to supply blood to systemic circulation
37
Treatment for Hypoplastic Left Heart Syndrome
- palliative care - cardiac transplant - palliative reconstructive surgery in 3 stages
38
S/S of Hypoplastic Left Heart Syndrome
- may be asymptomatic until ductus arteriosus closes and then newborn becomes cyanotic - gallop rhythm single heart sounds, soft systolic, ejection, holosystolic murmur
39
What are the focuses of Nursing Care for a child w/ Cardiac Disorder?
- improving oxygenation - promoting adequate nutrition - assist child and fam w/ coping/education - providing post op care - preventing infection
40
What position can the patient be put in for relieving hypercyanotic spells and provide supplemental oxygen?
knee-to-chest
41
Preop Assessments during Cardiac Surgery
- temperature and weight measurements - exam of extremities for peripheral edema, clubbing, and evaluation of peripheral pulses - auscultation of heart - respiratory assessment
42
What is the most common reason for admission to hospitals for kids w/ CHD?
Congestive Heart Failure
43
CHF occurs most often in who?
Children w/ congenital heart defects

Pediatrics (24 decks)

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