ch 26 cardio Flashcards
ductus arteriosus close-3
responds to higher oxygenation, constricts w/n 10-15 hrs ad closes 10-21 days
polycythemia-4
bone marrow response to chronic hypoxemia
- Hgb 20+
- bradyC
- worsen w dehydration
cardiac output controlled by-4
- HR (primary)
- preload
- contractility
- afterload
congenital heart disease cause-8
- fetal drug/alcohol/smoke exposure
- maternal viral inf
- high mom age
- mom metabolic d/o
- high altitude
- mom complications preg
- genetic
- prematurity
congenital heart defect categories-4
- increased pulmonary blood flow
- decreased pulmonary blood flow
- obstructed systemic blood flow
- mixed
increased pulmonary blood flow defects-3
patent ductus arteriosus, atrial septal defect, ventricular septal defect
decreased pulmonary blood flow defects-2
pulmonic stenosis, tetralogy of fallot
obstructive defects-2
aortic stenosis, coarctation of the aorta
mixed defects
transpostion of the great arteries
murmur-2
- first indication of defect
- fever and exercise
general clinical manifestation-6
- asymptomatic at birth or cord clamp
- older: chest pain, exercise intolerance*, arrhythmias, syncope, sudden death
increase pulmonary blood flow defect general s/s-8
Increased: HR, RR, Metabolic rate (inability to gain weight) Congestive heart failure Dyspnea Tachypnea Retractions Frequent respiratory infections
patent ductus arteriosus-3
Fetal circulation-blood bypasses lungs and goes to systemic circulation
Ductus does not close causing persistent fetal circulation
CXR may reveal left ventricular hypertrophy
patent ductus arteriosus s/s-6
dyspnea, tachyC, tachyP, bounding pulse, CHF, machinery murmur
patent ductus arteriosus tx-2
ibuprofen, indomethacin
atrial septal defect-4
Left to right shunting of blood
Opening in the atrial septum
-usually asymptomatic until preschool, possible CHF
-spontaneous closure
ventricular septal defect-5
Opening between the right and left ventricular septum
Most common heart defect
Systolic murmur noted, possible CHF
-spontaneous close 6mo
decreased pulmonary blood flow general info-3
Does not respond as expected to supplemental oxygenation
Polycythemia may occur-increase bleed w surgery
Hyper-cyanotic episodes or tet spell
mixed general info-6
Combination congenital defects
Newborn is dependent upon the mixing of pulmonary and systemic circulation for survival during the post-natal period
Generalized desaturation and cyanosis
Pulse ox less than 93% or cyanosis
Usually PaO2 less than 150 and the sats less than 85%
Requires further testing
Surgery required typically during the infancy period
decreased pulmonary blood flow-infant s/s-5
Cyanosis shortly after birth, often when ductus closes
Loud murmur
Cyanosis that does not respond to oxygen
Often stop during feedings to catch breath and diaphoretic during feeding
High metabolic rate-inadequate calories
decreased pulmonary blood flow-child s/s-8
Fatigue Clubbing Exertional dyspnea Hypoxemia Delayed developmental milestones High metabolic rate-poor weight gain May squat to relieve dyspnea Dizziness and syncope are serious signs indicating need for medical eval
hypercyanotic “tet” episode-2
squats, knee chest position
