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NUR 213 > CHD - Exam 3 > Flashcards

CHD - Exam 3 Flashcards

1
Q

The following are s/s of what CHD?

  • Infants/young children may be asymptomatic
  • May spontaneously close with first 4 years of life
  • Surgical repair required if not spontaneously closed by 4 y/o or if CHF is present
A

Atrial Septal Defect
or
ASD

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2
Q

Treatment/ Interventions for ASD

A

Surgical repair, if does not spontaneously close by 4 y.o. or if CHF is present

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3
Q

The following are s/s of what CHD?

  • Full, bounding pulses
  • Continuous murmur heard
  • Size of defect & how much blood passes through it determines how quickly signs of CHF develops
  • Increased HR, RR
  • Diaphoresis and tiring with feeding
A

Patent Ductus Arteriosis
or
PDA

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4
Q

Large PDA can cause what?

A

o CHF
o Costal retractions
o Hepatomegaly
o Failure to thrive

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5
Q

Treatment/interventions for PDA

A
  • Surgery is treatment of choice
  • Indomethacin (Indocin) – successful in preemies (given to close the PDA)
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6
Q

Nursing interventions for children recieving Indomethacin

A

o Must weigh 500-1750 grams
o Closes PDA
o Monitor UOP
o Monitor BUN and creatinine
Observe for bradycardia, bloody or black stools, hypoglycemia, or swelling

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7
Q

The following are s/s of what CHD?

  • Systolic murmur
  • Increases risk for pulmonary infections
  • Increases risk for pulmonary HTN
A

Ventral Septal Defect
or
VSD

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8
Q

Treatment/Interventions for VSD

A
  • Use pulse ox to do Critical Congenital Heart Defect (CCHD) screening, after 24 hrs of birth
  • Low levels may indicate a CCHD, further testing required
  • Conservative treatment if no CHF or pulmonary HTN
  • Surgical patch, if poor growth
  • Prophylaxis for infective endocarditis
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9
Q

The following are s/s of what CHD?

  • Hypoxia
  • Cyanosis (does not respond to O2 therapy)
  • Systolic murmur - loud
  • Squatting to increase blood flow to lungs
  • Poor eater, failure to thrive
  • Exercise intolerance
  • Recurrent respiratory infections
  • Hypercyanosis “Tet Spells”
  • Tachypneic, tachycardia
  • CHF
A

Tetralogy of Fallot

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10
Q

four dx that make up Tetralogy of Fallot

A
  • Pulmonic Stenosis
  • R ventricle hypertrophy
  • VSD
  • Over-riding Aorta (positioned directly over VSD)

defects cause low blood o2

Degree of pulmonary stenosis determines symptoms

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11
Q

Treatment/Interventions for tetralogy of fallot

A
  • Surgery in infancy to prevent pulmonary vascular disease
  • May require oxygen until surgery completed
  • Prophylactic Antibiotics to prevent endocarditis
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12
Q

“Tet spells”

A

Hypercyanosis; becomes cyanotic when playing or crying and draws their legs up or squats

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13
Q

Hallmark signs of tetrology of fallot

A
  • Cyanosis that does not respond to O2 therapy
  • Tet spells
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14
Q

The following are s/s of what CHD?

  • Cyanosis
  • CHF
  • SHOB
  • Poor feeding, failure to thrive
  • Complications: Dysrhythmias, Leaky heart valves
A

Transposition of the great vessels

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15
Q

This describes that CHD

  • Pulmonary artery arises from left side of heart
  • Aorta arises from the right side of the heart
A

Transposition of the Great vessels

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16
Q

Treatments/Interventiosn for Transposition of the Great vessels

A
  • Surgery (may be needed shortly after birth)
  • Without surgery, may be fatal within 6 months of age
17
Q

Complications of Transposition of the Great vessels

A
  • Dysrhythmias
  • Leaky heart valves
18
Q

Family teaching for a infant/child having cardiac surgery

A
  • Monitor VS
  • S/S of cardiac failure and CHF
  • CPR to parents
  • Use of equipment at home (O2 sat, scales, etc.)
  • Medication use, effects, and side effects
  • Post-op considerations
  • Diet – balanced, health food choices
  • Exercise, activity (no contact sports), return to school
  • Care of the surgical wound, S/S of infection
  • Avoid lifting child under the arms, do not use backpacks
  • Importance of maintaining follow-up care
  • Providing community-based resources to set-up home-bound schooling
19
Q

The following are S/S of what CHD?

  • Left ventricular hypertrophy
  • Low BP and weak pulses in lower extremities and groin
  • Pale, cyanotic skin color
  • Irritable
  • Heavy sweating
  • Difficulty breathing
  • Differences in BP measurements in upper and lower extremeties
    May or may not have murmurs – ausculate heart sounds
A

Coarctation of Aorta

20
Q

Coarctation of Arota is considered what kind of heart defect

A

Critical congenital heart defect

21
Q

Treatment for Coarctation of Aorta

A

Once symptoms are present, surgery is needed.
* Reconstruction of aorta
* Balloon angioplasty with or without stent
May require future surgeries or procedures as the client grows

22
Q

When is Critical congenital heart defect testing done?

A

24 hrs after birth

23
Q

What is used in CCHD testing

A

Pulse ox

24
Q

Low pulse ox levels during a CCHD testing requires what?

A

Further testing

NUR 213 (29 decks)

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