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RN Summer 2021 Test 1 > Ch. 12 Peds Cardiovascular Disorders > Flashcards

Ch. 12 Peds Cardiovascular Disorders Flashcards

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1
Q

How big is a child’s heart?

A

Size of fist

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2
Q

Normal HR?

A

60-160 bpm

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3
Q

The heart is composed of what 4 chambers?

A
  • Left and right atria

- Left and right ventricle

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4
Q

Fxn of right atrium

A

collects deoxygenated blood from the entire body, except for the lungs

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5
Q

Fxn of right ventricle

A

pumps deoxygenated to the lungs via the pulmonary artery

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6
Q

Fxn of left atrium

A

Collects oxygenated blood from the capillary beds of the lungs through the pulmonary veins

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7
Q

Fxn of left ventricle

A

Pumps oxygenated blood through the aorta to the systemic circulation

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8
Q

The 4 valves prevent

A

blood from regurgitating

  • Tricuspid
  • Bicuspid
  • Pulmonary
  • Aortic
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9
Q

The atrioventricular valves connect

A

the atria and ventricles

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10
Q

The tricuspid valve connects

A

the right atria and right ventricle

-3 leafed

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11
Q

The bicuspid valve connects

A

the left atria and left ventricle

-2 leafed

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12
Q

Aortic valve connects

A

Right ventricle and pulmonary artery

-3 leafed

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13
Q

Aortic valve connects

A

Left ventricle and ascending aorta

-3 leafed

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14
Q

The superior vena cavae lies? and carries blood from?

A
  • lies above the heart

- from the head, arms, and upper body

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15
Q

The inferior vena cavae lies? and carries blood from?

A
  • lies below the heart

- from the legs, abdominal cavity, and lower part of the body to the right atrium

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16
Q

Pulmonary artery carries

A

deoxygenated blood from the right ventricle to the lungs to be oxygenated

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17
Q

Pulmonary vein carries

A

oxygenated blood from capillary beds of the lungs to the left atrium and left ventricle

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18
Q

Aorta carries

A

oxygenated blood from the left ventricle to the rest of the body

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19
Q

Cardiac output

A

the amount of blood ejected from the right or left ventricle per minute

SV x HR = CO (L/min)

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20
Q

Stroke volume

A

amount of blood pumped out of the left ventricle per minute, which is altered by the size of the heart and the HR

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21
Q

The conduction of electrical impulses through the heart results in? and is measured by?

A
  • results in electrical discharge across the myocardium

- measured by an electrocardiogram (EKG)

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22
Q

What is the pacemaker of the heart? and causes?

A
  • SA node

- caused depolarization and contraction of the atria

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23
Q

What is the P wave the measure of?

A

blood being pumped into the ventricles

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24
Q

P-Q interval reflects?

A

slowed conduction to allow R and L ventricles to fill with blood

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25
Q

Q wave shows?

A

Contraction in the walls of the ventricles

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26
Q

R wave? and S wave?

A

the L ventricle contracts (R wave) just before the R ventricle (S wave)

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27
Q

T wave?

A

ventricles relax and wait for next signal

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28
Q

Before birth, how much blood bypasses the lungs?

A

90%

-the placenta is the organ of respiration

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29
Q

What is the most common cause of congenital cardiac malformations?

A

Genetic factors

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30
Q

When hemoglobin is <5 mg/dL what happens?

A

large amounts of deoxygenated blood is pumped into systemic circulation

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31
Q

Cyanosis results when

A

O2 sat is decreased to 85% with normal hemoglobin levels

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32
Q

Acquired heart disease can occur in

A

a normal heart or in a heart with a congenital defect

33
Q

Acquired heart disease is due to

A
  • Infections
  • Autoimmune factors
  • Genetic factors
  • Teratogens
  • Chemical agents (ETOH, ACE, chemo, smoking, Accutane, lithium, cocaine, warfarin, dilantin, Vit A)
  • Infectious agents (rubella, varicella, HIV)
  • Maternal factors
  • Physical agents (hot tubs)
34
Q

Diabetic moms increase risk for what in babies?

A

neural tube defects, malnutrition, and thyroid disorders

35
Q

Why do you need hx of sibling with heart defect?

A

b/c increased risk of infant having one as well

36
Q

Possible indicators of heart disease in children

A
  • FTT
  • Small gestation age
  • Poor weight gain
  • Dysmorphic features
  • Developmental disabilities
  • Chest wall deformities
  • Scoliosis
  • Clubbing and erythema in fingers and toes
37
Q

Shallow, rapid respirations with a rate more than 60 bpm in a content infant mean

A

investigate b/c may indicate left to right shunting

38
Q

S/S of pulmonary edema

A
  • increased work of breathing
  • grunting
  • nasal flaring
  • retractions
39
Q

Wide pulse pressure

A

diastolic is low with wide gap b/w S and D pressures

40
Q

BP of 20 mmHg greater than that of lower extremity is

A

indictive of aortic arch abnormalities

41
Q

Chest X-ray shows

A
  • Pulmonary vascularity
  • Cardiac size and shape
  • Lung vascular markings
  • Position of the stomach
42
Q

Blood gases measure?

Metabolic acidosis shows?

A
  • Metabolic acidosis shows as a decrease in pH and an increase in base excess.
  • Base excess is the accumulation of metabolic acids in the blood.
  • It is monitored by arterial, venous, or capillary blood. In cardiac disease, the partial pressure of carbon dioxide is generally within normal ranges.
43
Q

Electrocardiogram

A
  • Useful to determine conduction issues

- Needs to be evaluated by a cardiologist

44
Q

Echocardiogram

A
  • Ultrasound of the heart

- Noninvasive test that indicates structure, size, flow patterns, function, and the blood vessels attached to the heart

45
Q

Angiography

A

-Visualizes the structure and function of the ventricles –Dye injected via a catheter

46
Q

Cardiac Cath

A

small catheters or small, flexible tubes are inserted through small incisions in the neck or groin and threaded to the heart. These small tubes allow for blood samples to be taken, x-rays (fluoroscopy) to be done, and small instruments to be carried to the heart if repairs are needed

47
Q

Biopsy of the Myocardium

A
  • Frequent in heart transplants

- Monitors for rejection

48
Q

Pulmonary Artery Banding

A
  • Palliative measure to decrease pulmonary blood flow –Prevents pulmonary hypertrophy and pulmonary hypertension
  • Precursor to cardiac surgery, such as in large VSDs
49
Q

When do the ducts close in a full term baby?

A

100% within 72 hours of birth

50
Q

How does PDA cause bacterial endocarditis?

A

Caused by irritation of the smooth muscle tissue of the pulmonary artery

51
Q

Dopamine needed for

A

hypotension

52
Q

Digoxin needed for

A

HR

53
Q

Atrial septal defect occurs

A

between the right and left atria when the septal wall fails to form

54
Q

ASD allows for more blood? and leads to?

A
  • flow into the right side of the heart from the left atrium
  • increasing pulmonary blood flow to the lungs leading to pulmonary HTN with right atrial enlargement that can lead to right ventricular hypertrophy
55
Q

Why does a heart murmur occur with ASD?

A

b/c blood is being forced through pulmonary valve

56
Q

What is the most common overall congenital heart disease?

A

Ventricular septal defect

57
Q

VSD results in

A

right ventricle hypertrophy with left to right shunting that produces an increase in pulmonary blood flow that decreases pulmonary compliance
“stiff lungs”

58
Q

Tetralogy of Fallot associated with

A

chromosome 22 disorders

  • DiGeorge
  • Downs
59
Q

TOF results in

A

-right to left shunting which recirculates venous blood to the blood without it being oxygenated in the lungs

60
Q

TOF: tet spells

A

sudden, marked increase in cyanosis; syncope

61
Q

Pink tet

A
  • due to left to right shunting

- Keeps child pink

62
Q

Tricuspid atresia

A

missing or defective tricuspid valve

63
Q

Tricuspid atresia defect blocks

A

the blood flow from the right atrium to the right ventricle, diminishing the blood flow to the lungs
-if no VSD, then systemic blood flow is shunted across the right atrium through an ASD or the PFO

64
Q

Eisenmenger syndrome occurs with a

A

PDA, VSD, or ASD that pushes unoxygenated blood from right atrium/ventricle to left atrium/ventricle bypassing the lungs

65
Q

Eisenmenger syndrome leads to

A
  • right ventricular hypertrophy

- pulmonary hypertension

66
Q

What is pulmonary hypertension?

A

The lungs will not be able to handle this extra blood volume. In turn, the arteries that feed the lungs will become damaged and narrow

67
Q

Coarctation of the aorta

A

narrowing of the aorta b/w the upper and lower extremities

68
Q

What for coarctation of the aorta cause the BP to do?

A

Higher in upper extremities compared to lower

69
Q

Aortic Stenosis

Causes?

A

obstruction of blood flow from the left ventricle to the aorta
-causes: valve stenosis or narrowing

70
Q

Aortic stenosis leads to

A

left ventricle hypertrophy

71
Q

Scarring of the aortic valve occurs from

A

rheumatic fever

72
Q

Pulmonary stenosis

A

narrowing of the opening in the pulmonary artery or valve

73
Q

Pulmonary stenosis can be associated with

A

TOF

74
Q

TOF with Pulmonary atresia: VATER

A

v- vertebral
A - anal
T-E - tracheo - esophageal
R - renal

**all anomalies

75
Q

Supraventricular tachycardia

  • occurs?
  • HR?
  • tx?
  • med?
  • teaching to BM?
A
  • occurs in atria
  • HR: >220 bpm
  • Treatment:
  • stimulate vagal response through nasal suctioning
  • Apply crushed ice to forehead
  • Adenosine- rapid IVP in proximal site, repeat within 2 mins if no response
  • “bear down: when having BM to stimulate vagal response to slow HR
76
Q

Ventricular Tachycardia

A
  • occurs in ventricles
  • loss of consciousness
  • sudden death
77
Q 
Dysrhythmias: Torsades de Pointes 
-Prolonged?
-Causes?
s/s?
tx?
A
  • Prolonged QT intervals
  • type of ventricular tachy
  • Causes:
  • inherited
  • diarrhea
  • malnutrition
  • hypomagnesium
  • hypokalemia
  • hypocalcemia
  • drug induced (anti-arrhymics or some ABX)
  • s/s: rapid decline in BP, fainting, v-fib, and death
  • tx: remove causes (drugs, fix electrolytes)
  • implant defibrillator needed
78
Q

Bradycardia
causes?
tx?

A
  • sinus brady = QRS wave follows P wave
  • congenital, injury, or postsurgical
  • pacemarker may be needed
79
Q

Dysrhythmias: Wolff-Parkinson-White Syndrome
s/s?
tx?

A

-electrical stimulation reaches the ventricles too soon
“pre-excitatory snydromes”
-s/s: tachycardia, syncope, chest palpitations
-tx: ablation with radiofrequency

*can lead to death

RN Summer 2021 Test 1 (9 decks)

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