Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatric Nursing Care > Chapter 46: The Child with a Cardiovascular Alteration > Flashcards

Chapter 46: The Child with a Cardiovascular Alteration Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

the four pieces to Tetralogy of Fallot

A
  1. ventricular septal defect
  2. right ventricular hypertrophy
  3. right ventricular outflow tract obstruction
  4. overriding of the aorta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

purpose of using ABGs in diagnosing heart failure

A

oxygenation of arterial blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

(ACE inhibitors, digoxin) are preferred to treat heart failure

A

ACE inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

manifestations include mild tachycardia at rest, poor feeding, poor weight gain, dyspnea, tachypnea, fatigue, chronic abdominal pain, galloping rhythm, hepatomegaly, cardiomegaly, splenomegaly, decreased urine output, mottling cyanosis, pallor

A

heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

in hypertrophic cardiomyopathy, ECG will show changes that may lead to wearing a _______ monitor to screen for asymptomatic dysrhythmias

A

Holter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

IVIG has a risk for

A

allergic reaction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

if main treatment for hypoplastic left heart does not work, do these two things

A

treat for heart failure and put on heart transplant list

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when diagnosing heart failure, echocardiogram can detect these two things

A

physical changes of the heart
ejection fraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

before giving digoxin, need to do these three things

A

baseline ECG
check HR
check kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

in diagnosing infective endocarditis, _____________ are performed to identify the pathogen

A

blood cultures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

to be diagnosed with rheumatic fever, patient must have ___ major manifestation(s) or ___ major manifestation(s) and ____ minor manifestation(s), plus evidence of ________________

A

2, 1, 2, group A strep infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

this phase of Kawasaki disease lasts from days 1-10 and is characterized by a high fever that is unresponsive to treatment, bilateral conjunctivitis, changes to the mucous membrane, swelling of the hands and feet, generalized erythematous rash, enlarged cervical lymph nodes, and increase in irritability and tachycardia

A

acute phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

acute febrile inflammatory process that causes generalized vasculitis without a known cause

A

Kawasaki disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

children with heart failure have decreased appetite because of this

A

poor abdominal organ circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

this medication is used to reduce the workload of the heart by strengthening myocardial contractility and decreasing heart rate and conductivity

A

digoxin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

occurs due to malalignment of the ventricles during fetal development

A

Tetralogy of Fallot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

those at highest risk for infective endocarditis are considered for prophylactic antibiotics, including unrepaired ______________, those with a ________________, within 6 months of a(n) _______________, previous _______________, and ____________ patients

A

cyanotic lesion, prosthetic valve, cardiac repair, infective endocarditis, transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

manifestations of Tetralogy of Fallot get worse as the ______ closes

A

patent ductus arteriosus (PDA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

in diagnosing Kawasaki disease, frequent ___________ are done to identify abnormality early at these four time periods

A

echocardiograms
at diagnosis, 2 weeks, 6-8 weeks, 6-12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Tetralogy of Fallot is a (cyanotic, acyanotic) heart defect

A

cyanotic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

in diagnosing rheumatic fever, an ECG is used for this

A

rule out dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

these medications can be prescribed to treat carditis associated with rheumatic fever

A

anti-inflammatory medications (steroids, aspirin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

type of cardiomyopathy characterized by infiltration of the muscle by abnormal material

A

restrictive cardiomyopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

surgical correction of ventricular septal defect includes placing a(n) _____________ device via ___________ or ___________ the opening or placing a _________ via surgery

A

occluding, heart catheterization, suturing, patch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

when giving IVIG, nurse should monitor ____________, rechecking them every _________ for the first hour and then every __________ until infusion complete

A

vital signs, 15 minutes, 30 minutes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

this phase of Kawasaki disease lasts from day 11 to 25, when the fever disappears and most symptoms resolve, but have continued irritability, anorexia, desquamation of palms/fingers/toes, arthritis, cardiac manifestations (coronary artery aneurysms)

A

subacute phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

two treatments for large patent ductus arteriosus

A

nonsurgical occlusion via cardiac catheter
surgical occlusion via ligation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

most accurate time/age to perform pulse oximetry

A

after 24 hours old, before discharged

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

ideally, the ductus arteriosus should close within this time frame

A

within 24 hours after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

aspirin regime for Kawasaki disease

A

80-100 mg/kg/day divided into 4 doses/day and given until fever resolves
after fever resolves, dose dropped to 3-5 mg/kg/day and given once/day for up to 8 weeks (indefinitely with coronary artery aneurysm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

treatment for hypoplastic left heart

A

surgical ablation of tissue and open ventricle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Once medications for heart failure have been started, persistent symptoms and lack of weight gain indicate the need for this based on underlying cause

A

surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

if patient with heart failure does not gain weight with measures taken, may need to change to _______________ formula or place _________

A

higher calorie, NG tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

diseases of the heart muscles in which the pathology is not the result of congestive heart failure, coronary artery disease, or other systemic cause

A

cardiomyopathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

purpose of using CBC in diagnosing heart failure

A

to detect anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

major complication of rheumatic fever

A

rheumatic heart disease (scarring impairs pumping ability)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

atrial septal defects may close spontaneously by this age

A

4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

in diagnosing rheumatic fever, an echocardiogram detects this

A

valve damage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

this phase of Kawasaki disease begins when symptoms have disappeared and lasts until ESR returns to normal

A

convalescent phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

rheumatic fever typically occurs _________ after initial strep infection

A

2-3 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

occurs when there is an opening between the cardiac chambers or great arteries

A

shunting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

when treating Kawasaki disease, the nurse should ensure that the patient is adequately ___________

A

hydrated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

machine-like murmur, bounding pulses, widening pulse pressure

A

patent ductus arteriosus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

teach parents to look out for these manifestations of heart failure/congenital heart disease

A

manifestations of heart failure
increased cyanosis
dehydration
infection
dysrhythmias
decreased nutritional intake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

children with this have the highest risk for infective endocarditis

A

history of heart problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

purpose of using urinalysis in diagnosing heart failure

A

check kidney function

47
Q

autoimmune response that can affect the valves of the heart; body creates immune complexes that become lodged in tissues (joints and heart), creating the autoimmune response

A

rheumatic fever

48
Q

this treatment for Tetralogy of Fallot helps keep PDA open to help with blood flow

A

PGE-1 infusions

49
Q

this medication can help constrict patent ductus arteriosus in preterm infants only

A

indomethacin (prostaglandin inhibitor)

50
Q

congenital heart disease is classified based on

A

blood flow

51
Q

once diagnosed with hypertrophic cardiomyopathy, the child should be restricted from ________________________________

A

strenuous and competitive sports

52
Q

purpose of using ESR in diagnosing heart failure

A

detect any inflammatory process

53
Q

if vomit ONE dose of digoxin, do this

A

do not regive that dose, resume at next dose

54
Q

because there is a risk of contracting infective endocarditis again, __________________ are needed in either of two cases

A

prophylactic antibiotics
lifelong or 1 hour before procedures (dental work that manipulates gums, tonsillectomy, adenoidectomy, biopsy)

55
Q

heart initially responds to impaired pumping ability by _______________ heart rate; over time, the heart muscles become ______________ and _______

A

increasing, hypertrophied, weak

56
Q

manifestation of rheumatic fever: involuntary movements of extremities and face that affects speech

A

chorea

57
Q

manifestations include hypercyanotic episodes (Tet spells), hypoxia, harsh murmurs, boot shaped heart, cyanosis

A

Tetralogy of Fallot

58
Q

_____________ may be performed to release some of the hypertrophy in hypertrophic cardiomyopathy and improve symptoms, but it does not decrease the ________________

A

Surgery, mortality rate

59
Q

in infective endocarditis, _____________ can present as clumps of bacteria, fibrin, and platelets, posing a risk of __________

A

vegetation, embolus

60
Q

three treatment methods/care for patients with rheumatic fever

A

warm compresses on joints
placing in position of comfort
seizures precautions (chorea)

61
Q

IVIG can interfere with _____________ from vaccines; recommended that live virus vaccines are avoided for ____________ after the infusion

A

immunity, 11 months

62
Q

patients with rheumatic fever WITHOUT carditis will continue prophylaxis for __________ or until _________ of age (whichever comes last)

A

5 years, 21 years

63
Q

up to ___% of cases of ventricular septal defect will close on their own

A

60

64
Q

hallmark manifestation of infective endocarditis

A

new or worsening murmur

65
Q

congenital heart defect in which tissue is dysfunctional and cannot pump blood effectively

A

hypoplastic left heart

66
Q

if forget to give ONE dose of digoxin, then do this

A

give dose as soon as remember, then resume normal schedule

67
Q

it will be hard to get a venipuncture on (left, right) arm in a patient with hypoplastic left heart

A

left

68
Q

in bacterial infective endocarditis, the bacteria create a __________ on the heart muscles, which acts as a protective armor against antibiotics and makes treatment difficult

A

biofilm

69
Q

two treatments for Kawasaki disease

A

IVIG
high-dose aspirin regime

70
Q

before giving digoxin, HR needs to be at this level in a pediatric patient

A

> 100 (hold if <100)

71
Q

this test is diagnostic for hypertrophic cardiomyopathy

A

echocardiogram

72
Q

thrombocytosis occurs during this phase of Kawasaki disease, increasing the risk for emboli and MI

A

subacute phase

73
Q

to prevent contracting infective endocarditis, patients should be taught about these two things

A

good oral hygiene
reducing risk of seeking emergent dental care

74
Q

caused by untreated or partially treated group A strep infection

A

rheumatic fever

75
Q

patients with rheumatic fever WITH carditis will continue prophylaxis for __________ or until _________ of age (whichever is longer)

A

10 years, 40 years

76
Q

purpose of using CMP in diagnosing heart failure

A

check electrolyte levels that may be causing ECG changes that can lead to heart failure

77
Q

child with rheumatic fever is at an increased risk for ______________________ and must be on a _________________________

A

recurrent attacks of rheumatic fever, prophylactic antibiotic

78
Q

To help with lack of weight gain, teach parents to ______ feedings, have ___________ and _____________ feedings (every ____ hours), be in ___________ position while feeding to reduce stomach compression and help with respiratory effort

A

time, smaller, more frequent, 3, upright

79
Q

infective carditis is most often (fungal, viral, bacterial)

A

bacterial

80
Q

one of these two medications may be prescribed as prophylaxis for ventricular dysrhythmias in a patient with hypertrophic cardiomyopathy

A

beta blocker
calcium channel blocker

81
Q

in diagnosing infective endocarditis, a(n) ______________ will show the presence of vegetation

A

echocardiogram

82
Q

occurs when the heart is unable to circulate enough blood to meet the demands of the body

A

heart failure

83
Q

location to measure pulse oximetry

A

all four extremities

84
Q

main/required treatment for Tetralogy of Fallot

A

surgical correction of defects (open heart procedure that requires cardiopulmonary bypass)

85
Q

may be asymptomatic but manifestations can include fatigue, dyspnea on exertion, recurrent URI, systolic murmur, mitral valve regurgitation, heart failure, and risk for stroke

A

small atrial septal defect

86
Q

hypoplastic left heart is a (cyanotic, acyanotic) heart defect

A

cyanotic

87
Q

if forget to give TWO doses of digoxin (or vomit dose TWO times in a row), then do this

A

call provider immediately for evaluation

88
Q

In treatment of infective endocarditis, because the dose of antibiotics is so high, ________ and _______________ should be monitored closely, as well as side effects such as ______, ________, and _____________

A

peak, trough levels, liver, renal, ototoxicity

89
Q

in diagnosing rheumatic fever, a chest X-ray may reveal this

A

cardiomegaly

90
Q

for diagnosis of Kawasaki disease to be confirmed, the patient must have 4 out of 5 of these criteria with no evidence of another disease process

A

bilateral conjunctivitis
mucus membrane alterations
redness of hands and feet
rash on trunk
cervical lymph node enlargement

91
Q

four laboratory tests that can be used to diagnose infective endocarditis

A

CBC, CMP, ESR, rheumatoid factor

92
Q

may be asymptomatic but manifestations may include loud/shrill murmur, palpable thrill, gallop rhythm, and heart failure

A

ventricular septal defect

93
Q

treatment for atrial septal defect may include placement of ____________ device or patch with low dose __________ regime for ____________ (time period) post procedure

A

occluding, aspirin (high risk for clots), 6 months

94
Q

this type of cardiomyopathy can be asymptomatic or have very vague symptoms (dyspnea or chest pain with exertion, palpitations)

A

hypertrophic cardiomyopathy

95
Q

treatment for TET spells includes ____________ position and giving __________ and _____________

A

knee to chest, oxygen, morphine (drops tachypnea respirations down)

96
Q

disease of the heart muscle characterized by dilated and decreased contractility and dilation of the ventricles

A

cardiomyopathy

97
Q

if a reaction to IVIG occurs, it is treated with these two things

A

stopping infusion
administering epinephrine and diphenhydramine

98
Q

when diagnosing heart failure, chest X-ray can detect these two things

A

cardiomegaly
pulmonary infiltrates

99
Q

three risk factors for infective endocarditis

A

congenital heart disease
previous cardiac surgery
previous infective endocarditis diagnosis

100
Q

type of cardiomyopathy in which the cardiac muscles are enlarged and stiff and is a leading cause of sudden cardiac death in adolescents

A

hypertrophic cardiomyopathy

101
Q

teach parents about these three symptoms of worsening feedings associated with heart failure

A

increased tachypnea
diaphoresis during feeding
vomiting after feeding

102
Q

in hypertrophic cardiomyopathy, auscultation of heart sounds may reveal one of these two things

A

sounds normal
small systolic murmur with recent exertion

103
Q

manifestation of rheumatic fever: red skin lesions starting on trunk and spreading peripherally

A

erythema marginatum

104
Q

the child with hypertrophic cardiomyopathy may have one of these two things placed to help prevent or treat dysrhythmias

A

pacemaker, internal defibrillator

105
Q

prophylactic antibiotics for rheumatic fever can be given by these two routes/times

A

monthly IM
daily oral

106
Q

three other treatments for Tetralogy of Fallot

A

PGE1 infusions
management of Tet spells
treatment of iron deficiency anemia

107
Q

treatment for small patent ductus arteriosus

A

leave alone to close on own

108
Q

Jones Criteria for rheumatic fever includes these five major criteria and these four minor criteria

A

major: carditis, polyarthritis, chorea, erythema marginatum, subcutaneous nodules
minor: fever, polyarthralgia, elevated ESR or positive C-reactive protein, prolonged P-R interval

109
Q

infective endocarditis is often associated with __________ work that has manipulated the ______

A

dental, gums

110
Q

three medications that can help reduce cardiac load when treating heart failure

A

digoxin
diuretics
ACE inhibitors

111
Q

manifestation of rheumatic fever: small, nontender swellings often over the joints

A

subcutaneous nodules

112
Q

when rheumatic fever is confirmed, treatment includes this

A

10-day course of antibiotics

113
Q

treatment for infective endocarditis

A

high-powered antibiotic for 6-8 weeks (sent home with PICC line)

Pediatric Nursing Care (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions