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Peds > cardiovascular part 3 (2) > Flashcards

cardiovascular part 3 (2) Flashcards

1
Q

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

A

1a, 2a, 3c, 4b, 5a, 6b

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2
Q

With increased pulmonary blood flow congenital defects, what side of the heart has greater pressure

A

left

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3
Q

what determines the defect symptoms and increased pulmonary blood flow defacts?

A

size of defect

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4
Q

What is an opening in atrial septum that permits left to right shunting of blood

A

atrial septal defect

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5
Q

What symptoms do infants and young children show with atrial septal defect

A

asymptomatic

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6
Q

one are small to mid sized atrial septal defects diagnosed?

A

preschool or later

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7
Q

Describe the correlation between atrial septal defect and CHF?

A

rarely have CHF

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8
Q

What is the usual clinical therapy for smaller atrial septal defects?

A

Spontaneous closure within the first four years

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9
Q

What happens when an atrial septal defect is large or not closed by three years?

A

Transcatheter closure, device placed during. cardiac cath

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10
Q

How long does it take for the heart size to return to a normal after surgical repair of large atrial septal defect?

A

4-6 months

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11
Q

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

A

ventricular septal defect

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12
Q

What complications can come from moderate and large ventricular septal defects?

A

CHF, Inc pulmonary infactions, and pukmknary hypertension, delayed growth, failure to thrive

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13
Q

Can a ventricular septal defects increase in size?

A

no

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14
Q

How are small ventricular septal defects usually solved?

A

Usually close on their own within six months

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15
Q

how are moderate or large ventricular septal defects fix?

A

surgery

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16
Q

What are clinical manifestations of ventricular septal defect?

A

Congestive heart failure symptoms, pulmonary infections, pork growth, and failure to thrive

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17
Q

Which test establishes a diagnosis for ventricular subtle defect?

A

echo

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18
Q

What is important to feel for around a chest tube?

A

crepitis

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19
Q

What is crepitus and what does it feel like?

A

It’s an air leak in the subcutaneous tissue, it feels like rice crispies

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20
Q

what is needed at the bedside when a patient has a chest tube?

A
  1. Vaseline gauze (for leaks)
  2. 2 hemostats (to connect separated tuBing)
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21
Q

what is there an increased risk for after surgery for ventricular septal defect?

A

arrythmia and heart blocm

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22
Q

Which congenital results has blood shunted on the aorta to the pulmonary arteries?

A

Paren’t ductus arteriosis

23
Q

what kind of infants are most at risk for patent ductus arteriosis

A

premature infants

24
Q

clinical manifestations ductus arteriosis

A

dyspnea, tachypnea, tachycardia, full bounding puless, widened pulse pressure

25
Q

what kind of manifestations are seen in a large patent ductus arteriosis

A

Congestive part failure, intercostal retractions, hepatomegaly, poor growth and development

26
Q

What is the treatment of patent ductus arteriosis

A

surgical ligation, insertion of coli

27
Q

HIV medications can stimulate culture of patent ductus arteriosis in premature infants?

A

IV ibuprofen or indomethacin

28
Q

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?

A

coarctation of the aorta

29
Q

which ccongenital heart defect is narrowing or construction of the descending aorta which obstructs a systemic blood flow

A

coarctation of aorta

30
Q

What about coarctation of the sorts causes higher bps in upper than lower extremities

A

decreased blood flow through descending aorta

31
Q

how is coarctation of aorta diagnosed

A

CXR, cardiomegaly, pulmonary venous congestion, indentation of descending aorta

32
Q

what were the two surgical treatments of coarctation of aorta

A

1) Surgical resection of the narrowed aorta and anastomosis
2) Area that is narrow may be dilated with a balloon during a cardiac cath

33
Q

why does polycythemia occur in decreased pulmonary blood flow defects

A

excessive production of red blood cells to increase the amount of hemoglobin available to carry oxygen to the tissues

34
Q

What is the narrowing of a palmonic valve or valve area

A

pukmonic valve stenosis

35
Q

which part of the heart is affected by pulmonic stenosis and how?

A

Right ventricular hypertrophy

36
Q

what is the clinical therapy of pulmonic stenosis

A

dilation by balloon valvuloplasty during cardiac calf or surgical resection

37
Q

What kind of prophylaxis is necessary for pulmonic stenosis and for how long

A

lifelong infective endocrarditis prophylaxis

38
Q

What are the four defects that make up tetralogy of fallot

A
  1. pulmonic stenosis
  2. right ventricular hypertrophy
  3. ventricular septal defect
  4. overriding aorta
39
Q

what’s an overriding aorta

A

the aortic valve is enlarged and appears to arise from both the left and right ventricles instead of just the left

40
Q

when is tetraoly of fallout usually diagnosed

A

first few days of life

41
Q

When does the infant become hypoxic and cyanotic with tetraolgy of fallot

A

when the ductus arteriosis ckoses

42
Q

what determines the severity of cyanosis and symptoms in tetraology of fallot

A

degree of pulmonic stenosis

43
Q

what is a “Tet spell”

A

hypercyanotic episode in tetrilogy of fallot

44
Q

what are hypercyanotic episodes in tetralogy of fallout caused by?

A

crying, feeding, warm bath, bowel mvmt

45
Q

what to do during a tet spell (TOF)

A

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

46
Q

diagnosis of tet of fallot

A

CXR, EKG, echo

47
Q

When is immediate surgical intervention required for tet of fallot

A

a hypercyanotic ep

48
Q

What device is used after surgery for tet of fallot

A

pacemaker

49
Q

How long does it take for the heart to completely heal after surgery for tet of fallot

A

4-6 mo

50
Q

An increased pulmonary blood flow defect has what type of blood shunting?

A

left to right

51
Q

Which defect repair may have an additional risk for arrhythmias due to the normal conduction of the heart

A

Ventricular septal defect

52
Q

which congenital heart defect has a distinctive murmur which helps in identifying the defect prior to diagnostic testing

A

patent ductus arteriosis

53
Q

Which defect is a decreased pulmonary blood flow defect

A

pulmonic stenosis

54
Q

what would be part of your incision assessment in an infant with surgical repair of a congenital heart defect

A

Color, temperature, drainage, edema, approximation

Peds (30 decks)

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