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Peds Week 2 > CV-Heme > Flashcards

CV-Heme Flashcards

(73 cards)

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1
Q

What is cardiac output?

A

Volume of blood pumped by heart in one minute

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2
Q

What is stroke volume?

A

Volume of blood pumped by heart in one beat

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3
Q

Formula for Cardiac Output?

A

HR x Stroke Volume

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4
Q

What is the most important vital sign that indicates how child is doing?

A

Heart Rate

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5
Q

What is Foramen Ovale?

A

Opening on wall between right and left atrium on septal wall

Blood from left and right atrium to mix.

Closes after birth

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6
Q

What is ductus arteriosus?

A

Connects the pulmonary artery to the aortic arch.

It closes off and turns into ligamenum arteriosus after birth

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7
Q

What is the most common heart anomaly?

A

Atrial septal defect (ASD)

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8
Q

Some causes of congenital heart disease?

A 
Drug exposure:
~Lithium
~Depakote (valproic acid)
~ETOH
~Tobacco

Infection
~Rubella

Advanced maternal age (40 yrs +)

Chromosomal abnormalities
~Trisomies
~Turner
~Marfan 
~DiGeorge
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9
Q

In Congenital Heart Disease, pressure within the heart is ___

A

Right side greater than left side

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10
Q

There is less resistance in pulmonary circulation than ____ circulation

A

systemic

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11
Q

Blood flows from area of ___ to ____ pressure

A

high

low

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12
Q

Abnormal connections change pressure result in ___ and ___

A

Left-to-right shunt

Right-to-left shunt

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13
Q

What defects cause increase in pulmonary blood flow?

A

ASD
VSD
PDA

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14
Q

What defects cause obstruction of blood flow from ventricles? (blood cannot get out of ventricles)

A

Coarctation of aorta
Aortic stenosis
Pulmonic Stenosis

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15
Q

What defect causes decreased pulmonary blood flow? (less blood going to lungs)

A

Tetralogy of Fallot

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16
Q

What defect causes mixed blood flow?

oxygenated and unoxygenated blood mixing together.

A

Transposition of great arteries

Hypoplastic left heart syndrome

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17
Q

What is the most common hematologic disorder of childhood?

A

anemia

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18
Q

What is anemia defined as?

A

Decreased RBC’s and/or Hgb concentration below normal.

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19
Q

Why does it take a while to notice anemia in children?

A

they adapt so well

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20
Q

What are causes of decreased red blood cell production?

A

Nutritional deficiency

Bone marrow failure

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21
Q

What are causes of increased red blood cell loss?

A

Acute blood loss

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22
Q

What are the causes of increased red blood cell destruction?

A

Intracorpuscular (Sickle cell disease)

Extracorpuscular (chemo, immunologic, infection)

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23
Q

How do we treat anemia?

A

Treat underlying cause

Supportive care
~Oxygen
~Bed rest
~IV fluids to replace volume

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24
Q

Nursing care management for anemia?

A

Prepare child and family for lab tests

Decrease O2 demands
~assess energy level
~minimize excessive demands

Prevent infection

Support family

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25
Is iron deficiency anemia preventable?
Yes
26
Why are adolescents at risk for iron deficiency anemia?
Rapid growth and poor eating habits
27
Why are premature infants at risk for iron deficiency anemia?
Did not have chance to build iron stores during last trimester
28
Why are children 12-36 months at risk for iron deficiency anemia?
Dietary changes from formula or breast feeding to cows milk. Milk is not high in iron.
29
Why do we give vitamin C with iron?
helps absorb iron
30
Which iron is best to give?
Ferrous iron
31
How do we administer oral iron?
use straw, or medicine dropper, and put in back of throat.
32
How is iron injection given?
Z track deep IM Do not massage 1 mL in one site
33
Can iron turn stool dark?
Yes
34
If both parents have sickle cell trait, each offspring will have what chance of having disease?
25% | 1 in 4
35
Which hemoglobin replaces regular hemoglobin in sickle cell anemia?
Hgb S
36
Which hemoglobin replaces regular hemoglobin in sickle cell anemia?
Hgb S
37
What is the leading cause of death in young children with sickle cell disease?
bacterial infection d/t immunocompromise
38
What are precipitating factors for a sickle cell crisis?
Anything that increases body's need for oxygen or alters transport of oxygen.
39
What are signs of a sickle cell crisis?
Fever Pain Tissue enlargement
40
What is a splenic sequestration?
Blood pools in liver and spleen and not enough blood can get in to circulation. Life threatening
41
What are signs of splenic sequestration?
Profound anemia weakness hypovolemia shock
42
How is sickle cell disease diagnosed?
Cord blood in newborn Newborn screen Genetic testing Sickle-turbidity test, electrophoresis May be diagnosed as a toddler after acute respiratory or GI infection
43
What is the medical management for sickle cell?
Aggressive treatment of infection Prophylactic abx from 2 mo to 5 years Monitor Retic count to evaluate bone marrow function Blood transfusion (may reduce ischemia if given early in crisis)
44
Why do we give iron chelation treatment for sickle cell?
Frequent transfusions increases iron in tissues (hemosiderosis). Iron is building up in tissue - chelation therapy binds to iron and gets excreted
45
What drug is given to sickle cell patient?
hydroxurea **CYTOTOXIC**
46
What are the main treatment goals for sickle cell
``` Pain Management Oxygen Hydration (oral or IV) Rest electrolyte replacement ```
47
Hemophilia is an __-linked recessive gene
X Affects only boys
48
Which hemophilia is considered "classic"
A
49
What factor is deficient in hemophilia A?
factor 8
50
Which hemophilia is called "Christmas disease"?
Hemophila B
51
What factor is deficient in hemophilia B?
factor 9
52
What are some manifestations of hemophilia?
Mild to severe bleeding ecchymosis, epistaxis, hematuria
53
Why do hemophilia symptoms often not show up until 6 months of age?
mobility leads to injuries from falls/accidents
54
What is hemarthrosis?
Bleeding into joint spaces of knee, ankle, elbow. Can lead to problems with mobility.
55
How is hemophilia diagnosed?
Amniocentesis Genetic testing Labs: low levels of factor 8 or 9, PTT normal: platelet count, PT, fibrinogen
56
What is the medical management for hemophilia?
Limiting bleeding and preventing complications Replace missing clotting factors Corticosteroids if hemarthrosis Transfusions
57
What is the drug to treat hemophilia
desmopressin (DDAVP)
58
What does DDAVP do?
Causes 2 to 4 times increase in factor 8 activity Used for mild hemophilia
59
Is there a cure for hemophilia?
No
60
What are some interventions for hemophilia patients?
Close supervision and safe environment. Injury prevention Dental procedures in controlled situation Shave only with electric razor Superficial bleeding: pressure for 15 min and ice to vasoconstrict If significant bleeding, need transfusion
61
What is the priority care for hemophilia patient?
Prevent bleeding!!!
62
What is the treatment when hemophilia patient is having hemiarthrosis?
Elevate and immobilize joint Ice Analgesic ROM after bleeding stops to prevent contractures PT Avoid obesity to minimize joint stress
63
What is the most commonly diagnosed cancer in children under age 14?
Leukemia
64
What are the two main types of leukemia?
ALL | AML
65
What is Acute lymphoblastic leukemia?
~Most common ~Peak onset 2-3 years of age ~Most common in caucasian and boys
66
What is acute myelogenous leukemia?
Most common in children under 2 and adolescent More common in males and Asians/Pacific Islanders
67
What is the pathophysiology of leukemia?
Stem cells in bone marrow produce immature WBC that do not function properly These cells fill bone marrow and spill into circulatory system, replacing normal WBC, RBC, & Platelet
68
What are the clinical manifestations of leukemia?
Standard anemia clinical manifestations, but also: large bone/joint pain hepatosplenomegaly lymphadenopathy ``` IF CNS INVOLVEMENT: HA vomiting papilledema testicle enlargement ```
69
How is leukemia diagnosed?
Blood counts (anemia, thrombocytopenia, neutropenia) Bone marrow biopsy (immature/abn lymphoblasts) Elevated Ca+, K+, Phosphorus
70
What is the treatment for leukemia?
Radiation and chemotherapy HSCT for AML HSCT for ALL after relapse
71
What is the prognosis for leukemia?
90% survival rate for low-risk | 75-80% survival rate for high-risk
72
What is the nursing management for leukemia?
``` Assessment!! Signs of bleeding/bruising/petechiae Signs of infection Renal function: spec grav, I*O, daily weight Nutrition: diet, n/v, constipation Oral mucosal ulcers Behavioral changes Pain/procedural pain ```
73
What is the nursing intervention for leukemia?
Prevent infection!! Monitor kidney function (watch for hematuria). Keep spec grav low to make sure they are hydrated Teach: med administration, side effects, worsening condition Family support: coping, support groups

Peds Week 2 (2 decks)

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