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Peds > cardiovascular part 2 (2) > Flashcards

cardiovascular part 2 (2) Flashcards

1
Q

where is arterial blood pumped in a fetus in utero

A

right side of heart

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2
Q

does blood go through the fetus lungs in utero?

A

no, rerouted

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3
Q

what is the fetal vascular channel between the pulmonary artery and the descending aorta

A

ductus arteriosis

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4
Q

where does the majority of blood pumped by the right side of the heart go to?

A

ductus arteriosis

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5
Q

what is the fetal opening in the atrial septum, takes blood from right atrium to left atrium

A

foramen ovale

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6
Q

what stimulates the foramen ovale to close?

A

increased left atrium pressure

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7
Q

when does foramen ovale close

A

shortly after birth?

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8
Q

when does the ductus arteriosis close, and by when is it permanently close?

A

closes within 10-15 hours after birth, permanently after 10-21 days of birth

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9
Q

what does a patent ductus arteriosis cause?

A

oxygenated blood from aorta to lead into unoxygenated blood in the pulmonary artery

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10
Q

when does the heart develop in gestation

A

4th-7th weeks

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11
Q

when do most cardiac defects develop in utero

A

8th week

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12
Q

what are some factors that can contribute to congenital heart disease

A
  • maternal drug/alc use
  • maternal viral infections
  • maternal metabolic disorders
  • genetics
  • increased age
  • chromosomes
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13
Q

what is an increased pulmonary blood flow defect with a defect in the right atrium

A

atrial septal defect

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14
Q

how does blood shunt in atrial septal defect

A

left → right

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15
Q

what kind of symptoms will occur with atrial septal defect

A

heart failure symptoms

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16
Q

which defect is an opening between ventricles

A

ventricular septal defect

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17
Q

describe ventricular septal defects pressure and blood flow

A

increased pressure on the left side, shunts left to right, increased pulmonary blood flow

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18
Q

what symptoms will occur in ventricular septal defect`

A

heart failure symptoms

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19
Q

when is patent ductus arteriosis classified?

A

if it does not close by 21 days

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20
Q

where is blood shunted from and to in patent ductus arteriosis

A

from aorta to pulmonary artery

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21
Q

what kind of blood flow is in patent ductus arteriosis

A

increased pulmonary blood flow

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22
Q

where is the most pressure in a patent ductus arteriosis defect

A

aorta

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23
Q

what defect is narrowing of the descending aorta

A

coarctation of the aorta

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24
Q

what kind of blood flow does coarctation of the aorta have

A

obstructed systemic blood flow (restricted flow from aorta = less to the body)

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25
Q

where does coarctation of the aorta restrict flow from?

A

the left ventricle

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26
Q

what are signs and symptoms of coarctation of the aorta dependent on?

A

size of the defect

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27
Q

which defect is a cyanotic heart defect

A

tetralogy of fallot

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28
Q

what kind of bloodflow does tetralogy of fallot have?

A

decreased pulmonary blood flow

29
Q

what are the 4 defects that make up tetralogy of fallot?

A
  1. right ventricular wall hypertrophy (narrowing)
  2. narrowing of pulminary valve (pulmonic stenosis)
  3. ventricular septal defect
  4. overriding aorta
30
Q

what causes the right ventricle hypertrophy in tetralogy of fallot

A

pulmonic stenosis causes the right ventricle to work harder than it should

31
Q

where is the shunting of blood in tetralogy of fallot

A

there is none

32
Q

why is there decreased pulmonary blood flow in tetralogy of fallot?

A

pulmonic stenosis (narrow pulmonsry valve)

33
Q

which procedure has a radiopaque catheter inserted into the heart from a peripheral blood vessel, has contrast media put through

A

cardiac cath

34
Q

what can assess congenital heart defects, valve disease, and coronary heart disease

A

cardiac cath

35
Q

where does a cardiac cath measure oxygen saturation

A

in the hearts chambers and great arteries

36
Q

where dies a cardiac cath measure pressure gradients

A

pulmoanry vessels and heart chambers

37
Q

how long is rpessure held on a cardiac cath afterward?

A

15 mins

38
Q

describe dressing assessment intervals directly after a cardiac cath

A

every 5 min for 15 mins, every 15 mins for 1 hour, then hourly

39
Q

which vital signs indicate bleeding

A

increased pulse and decreased bp

40
Q

wha tcan contrast media cause

A

diuresis (watch I&O)

41
Q

how long should the HOB be flat for after a cardiac cath

A

4-6 hours

42
Q

where should pressure be held if a cardiac cath site bleeds?

A

an inch above the site (inch closer to heart, this is on leg)

43
Q

what is when cardiac putput is inadequate to support the bodys circulatory and metabolic needs

A

congestive heart failure

44
Q

what is congestive heart failure cuased by?

A

congenital heart defect or acquired heart disease

45
Q

what are some clinical manifesttions of CHF in infants

A
  • tires easily, with feeds especially
  • weight loss or lack of gain
  • diaphoresis (esp. feeding)
  • frequent resp infections
  • color changes; mottling or pallor
46
Q

CHF clinical manifestations in toddler/older child

A
  • exercise intolerance
  • dyspnea
  • abd pain/distention
  • peripheral edema
47
Q

what does pulmonary venous cingestion (left sided HF) in CHF look like?

A
  • tachypnea, wheezing, crackles, retractions, cough, dyspnea, grunt, flare, cyanosis
48
Q

what does systemic venous congestion (right sided HF) in CHF look like?

A
  • tender/enlarged liver
  • ascites
  • periorbital edema
  • peripheral edema
  • weight gain
  • neck vein distention
49
Q

Which diagnostic method of congestive heart failure shows cardiac enlargement in venous congestion or signs of pulmonary edema

A

CXR

50
Q

Which diagnostic tool of congestive heart failure confirms the diagnosis, and shows cardiac defects or ventricular dysfunction

A

Echocardiogram

51
Q

which diagnostic method of congestive heart failure identifoes arrythmias

A

electrocardiogram

52
Q

goals of CHF?

A
  • treat the cause
  • make the hard work more efficiently and remove excess fluid
53
Q

Which medications promote fluid excretion in congestive heart failure

A

diuretics like furosemide

54
Q

what needs supplemental when on diuretics?

A

potassium

55
Q

Which medications for congestive heart failure are used to decrease blood pressure, therefore decreasing the workload of the heart

A

angiotensin converting enzyme (ACE) inhibitors (captopril), and beta blockers!!!! (propranolol)

56
Q

what is the most common sign of digoxin toxicity in congestive heart failure treatment

A

arrythmias

57
Q

which medication for congestive heart failure slows the heart rate, increases cardiac filling time and myocardial contractility to improve systemic circulation

A

digoxin

58
Q

What kind of dosing is used with digoxin?

A

loading dose and then maintenance dose

59
Q

Which heart rates lead to digoxin being held in infants and children?

A

infants = <90, children = <70

60
Q

A decrease in which electrolyte increases the risk of digoxin toxicity?

A

potqssium

61
Q

What kind of diets are recommended for infants with congestive heart failure?

A

High calorie formula and NG feeds

62
Q

What kind of meals should an older child with CHF have?

A

small frwqunt meals

63
Q

What position is best for CHF?

A

semi-fowlers

64
Q

Fetal circulation includes which of the following?
1. ductus arteriosis
2. foramen ovale
3. pulmonary artery
4. pulmonary vein

A

1 and 2

65
Q

Diagnosis and testing for CHF would include?
1. EKG, CXR, and ultrasound
2. Stress test, cardiac catheterization, EKG
3. EKG, CXR, echocardiogram, cardiac catheterization
4. Echocardiogram, cardiac catheterization

A

3

66
Q

T or F?
cardiac catheterization puts the infant or child at risk for arrhythmias

A

true

67
Q

early clinical manifestations for an infant with congestive heart failure could include which of the following? choose all
1. Inc weight gain
2. eager eater
3. emesis
4. poor weight gain
5. bottle feeding taking longer than 30 min

A

4 and 5

68
Q

Two month old infant is admitted with congestive heart failure. Which would be a daily nursing intervention
1. weight
2. Elevating head of bed
3. small frequent meals
4. assessment q8h

A

1

Peds (30 decks)

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