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NUR 331 > congenital Cardiac > Flashcards

congenital Cardiac Flashcards

1
Q

congestive heart failure

A

Inability of heart to pump enough blood to meet bodies demands

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2
Q

sx of pulmonary venous congestion

A

Increased respiratory rate
Nasal flare
Wheezing , crackles
Grunting
Retractions

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3
Q

sx systemic congestion

A

Hepatomegaly
Ascites
Edema
Weight gain
JVD

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4
Q

impaired myocardial function sx

A

increased heart rate, weak pulses
Decreased blood pressure
Cool extremities
gallop murmur

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5
Q

increased metabolic rate sx

A

FTT
Slow weight gain
Sweating

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6
Q

Medications to treat CHF

A

Furosemide – decrease fluid
Ace inhibitors – decrease BP, afterload
Digoxin – increase contractility, decrease heart rate, increase BP

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7
Q

what is the only oral ionotropic medication?

A

Digoxin

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8
Q

when to hold digoxin

A

Infants-heart rate, less than 90 to 110
Older kids – heart rate less than 70
Vomiting
Low potassium level <3.5

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9
Q

other digoxin rules

A

Give at regular intervals
Give one hour before or two hours after eating
Check apical rate one minute before
Don’t mix with food or water
Brush after – stains

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10
Q

What to do if missing a dose of digoxin

A

less than four hours, give
Greater than four hours skip

Two doses - call HCP

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11
Q

Signs of digoxin toxicity

A

nausea/vomiting
Bradycardia
Anorexia
Vision disturbances
Elevated potassium

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12
Q

what is the antidote for digoxin toxicity?

A

Digibind

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13
Q

nursing care for CHF patient

A

Prevent crying
Anticipate needs
Promote rest
Group activities together
Neutral thermal environment
Avoid construction , crowded places

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14
Q

Nutrition for CHF patients

A

small, frequent meals
Feed less than 30 minutes at a time, remaining NG tube
Calm environment
Semi erect position
Burp before during and after
Increase calories per ounce with formula
Soft premie nipple with large volume

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15
Q

arterial septal defect (ASD)

A

Hole between atrias
Left to right shunting
More blood to the lungs

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16
Q

ventricular septal defect (VSD)

A

hole between ventricles
Left to right shunting
More blood to the lungs

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17
Q

T/F it is important to stay up-to-date on vaccines with CHF patients

A

True, most are eligible for high up vaccines

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18
Q

patent ductus arteriosus (PDA)

A

Fetal structure fails to close
Blood is shunted from aorta to pulmonary artery

19
Q

treatment for PDA

A

Indomethacin – anti-prostaglandin E promotes closure of PDA

Ibuprofen

20
Q

coarctation of aorta

A

Narrowing of aorta distal to ductus arteriosus

21
Q

what are the pressure changes with COA?

A

Increased pressure, proximal to defect
Decreased pressure distal to defect

22
Q

s/sx COA

A

Headache
Nosebleed
Increased blood pressure in upper extremities
Weak/absent lower extremity pulses
bounding upper extremity pulses
Cool legs

23
Q

Treatment of COA

A

Prostaglandin E

24
Q

Aortic stenosis

A

narrowing fusion of aortic valves

Blood backs up into the right side of the heart and enlarges

Hypertrophy of left ventricle

25
Q

s/sx aortic stenosis

A

Exercise intolerance
Poor feeding
Faint pulse, increased HR
Chest pain

26
Q

what is the level of activity patients with aortic stenosis should be doing?

A

Limited activity, but not bedrest

Example – elevator versus stairs

27
Q

Pulmonic stenosis

A

Narrowing of valves of pulmonary artery
Small left ventricle

28
Q

Atresia

A

Total fusion
no blood flow to the lungs

29
Q

polycythemia

A

thick blood
More RBCs
More at risk of clots in stroke

Prevented by hydration

30
Q

tetralogy of fallot

A

right ventricle hypertrophy
VSD
Pulmonic stenosis
Overriding aorta

31
Q

hyper cyanosis

A

Hyper contractility
Tet spell

32
Q

Hypoxic squat

A

increases vascular resistance

Decreases venous return of deoxygenated blood

Diverts more blood to the pulmonary artery

33
Q

TET spell guidelines

A

1- knee to chest position
2- oxygen
3- morphine

34
Q

what is the role of morphine?

A

Relaxes infundibular muscle
Allows more blood to leave right ventricle

35
Q

tricuspid atresia

A

Failure of tricuspid valve to develop

36
Q

treatment of tricuspid atresia

A

Prostaglandin E
Digoxin
Diuretics
Surgery

37
Q

transposition of the great arteries

A

Pulmonary artery connects to the left ventricle

Aorta connects to the right ventricle

38
Q

treatment for transposition of great arteries

A

Arterial switch procedure within the first few weeks of life

IV. Prostaglandin E

Surgery

39
Q

Truncus arteriosus

A

Pulmonary artery an aorta fail to divide

One single, large vessel, empties both ventricles

40
Q

Hypoplasia left heart syndrome (HLHS)

A

small/absent left ventricle-severe hypoplasia

Mixed blood to the lungs

41
Q

treatment for HLHS

A

Prostaglandin E
Transplant

42
Q

discharge planning for heart surgery

A

Wound care – sternal incision
Prophylaxis antibiotics for bacterial endocarditis
When to call HCP
Self limit activities
Med. Teaching.

43
Q

how should a child be picked up after open heart surgery?

A

Scooped under their bottom and back

Do not pick up under arms for at least two weeks

44
Q

what is the role of prostaglandin E

A

Keeps PDA open

NUR 331 (27 decks)

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