cardiovascular part 3 (2) Flashcards
Match the congenital heart defects with their blood flow!
(a= increased pulmonary flow; b= decreased pulmonary flow; c= obstructed systemic flow)
1. atrial septal defect (ASD)
2. ventricular septal defect
3. coarctation of aorta
4. tatralogy of fallot
5. patent ductus arteriosis
6. pulmonic stenosis
1a, 2a, 3c, 4b, 5a, 6b
With increased pulmonary blood flow congenital defects, what side of the heart has greater pressure
left
what determines the defect symptoms and increased pulmonary blood flow defacts?
size of defect
What is an opening in atrial septum that permits left to right shunting of blood
atrial septal defect
What symptoms do infants and young children show with atrial septal defect
asymptomatic
one are small to mid sized atrial septal defects diagnosed?
preschool or later
Describe the correlation between atrial septal defect and CHF?
rarely have CHF
What is the usual clinical therapy for smaller atrial septal defects?
Spontaneous closure within the first four years
What happens when an atrial septal defect is large or not closed by three years?
Transcatheter closure, device placed during. cardiac cath
How long does it take for the heart size to return to a normal after surgical repair of large atrial septal defect?
4-6 months
One month old Sarah comes to the health care provider’s office for her one month checkup. She had a small murmur noted at her one week check up. Mom tells you that Sarah’s bottle ticks 40 minutes for her to finish. She becomes diaphoretic with bottle feeding. Past couple days Mom says she has become purple when fussy.
poor weight gain, cardiac enlargement, and pneumonia found
echo shows right ventricular hypertrophy and hole in sseptum between left and right ventricles
which defect does she have
ventricular septal defect
What complications can come from moderate and large ventricular septal defects?
CHF, Inc pulmonary infactions, and pukmknary hypertension, delayed growth, failure to thrive
Can a ventricular septal defects increase in size?
no
How are small ventricular septal defects usually solved?
Usually close on their own within six months
how are moderate or large ventricular septal defects fix?
surgery
What are clinical manifestations of ventricular septal defect?
Congestive heart failure symptoms, pulmonary infections, pork growth, and failure to thrive
Which test establishes a diagnosis for ventricular subtle defect?
echo
What is important to feel for around a chest tube?
crepitis
What is crepitus and what does it feel like?
It’s an air leak in the subcutaneous tissue, it feels like rice crispies
what is needed at the bedside when a patient has a chest tube?
- Vaseline gauze (for leaks)
- 2 hemostats (to connect separated tuBing)
what is there an increased risk for after surgery for ventricular septal defect?
arrythmia and heart blocm
Which congenital results has blood shunted on the aorta to the pulmonary arteries?
Paren’t ductus arteriosis
what kind of infants are most at risk for patent ductus arteriosis
premature infants
clinical manifestations ductus arteriosis
dyspnea, tachypnea, tachycardia, full bounding puless, widened pulse pressure
what kind of manifestations are seen in a large patent ductus arteriosis
Congestive part failure, intercostal retractions, hepatomegaly, poor growth and development
What is the treatment of patent ductus arteriosis
surgical ligation, insertion of coli
HIV medications can stimulate culture of patent ductus arteriosis in premature infants?
IV ibuprofen or indomethacin
10 y.o. Is brought in five PMS to the emergency department. mother called 911 because her baby was not acting right and turning colors while feeding.
RR 70(high), HR good, pox 90 low, BP good, brachial/radial bounding pulses, femoral/pedal pulses weak
CXR showed cardiomegaly, BP higher in upper extremities
which congenital heart disorder?
coarctation of the aorta
which ccongenital heart defect is narrowing or construction of the descending aorta which obstructs a systemic blood flow
coarctation of aorta
What about coarctation of the sorts causes higher bps in upper than lower extremities
decreased blood flow through descending aorta
how is coarctation of aorta diagnosed
CXR, cardiomegaly, pulmonary venous congestion, indentation of descending aorta
what were the two surgical treatments of coarctation of aorta
1) Surgical resection of the narrowed aorta and anastomosis
2) Area that is narrow may be dilated with a balloon during a cardiac cath
why does polycythemia occur in decreased pulmonary blood flow defects
excessive production of red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues
What is the narrowing of a palmonic valve or valve area
pukmonic valve stenosis
which part of the heart is affected by pulmonic stenosis and how?
Right ventricular hypertrophy
what is the clinical therapy of pulmonic stenosis
dilation by balloon valvuloplasty during cardiac calf or surgical resection
What kind of prophylaxis is necessary for pulmonic stenosis and for how long
lifelong infective endocrarditis prophylaxis
What are the four defects that make up tetralogy of fallot
- pulmonic stenosis
- right ventricular hypertrophy
- ventricular septal defect
- overriding aorta
what’s an overriding aorta
the aortic valve is enlarged and appears to arise from both the left and right ventricles instead of just the left
when is tetraoly of fallout usually diagnosed
first few days of life
When does the infant become hypoxic and cyanotic with tetraolgy of fallot
when the ductus arteriosis ckoses
what determines the severity of cyanosis and symptoms in tetraology of fallot
degree of pulmonic stenosis
what is a “Tet spell”
hypercyanotic episode in tetrilogy of fallot
what are hypercyanotic episodes in tetralogy of fallout caused by?
crying, feeding, warm bath, bowel mvmt
what to do during a tet spell (TOF)
Place infant in knee trust position, calm them, oxygen, morphine to suppress respirations, beta blockers to reduce heart rate and muscle spasm, PRBCs if anemic, iv fluid
diagnosis of tet of fallot
CXR, EKG, echo
When is immediate surgical intervention required for tet of fallot
a hypercyanotic ep
What device is used after surgery for tet of fallot
pacemaker
How long does it take for the heart to completely heal after surgery for tet of fallot
4-6 mo
An increased pulmonary blood flow defect has what type of blood shunting?
left to right
Which defect repair may have an additional risk for arrhythmias due to the normal conduction of the heart
Ventricular septal defect
which congenital heart defect has a distinctive murmur which helps in identifying the defect prior to diagnostic testing
patent ductus arteriosis
Which defect is a decreased pulmonary blood flow defect
pulmonic stenosis
what would be part of your incision assessment in an infant with surgical repair of a congenital heart defect
Color, temperature, drainage, edema, approximation
