CHD - Exam 3 Flashcards
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
Atrial Septal Defect
or
ASD
Treatment/ Interventions for ASD
Surgical repair, if does not spontaneously close by 4 y.o. or if CHF is present
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
Patent Ductus Arteriosis
or
PDA
Large PDA can cause what?
o CHF
o Costal retractions
o Hepatomegaly
o Failure to thrive
Treatment/interventions for PDA
- Surgery is treatment of choice
- Indomethacin (Indocin) – successful in preemies (given to close the PDA)
Nursing interventions for children recieving Indomethacin
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
The following are s/s of what CHD?
- Systolic murmur
- Increases risk for pulmonary infections
- Increases risk for pulmonary HTN
Ventral Septal Defect
or
VSD
Treatment/Interventions for VSD
- 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
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
Tetralogy of Fallot
four dx that make up Tetralogy of Fallot
- Pulmonic Stenosis
- R ventricle hypertrophy
- VSD
- Over-riding Aorta (positioned directly over VSD)
defects cause low blood o2
Degree of pulmonary stenosis determines symptoms
Treatment/Interventions for tetralogy of fallot
- Surgery in infancy to prevent pulmonary vascular disease
- May require oxygen until surgery completed
- Prophylactic Antibiotics to prevent endocarditis
“Tet spells”
Hypercyanosis; becomes cyanotic when playing or crying and draws their legs up or squats
Hallmark signs of tetrology of fallot
- Cyanosis that does not respond to O2 therapy
- Tet spells
The following are s/s of what CHD?
- Cyanosis
- CHF
- SHOB
- Poor feeding, failure to thrive
- Complications: Dysrhythmias, Leaky heart valves
Transposition of the great vessels
This describes that CHD
- Pulmonary artery arises from left side of heart
- Aorta arises from the right side of the heart
Transposition of the Great vessels
Treatments/Interventiosn for Transposition of the Great vessels
- Surgery (may be needed shortly after birth)
- Without surgery, may be fatal within 6 months of age
Complications of Transposition of the Great vessels
- Dysrhythmias
- Leaky heart valves
Family teaching for a infant/child having cardiac surgery
- 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
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
Coarctation of Aorta
Coarctation of Arota is considered what kind of heart defect
Critical congenital heart defect
Treatment for Coarctation of Aorta
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
When is Critical congenital heart defect testing done?
24 hrs after birth
What is used in CCHD testing
Pulse ox
Low pulse ox levels during a CCHD testing requires what?
Further testing
