Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Pediatrics > Chapter 8: Cardiovascular > Flashcards

Chapter 8: Cardiovascular Flashcards

1
Q

Indications of adequate peripheral perfusion includes:

A

1) cap refill less than 2 sec
2) palpable pulses
3) skin warm to touch
4) able to feel sensations

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

What are the three types of murmurs and briefly explain each one

A

1) Innocent - no physiological or anatomical cause
2) Functional - physiological cause but not anatomical defect
3) Organic - anatomical defect w/ or w/o physiological abnormality

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

Murmur that is very loud, w/ a thurst and thrill

A

Grade V

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

Murmur that is loud w/ a thrill

A

Grade IV

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

Murmur that is moderately loud w/o a thrill or thrust

A

Grade III

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

Murmur that is loud enough to be heard w/o a stethocope

A

Grade VI

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

What type of test can produce images of your heart via pulsed, high-frequency sound waves?

A

Echocardiogram

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

What type of test provides information about the heart’s electrical activity?

A

ECG/EKG

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

A TEE can be used in conjunction w/ what test to view the posterior structures of the heart?

A

echocardiogram

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

Which of the following should be included in your teaching for child who is scheduled for an echocardiogram?

a) Child should NOT eat or drink 2 hours prior to procedure
b) Child should hold as still as possible during the test and refrain from talking
c) Child will have to be restrained to a chair to prevent movement
d) Child will have to perform mild exercise during the test on a treadmill

A

b

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

What can an ECG/EKG detect?

A
  • arrhythmias
  • ischemia
  • injury
  • necrosis
  • blocks
  • conduction delays
  • chamber enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The nurse has admitted a child w/ a cyanotic heart defect. The nurse would expect the initial lab results to show which of the following?

a) a high Hgb
b) low Hct
c) high WBC count
d) low platelet count

A

b

Bone marrow produces more RBCs in response to hypoxia

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

What type of test can show cross-sections of the heart?

A

MRI

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

What questions would you ask the patient prior to having an MRI?

A
  • metal objects/jewelry
  • tattoos
  • allergies to shellfish and iodine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

MRIs are helpful in detecting:

A

congenital (birth) defects

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

Valve replacements are indicated for:

A

heart valve narrowing (stenosis) and heart valve leaking (insufficiency)

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

Valvular problems are commonly caused by what?

A
  • Rheumatic Fever
  • Congenital Heart Defects
  • Heart Failure
  • Endocarditis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the most important things to monitor post-op valve replacement?

A

HAT

  • hypotension
  • arrhythmias
  • thrombus formation
  • VS
  • I/O
  • weight
  • labs
  • CXR
  • ABGs
  • Pulmonary catheter readings
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

S/S of bleeding include

A
  • black, tarry stools (GI)
  • bleeding gums
  • excessing bleeding from minor cuts and scrapes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which of the following is true regarding a valve replacement

a) Valves will need to be replaced every 5 years
b) You will not be allowed to exercise at all
c) Lifetime anticoagulant therapy will be necessary
d) A valve replacement will shorten one’s life by 10-15 years

A

C

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

What should you include in your teaching regarding a valve replacement?

a) use a medium bristled brush when brushing your teeth
b) antibiotics should be taken prior to any dental work or invasive procedures to prevent endocarditis
c) Clicking sounds are abnormal and should be reported to the provider immediately
d) excessive bleeding is expected when having a minor cut and can be treated simply by applying a cold compress

A

b

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

What procedure requires an insertion of a radiopaque catheter via the femoral artery in order to visualize the heart and vessels?

A

Cardiac cath

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

It is normal for the patient to feel cool after the contrast is injected for a cardiac catherization.

True/False

A

False

“warm” not “cool”

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

What should you include in your assessment pre-op a cardiac catheterization

A
  • weight
  • I/O
  • Child’s color, temperature, and pedal pulses (mark distal pulses w/ indelible ink)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Nursing care post-op a cardiac catheterization includes:
- keeping the affected area immobile for 4-6 hrs to prevent hemorrhage - restrict fluids to prevent hypervolemia (as orders) - instruct to rest to prevent cardiac overload - ensure adequate fluid intake (fluid or I.V.) to compensate for blood loss during procedure and diuretic action of contrast - monitor I/O, V/S, S/S of infection, rejection adverse rxns from immunosuppressive therapy, hemorrhage, hematoma formation - keep child warm to prevent heat loss
26
What would you instruct the child's parents regarding the care of their child at home post-op cardiac catheterization? 1) How to clean the site 2) Activity 3) Diet 4) Pain management 5) What to monitor for
Cleaning site: - remove pressure dressing day after procedure - continue to cover site w/ adhesive bandage for several days - keep affected area clean and dry - give sponge baths only until site is healed Activity: -avoid strenuous exercise Diet: -regular Pain: -ibuprofen or tylenol Monitor: - temperature; report fever asap (for infection) - redness, swelling, drainage, and bleeding at site
27
Chest tubes are generally removed how many days after cardiac surgery?
1st to 3rd day
28
It is normal for the child's temperature to be elevated up to 100F in the first 48 hrs following a cardiac surgery. True or False
True
29
What congenital heart defects increase pulmonary blood flow/
- ASD - VSD - PDA
30
An opening between the left and right atrium is referred to as what congenital heart defect?
Atrial Septal Defect
31
An opening between the left and right ventricle is referred to as what congenital heart defect?
Ventrical Septal Defect
32
When the conduit between the pulmonary artery and aorta fails to close 24-48 after birth, it is referred to as what congenital heart defect?
Patent Ductus Arteriosus
33
ASD can result to:
- Right atrial and ventricle volume overload - pulmonary artery HTN - Right ventricular hypertrophy - heart failure
34
Signs and symptoms of ASD includes:
- fatigue after exercise - mid-systolic murmur at the 2nd-3rd left ICS - diastolic murmur at the left lower sternal border - clubbing, cyanosis - asymptomatic
35
Cyanosis that worsens with crying is most likely associated with cardiac/pulmonary causes because crying increases pulmonary resistance to blood flow, resulting in an increased right-to-left shunt.
cardiac
36
Cyanosis that improves with crying is most likely due to cardiac/pulmonary causes because deep breathing improves tidal volume
pulmonary
37
How is ASD treated?
- antibiotics to prevent endocarditis | - surgery
38
How is PDA treated?
- indomethocin | - surgery
39
In PDA, you can expect the following:
- machine-hum murmur - bounding pulses - wide pulse pressure - HF
40
The failure of the ventricular septum to close @ 8 weeks gestation is referred to which congenital heart defect?
Ventricular Septum Defect (VSD)
41
The ventricle septum can close spontaneously. True/False
True
42
VSD can result to
- HF - liver, heart spleen enlargement - cyanosis, clubbing if R-to-L shunt occurs - tachycardia, diaphoresis
43
Obstructive defects include
- coarctation of the aorta - pulmonary stenosis - atrial stenosis
44
The narrowing of the aorta is referred to as what obstructive defect?
coarctation of the aorta
45
If the coarctation of the aorta is left untreated it can cause:
Left sided heart failure
46
What would you expect to find in terms of blood pressure and pulse in a child with a coarctation of the aorta?
- elevated BP + bounding pulses in upper extremities (head, neck, arms) - decreased BP + weak pulses in the lower extremities (legs, trunk, femoral)
47
Coarctation of the heart can cause the following:
- HA, dizziness, fainting - nosebleeds - difficulty walking****
48
Heart Failure is usually treated with
- digoxin - K+ wasting diuretics (encourage diet hight in potassium) - ACE inhibitors (monitor BP and K+ levels; causes vasodilation) - beta blockers (causes vasodilation) - oxygen
49
Narrowing of the pulmonic valve or artery is referred to as
pulmonary stenosis
50
Narrowing of the aortic valve is referred to as
aortic stenosis
51
S/S of Pulmonary Stenosis includes:
- systolic ejection murmur - cyanosis - cardiomegaly (Right side would be obstructed because blood is coming from the right when is going through the pulmonary artery. This causes right ventricular hypertrophy and right sided heart failure)
52
S/S of Aortic Stenosis includes:
- pulmonary edema d/t to back flow of blood into lungs thus causing left sided heart failure and left ventricular hypertrophy - infant: faint pulses, hypotension, tachycardia, poor feeding - child: exercise intolerance, dizzy, CP, ejection murmur
53
Teralogy of Fallot includes which defects:
- pulmonary stenosis - overidding aorta (OA) - right ventricular hypertrophy (RVH) - ventricular septum defect (VSD)
54
The hallmark sign of Teralogy of Fallot is
cyanosis
55
Blood shunts from right to left with Teralogy of Fallot causing deoxygenated blood to mix w/ oxygenated blood thus causing child to appear cyanotic. True/False
True
56
S/S of Teralogy of Fallot
- Cyanosis (worsens in 1st year of life) | - systolic murmurs
57
Babies/children w/ Tet/Blue spells would appear
cyanotic
58
Babies with Pink tets would appear
non-cyanotic
59
S/S of tet or pink tets include:
- dyspnea - bradycardia - deep "sighing" respirations - syncope - occurs mainly in the AM preceded by crying, feeding, or BM
60
Tet or Pink Tets can be managed by
- knee-to-chest positioning - oxygen - morphine (aids in vasodilation) - beta blockers (prevents Tet spells) - ABX (prevents endocarditis) - surgical shunt repair
61
Infective (Bacterial) Endocarditis affects which part of the heart
inner lining (heart, valves, prosthetics)
62
Untreated endocarditis can lead to:
- permanent valvular damage - HF - death
63
Endocarditis can be treated with
ABXs (geramycin)
64
S/S of endocarditis includes
- malaise - fever (may recur for weeks) - myalgias/artralgias - HA - weight loss - splenomegaly - petechiae - splinter hemorrhages under nail*
65
Osler's nodes, Janeway lesions, and Roth's spots are all signs of
endocarditis
66
Purplish macule of palms and fingers?
Janeway lesions
67
Tender, raised, subQ lesions on fingers, toes?
Osler's nodes
68
Hemorrhagic areas w/ white centers on retina?
Roth's Spots
69
Signs of Heart Failure includes
- tachycardia (early); bradycardia (late) - diaphoresis - cool extremities (d/t poor peripheral perfusion) - peripheral edema* - respiratory distress - hepatomegaly - weight gain
70
What to monitor for in patients w/ HF
- weigh (daily) - HR, BP - BUN, creatinine, electrolytes - peripheral edema*
71
Nursing interventions for HF
- oxygenation (improves tissue perfusion) - positioning in semi-fowlers position (decreases resp. effort) - sedation/analgesics - restrict sodium (Na+) - conserving energy - provide quiet, restful environment - increase caloric intakes
72
Signs of digoxin toxicity includes
- N/V - anorexia - abdominal pain - arrhythmias
73
When providing digoxin for heart failure, it is important to check the ________ pulse for ______________ and withhold if:
- apical - 1 minute - infant: <90 - 110/min children: <70/min
74
Which disease is characterized as the "strawberry tongue"?
Kawasaki disease
75
In the acute phase of Kawasaki Disease, a child can expect the following
- fever (>102.2) over 5 days - red eyes w/o discharge; conjunctivitis - strawberry tongue w/ white coating or red bumps on posterior - lymphadenopathy - intense oral, palmar, and plantar erythema and sweeping - dermatitis of trunk - maculopapular rash
76
Treatment of Kawasaki Disease includes:
- high doses of aspiring (80-100 mg/kg/day q 6h (anti-inflammatory dose) - IVIG - IV immune globulin (2g/kg over 8-12 hrs) -
77
When taking aspirin, you should advise client to take it with
milk or food
78
Aspirin therapy for a child w/ Kawasaki Disease should be increase/decreased by ___________mg/kg/day if child has been afebrile for at least 6-8 weeks
- decrease | - 3-5 mg/kg/day
79
Children w/ Kawasaki Disease should avoid
- immunization for 11 months | - second-hand smoke
80
Signs of Aspirin toxicity includes:
- tinnitus - bleeding - hyperventilation - drowsiness
81
Nursing care for a child w/ Kawasaki Disease includes
- applying cool cloths to skin - apply lotion - provide sponge baths w/ tepid (slightly warm) water - provide quite environment - perform passive ROM in bathtub - provide heart healthy diet - provide IV or PO foods, soft foods
82
Rheumatic fever is usually acquired
genetically
83
Rheumatic fever usually develops _________ weaks after
being infected with GABHS (group A beta-hemolytic streptococci)
84
Rheumatic fever involves which parts of your body?
- heart - joints - CNS - skin - SubQ tissues
85
Treatment for Rheumatic fever includes
-ABXs (penicillin 200,000 units daily for 2 days or PCN G 1.2 million units IM monthly or Sulfadiazine 1 gm PO daily)
86
Clients w/ Rheumatic fever should be advised to take
ABXS before, during, and after dental work or major surgeris
87
Length of treatment for rheumatic fever can last up to
5 years or more depending on the type carditis
88
What is used to diagnose Rheumatic Fever?
Jones Criteria
89
Jone's Major Criteria includes which of the following? - endocarditis - joint pain (arthralgia) - SubQ nodules - fever - joint pain (migratory polyarthritis) - erythema marginatum - prolonged PR intervals - elevated acute phase reactants - sydenhams' chorea (rapid, jerky, movements)
- endocarditis - SubQ nodules - joint pain (migratory polyarthritis) - erythema marginatum - sydenhams' chorea (rapid, jerky, movements)
90
Jone's Minor Criteria includes which of the following?
- fever - prolonged PR intervals - joint pain (arthralgia) - elevated acute phase reactants
91
Jones Criteria requires the following in order for a client to be diagnosed w/ Rheumatic Fever
2 major criteria + 1 minor 1 major criteria + 2 minor w/ evidence of a previous GABHS infection
92
Lab findings would indicate the following for rheumatic fever
- (+) ASO titer (most reliable) - (+) throat culture - elevated WBC - Elevated ESR, + CRP (C-reactive protein) - 1 degree AV block on ECG

Pediatrics (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions