Congenital Heart Defects Flashcards
Right to Left Blood Flow is Serious and causes Hypoxia
Truncus Arteriousus & Tricuspid Atresia ( Less Tested)
Name the 2 more tested
Tetrology of Fallot
Transposition of the great arteries
Right to Left Blood Flow is Serious and causes Hypoxia
S/S Polycythaemia
Why is this dangerous & what is a priority intervention
Polycythaemia
Excessive RBC
They can Clot together and cause a CVA (stroke)
Priority Intervention: Hydration
Always report a hemoglobin over ____ to HCP
22
Name S/S associated with Right to Left Blood Flow
Cyanosis, Poor Feeding, Clubbed Fingers, Dyspnea, Tachycardia, Polycythaemia (excess RBC)
Primary reason for a newborn with congenital heart disease to be well-hydrated
Reduce the risk of CVA
Cyanotic congenital heart defect. The nurse understands that chronic hypoxia from this disorder can result in which finding.
Polycythaemia
Congestive heart failure
(Right to left) or (Left to Right)
Left to Right- less serious than Right to left
Congestive heart failure
S/ S
Most important
Describe skin
Eyes
Diapers
During feeding
Weight gain
Skin: Pale, Cool extremities
Eyes: Puffyness around (periorbital edema)
Diapers; Fewer
Feeding: Diaphoresis & Grunting
Child diagnosed with Right-to-Left shunt… which is the most common finding?
Blueish discoloration of the skin
During Hypercyanotic Spell of TOF
Interventions
Infant
Older children
Infant: Knees to Chest
Older children: Squatting Posistion
Prevention of cyanosis in TOF
Don’t
Do
Don’t interrupt sleep
Do offer a pacifier during crying
Do small & frequent meals
- Treatment for TOF
- Surgical repair
Which post op findings indicate surgery was successful
Absence of Cyanosis when feeding
Lips pink when crying
32 breaths per minute
Decreased feedings
Reduction in Wet Diapers
Pale, cool extremities
Periorbital edema
Weight gain
Report all of these to a HCP
Which disease are they associated with
Heart Failure
Reversal of the 2 main arteries leaving the heart
Pulmonary Artery & aorta
Is called….
Transposition of the Great Vessels
90% fatal if not corrected in 1st year
(Left to Right) or (Right to Left)Cardiac Shunts
S/S
Diaphoresis (During Feeding)
Heart Murmur
Poor weight gain
Increased Risk: Heart Failure/ Pulmonary HTN
Left to Right
Left to Right Blood flow
ASD
Atrial Septal Defect (Hole in Septum)
This finding ____ is normal and to be expected
Treatment….
Murmur is normal and to be expected
Treatment closes naturally/ Surgical repair
VSD
Ventricular Septal Defect
Hole between the ventricles
S/S
_____ during feeding (increased respitory effort)
Systolic heart murmur (left sternal border)
Treatment….
Grunting during feeding
Treatment: Closes naturally/ Surgical repair
Machinery-like murmur on Ausculation of the heart and signs of heart failure…which disorder
PDA
Patent Ductus Arterious
Surgical repair for PDA patent ductus arteriosus is preformed to prevent which complications….
Worsening of Pulmonary Vascular Congestion
What does Stenosis mean
Stiffness & Narrowing
Pulmonic Stenosis
Symptoms
Right Ventricular ____
Loud “systolic ejection” heart murmur
Treatments
Right Ventricular Hypertrophy
Treatments
Ballon angioplasty
Surgical Repair: Valveotomy
Aortic Stenosis
Symptoms
(Decreased/ Increased) Cardiac output
Vital signs: BP / HR
Decreased
Low BP / tachycardia
Which cardiac defect causes narrowing of the aortic valve
Aortic Stenosis
Decreased cardiac output
S/S
Upper extremities:
High BP, Bounding Pulse
Lower extremities:
Cool, Low BP & Diminished Pulse
Treatment
COA
Coarctation of Aorta
(Narrowed Aorta)
Treatment
Balloon Angioplasty
Stents
Cardiac Catheterization
Before
Assess for alargy to
NPO Status?
Report what?
Iodine. Used as a contrast dye
NPO, Yes 4 - 6 hrs for children
Shorter NPO for infants
Report Diaper Rash.
Can introduce bacteria into blood steam
Cardiac Catheterization
After
Priority Assessments
Pulses Distal to cath site.
Which of the following is normal
Weak Pulses
Cool extremities
Pale extremities
Straighten leg (how long)
No baths immediately afterward to prevent infection
Weak Pulse is normal after cardiac Catheterization
Cool, Pale extremities is not
Straighten Leg 4 - 8 hrs
After cardiac Catheterization the nurse assesses that the pedal pulse distal to the insertion site is weaker.
Which is the nurses best action
Record data
This is a normal findings
After cardiac Catheterization of a child which assessment Findings is most concerning for a nurse
Affected extremity Cool to touch
Chest tube monitoring (Infant)
Report to HCP
1hr Over _____ mL/ kg
3 hrs Over ___ mL / kg / hr
Indicates: Severe bleeding & cardiac tamponade
1hr Over 5 - 10 mL/ kg
3 hrs Over 3 mL / kg / hr
Surgical repair of a congenital heart defects
Most important for the nurse to include in the post op care plan
Elevate the clients head to reduce respitory effort
Can you apply lotion or powder to an incision site after surgery?
No risk for infection
