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IM 5.5 Test 4 > Cardiovascular Dysfunction > Flashcards

Cardiovascular Dysfunction Flashcards

1
Q

atresia

A

congenital absence or pathological closure

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2
Q

Stenosis

A

anatomic narrowing

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3
Q

Normal cardiac flow

A

S/IVC - RA - Tricuspid valve - RV - Pulmonary valve - pulmonary artery - lungs - pulmonary veins - LA - mitral valve - LV - aortic valve - aorta - body

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4
Q

high pressure side prenatally

A

right side

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5
Q

high pressure side after birth

A

left side

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6
Q

blood follows the path of

A

least resistance

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7
Q

congenital heart disease

A

abnormalities present at birth

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8
Q

acquired heart disease

A

occur after birth

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9
Q

biggest cause of death in the first year of life

A

congenital heart defects

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10
Q

most common congenital heart defect

A

VSD

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11
Q

cause of congenital heart defects

A

etiology unknown in 90% of cases

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12
Q

FAS relation to congenital heart defects

A

50% of FAS kids have a heart defect

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13
Q

what chromosomal abnormality is associated with heart defects

A

downs syndrome

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14
Q

diagnostic procedures for cardiac abnormalities X4

A

EKG, CXR, ECHO, cardiac cath

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15
Q

CXR shows X3

A

size, cardiomegaly, pulmonary congestion

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16
Q

what is an echo

A

high frequency sound waves to produce real time image

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17
Q

cardiac cath as a diagnostic

A

defines a defect prior to surgery by determining blood flow patterns

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18
Q

cardiac cath as interventional

A

balloon to correct aorta/valve issues or mesh devices to close septal defects

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19
Q

cardiac cath electrophysiology

A

stimulate different areas of the heart to determine which area is causing arrhythmia then cauterize it

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20
Q

cardiac cath pre procedural care

A

mark pulses prior to cath in case it is hard to find after procedure

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21
Q

cardiac cath post procedure

A

pulses for equality and symmetry

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22
Q

how long do you keep extremity straight for venous caths

A

4-6 hours

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23
Q

how long do you keep extremity straight for arterial caths

A

6-8 hours

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24
Q

for bleeding at cath entry site

A

apply direct continuous pressure 1 inch above entry site

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25
Q

how long should activity be limited following a cardiac cath

A

24 hours

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26
Q

left to right shunt

A

blood flows from systemic circulation to pulmonary leading to increased pulmonary blood flow

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27
Q

right to left shunt

A

blood flows from pulmonary circulation to systemic, allowing deoxygenated blood to flow into body

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28
Q

atrial septal defect shunting

A

left to right - increased pulmonary blood flow

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29
Q

ASD patho

A

abnormal opening between the atria

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30
Q

small ASD defect s/s

A

potentially asymptomatic

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31
Q

large ASD defect s/s X3

A

fatigue, SOB, respiratory infections

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32
Q

ASD treatment - spontaneous closure

A

depends on the size of the defect and the age of the child

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33
Q

ASD treatment - catheter closure

A

septal occluders - smaller defects

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34
Q

ASD treatment - surgical closure

A

pericardial/dacron patch for moderate to large defects

sutures for smaller defects

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35
Q

Ventricular Septal Defect shunting

A

left to right shunt

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36
Q

VSD patho

A

abnormal opening between the right and left ventricle

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37
Q

VSD s/s small defect

A

probably asymptomatic. no physical restrictions. only requires reassurance and periodic follow-ups

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38
Q

VSD s/s moderate to large defect

A

CHF common

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39
Q

VSD treatment - spontaneous closure

A

occurs 20-60% of the time - depends on size of defect and the age of the child

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40
Q

VSD treatment small defects

A

sutures

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41
Q

VSD treatment large defects

A

patches

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42
Q

VSD palliative care

A

pulmonary artery banding with the goal to decrease pulmonary blood flow

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43
Q

preferred approach in VSD

A

complete repair in infancy

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44
Q

PDA shunting

A

left to right shunt

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45
Q

PDA patho

A

failure of the ductus arteriosus to close within the first 3 weeks of life

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46
Q

small PDA s/s

A

asymptomatic

47
Q

large PDA s/s

A

CHF, FTT, machinery like murmur with frequent respiratory infections

48
Q

PDA non surgical treatment

A

indomethacin (close), prostaglandin (open) and coils

49
Q

indomethacin is used in X2

A

premature infants and some newborns

50
Q

PDA surgical treatment

A

ligation

51
Q

tetraology of fallot patho

A

4 cardiac defects - VSD, pulmonary stenosis, overriding aorta, right ventricular hypertrophy

52
Q

tetraology of fallot s/s X4

A

cyanosis, tachypnea, clubbing and growth retardation

53
Q

tet spells preceded by

A

feeding, crying, defecation or stressful procedures

54
Q

tet of fallot shunting

A

right to left shunt

55
Q

tet spells occur during X YOL before X months old and usually at X time of day

A

1st year of life, usually before 2 months old and usually in the morning

56
Q

what are tet spells

A

acute episodes of cyanosis and hypoxia

57
Q

tet spells nursing interventions X4

A

knee chest positioning, blow by 100% O2, morphine, IVF replacement

58
Q

tet of fallot treatemtn

A

prevent infections, monitor/treat anemia, surgical correction

59
Q

surgery for tet of fallot

A

palliative shunt with complete repair at 6 mo-1 yr

60
Q

coarctation of aorta patho

A

narrowing of aorta at or near the ductus arteriosus

61
Q

coarctation of aorta s/s

A

elevated BP in arms with bounding pulses, decreased BP in legs with weak/no pulses, cool lower extremities

62
Q

coarctation of aorta treatment - non surgical

A

infants and children - balloon angioplasty

adolescents - stent placement

63
Q

coarctation of aorta treatment - surgical post op complications

A

HTN and recoarctation

64
Q

aortic stenosis patho

A

narrowing of the aortic valve from 3 to 2 leaflets

65
Q

aortic stenosis leads to X4

A

left ventricular enlargement, decreased cardiac output, left ventricular hypertrophy, increased left atrial pressure

66
Q

aortic stenosis s/s mild to moderate

A

asymptomatic

67
Q

aortic stenosis s/s severe in newborns

A

decreased cardiac output, faint pulses, hypotension, tachycardia, poor feeding

68
Q

aortic stenosis s/s severe children

A

chest pain, SOB, syncope, exercise intolerance, dizziness

69
Q

aortic stenosis physical restrictions in mild cases

A

able to participate in most sports and activities

70
Q

aortic stenosis physical restrictions in mod-severe cases

A

no sustained strenuous activities, no competitive sports

71
Q

the only heart defect where activity may be restricted

A

aortic stenosis

72
Q

non-surgical aortic stenosis treatment

A

balloon valvuloplasty

73
Q

surgical aortic stenosis treatment

A

valvotomy, valve replacement

74
Q

pulmonic stenosis patho

A

narrowing of pulmonary valve or artery

75
Q

mild pulmonic stenosis s/s

A

asymptomatic or mild cyanosis

76
Q

mod-severe pulmonic stenosis s/s

A

CHF and requires elective treatment

77
Q

non-surgical pulmonic steonsis tx

A

balloon valvuloplasty

78
Q

surgical pulmonic stenosis tx

A

valvotomy and valve replacement

79
Q

hypoplastic left heart syndrome patho

A

underdevelopment of the left side of the heart d/t hypoplastic left ventricle, aortic atresia with oxygenation dependent on ASD or PFO and systemic blood flow is dependent on PDA

80
Q

HLHS s/s

A

mild cyanosis, heart failure, lethargy, cold hands and feet

81
Q

normal O2 level in HLHS

A

75-80%

82
Q

HLHS treatment

A

staged reconstruction (3 operations), heart transplant

83
Q

HLHS prognosis without treatment

A

fatal within 3 weeks of life

84
Q

HLHS medication

A

prostaglandin infusion

85
Q

right sided failure

A

right ventricle is unable to pump blood effectively into pulmonary artery

86
Q

left sided failure

A

left ventricle is unable to pump blood into the systemic circulation

87
Q

digoxin method of action

A

effects the rate and power of contraction

88
Q

DNU digoxin in infants when X

A

90-110

89
Q

DNU digoxin in children when X

A

below 70

90
Q

captopril

A

ACE inhibitor

91
Q

enalapril

A

ACE inhibitor

92
Q

lisinopril

A

ACE inhibitor

93
Q

carvediolol

A

beta blocker

94
Q

furosemide

A

diuretic

95
Q

chlorothiazide

A

diuretic

96
Q

spirnolactone

A

diuretic

97
Q

infection endocarditis patho

A

infection of the valves and inner lining of the heart caused by bacteria that enter the blood stream and settle in the heart lining, heart valve or blood vessel

98
Q

infective endocarditis treatment

A

blood cultures, abx, surgery, echo

99
Q

highest risk for infective endocarditis

A

children who have undergone surgical repair/palliative surgery for valvular abnormalities, prothetic valves, conduits/shunts

100
Q

infective endocarditis prognosis

A

fatal if untreated

101
Q

infective endocarditis s/s

A

hx of dental procedure with a new murmur or change in existing one

102
Q

infective endocarditis prevention

A

good oral hygiene and amoxicillin 1 hr before dental procedures

103
Q

rheumatic fever patho

A

inflammatory disease that occurs as a rxn to GABHS pharyngitis

104
Q

rheumatic fever s/s

A

usually 2-4 weeks after a strep throat infection, elevated ASO titer, polyarthritis, erythema marginatum, chorea, arthralgia

105
Q

erythema marginatum

A

round, 2 circle rash - characteristic for rheumatic fever

106
Q

rheumatic fever complications

A

inflammation in joints, skin, brain, serous surfaces, and heart - most common mitral valve damage

107
Q

rheumatic fever treatment

A

10 day PCN with aspirin and prednisone

108
Q

kawasaki disease patho

A

acute systemic vasculitis

109
Q

kawasaki risk factors

A

males, asians, kids under 5

110
Q

kawasaki diagnostic

A

elevated CRp and ESR and Plt

111
Q

kawasaki acute phase

A

fever for 5+ very irritable, erythema/edema of hands/feet, strawberry tongue

112
Q

kawasaki subacute phase

A

desquamation of fingers/toes

113
Q

kawasaki convalescent phase

A

begins when all clinical signs start to resolve 6-8 weeks after onset

114
Q

kawasaki treatment

A

IVGG - high doses, aspirin,

IM 5.5 Test 4 (3 decks)

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