Concept Perfusion: Congential Heart Defects Flashcards
Volume of blood ejected from ventricles depends entirely on heart rate until age _____ years.
5
Why do infants have a greater risk of heart failure then older children?
Because of the abnormal formation of the heart during fetal development. At birth the right ventricle is bigger than the left because in utero the right ventricle is responsible for pumping the blood throughout the body.
What is the normal pulse ox reading in pediatric perfusion ?
95-98%
_____ issues occur first before a cardiac event.
respiratory
_____% quiet child abnormal. < 85% is a hypoxic event.
94%
With neonates cyanosis may not be seen until arterial saturation is < ____%
79%
How do children respond to hypoxemia?
with BRADYCARDIA
How many different types of documented congenital heart defects are there?
more than 35
What % of infants born with a congenital heart defect have critical heart defect that requires surgery or interventional catheterization in first 6 months of life.
40 %
one quarter of all children born with a congenital heart defect ___.
die
one third that do not survive are less than ___ year or age.
one
what are the risk factors for congenital heart defects?
- fetal exposure to drugs, alcohol, cigarette smoke
- maternal viral infections
- maternal metabolic disorders (diabetes mellitus)
- increased maternal age
- genetic factors
- chromosomal abnormalities
What should be covered in the assessment of a child with a cardiac condition?
- respirations
- pulse characteristics
- blood pressure
- color
- chest
- heart auscultation
- fluid status
- activity and behavior
- general
What diagnostic test are done for congenital heart defects?
- chest x ray
- computerized tomography (CT)
- magnetic resonance imaging (MRI)
- electrocardiogram (ECG)
- Echocardiogram
- Cardiac catheterization
What should be done pre-cardiac catheterization?
- NPO except for medications
- arrive 1 to 2 hours prior to procedure if coming from home
- oral sedative
- have void
- baseline vitals
- color, skin temperature, and cap refill
- hemoglobin and hematocrit
- pedal and popliteal pulses
What should the nurse assess for and manage post cardiac catheterization ?
- continuous cardiac monitor
- apply pressure to site x 15 minutes. pressure dressing for several hours
- monitor pressure dressing for bleeding q5 minx3 then q15min left in place for several hours.
- assess perfusion lower extremities, compare precath to postcath
- frequent vitals
- monitor I&Os, encourage fluids
- bedrest. DO NOT raise head of bed for 4-6 hours
- quiet activities for 24 hours
what is the pathophysiology of a ventricular septal defect?
- increased pulmonary flow
- increased pulmonary vascular resistance
- depending on size of opening and amount of blood may develop CHF.
- right ventricular hypertrophy may develop to compensate.
small ______ may close spontaneously within the first 6 moths of life.
VSD
___ to ____% VSD cases close within the first two years of life.
75 to 80 %
one should wait until the child is _____ or _______ to repair unless worsening complications occur.
symptomatic or older
What is the main goal of treatment for VSD?
prevent long term effects of pulmonary hypertension and irreversible pulmonary vascular disease until heart is repaired.
What are the clinical manifestations of VSD?
- increased heart rate
- increased respirations
- increased metabolic rate
- diaphoresis during sucking
- poor growth and weight gain
- major complications: pulmonary artery hypertension
A diuretic inhibits chloride transport of sodium into circulation. Na and water are lost with K, Ca, and Mg.
Furosemide (Lasix) – Loop diuretic
Acts on distal renal tubules to promote sodium and water excretion and potassium retention.
Spironolactone (Aldactone) – Potassium Sparing diuretic
dilates the arterioles (vasodilation) and promotes sodium chloride and H2O excretion.
Hydrochlorothiazide (HCTZ) – Thiazide and thiazide like diuretic
