Cyanotic heart defects

Question 1

cyanotic defects

Answer 1

caused by defects that result in decreased pulmonary blood flow

Question 2

what side of the heart is pressure greater in, in cyanotic defects?

Answer 2

pressure is greater on the pulmonic side so blood shunts from RT to LT
mixed oxygenated and deoxygenated blood flows to the systemic circulation resulting in hypoxia

Question 3

symptoms of cyanotic heart defects

Answer 3

cyanosis
polycythemia
digital clubbing
altered ABG’s

Question 4

general interventions for cyanotic heart defects

Answer 4

good skin care
supplemental O2
monitor and prevent dehydration
developmentally appropriate preparation for tests and procedures

Question 5

nursing considerations for cyanotic heart defects

Answer 5

alteration in oxygenation
anxiety caused by cyanosis
dehydration
prevention and accurate assessment of respiratory infections.

Question 6

decreased pulmonary blood flow disorders

Answer 6

tetralogy of fallot

tricuspid atresia

Question 7

tetralogy of Fallot

Answer 7

combination of 4 defects
present at birth
cause oxygen-poor blood to flow out of the heart and into the rest of the body.

Question 8

clinical manifestations of tetralogy of fallot

Answer 8

heart murmur with thrill
polycythemia
hypoxic episodes (squatting position)
metabolic acidosis
poor growth
clubbing
exercise intolerance

Question 9

what does surgery do for tetralogy of fallot kids?

Answer 9

improved quality of life and longevity

done is stages starting at 6 months old

Question 10

what are the stages of surgery of tetralogy of fallot?

Answer 10

blalock-taussing shunt
VSD repair
pulmonary valvotomy

Question 11

what to do for hypercyanotic spells

Answer 11

employ calm comforting approach
knee-chest position
100% O2 by face mask
give morphine
IV fluid replacement and volume expansion if needed
repeat morphine
** do each intervention one at a time, and when it works you can stop**

Question 12

tricuspid atresia

Answer 12

failure of tricuspid valve to develop resulting in no communication between right atrium and left ventricle resulting in severe right hypoplasia or absence of right ventricle
** need foramen ovale to stay open

Question 13

clinical manifestations of tricuspid atresia

Answer 13

cyanosis
caused by the loss of patent foramen ovale
give prostaglandin E to keep it open

Question 14

treatment of tricuspid atresia

Answer 14

prostaglandin E to keep foramen ovale open
Digoxin and Diuretics
palliative surgical repair to improve pulmonary blood flow

Question 15

mixed blood flow heart defects

Answer 15

transposition of the great arteries
truncus arteriosus
hypoplastic left heart

Question 16

transposition of the great arteries

Answer 16

pulmonary arteries arise from LT ventricle and the Aorta arises from right ventricle. no communication between the systemic and pulmonary circulations

Question 17

signs and symptoms of transposition of the great arteries

Answer 17

increasing cyanosis as foramen ovale closes

Question 18

treatment of transposition of the great arteries

Answer 18

arterial switch procedure in the first weeks of life

IV prostaglandin E to keep foramen ovale open and/or balloon atrial septoplasty

Question 19

Truncus arteriosus

Answer 19

pulmonary artery and aorta fail to divide during embryonic development. One single large ventricle empties both ventricles

Question 20

clinical manifestations of truncus arteriosus

Answer 20

cyanosis
CHF
heart murmer

Question 21

treatment of truncus arteriosus

Answer 21

surgical repair during the first few months of life

digoxin and diuretics

Question 22

hypoplastic left heart syndrome (HLHS)

Answer 22

aortic valve atresia, mitral atresia or stenosis, small or absent left ventricle, severe hypoplasia of the ascending aorta and aortic arch
*NEED TRANSPLANT*
under developed LT side of heart
small left ventricle
aortic atresia
descending aorta receives blood via PDA

Question 23

signs and symptoms of HLHS

Answer 23

cyanosis
weak, peripheral pulses
cool extremities
respiratory distress
often times no murmur

Question 24

therapeutic management of HLHS

Answer 24

prostaglandin E to keep PDA open
fontan procedure
norwood procedure
TRANSPLANT

Question 25

fontan procedure

Answer 25

direct blood flow to pulmonary artery from RA

Question 26

norwood procedure

Answer 26

anastomosis of main PA to the aorta, shunt from RV to PA

Question 27

complications of heart surgery

Answer 27

CHF
dysrhythmias
cardiac tamponade
atelectasis
pneumothorax
pulmonary edema
pleural effusions
cerebral edema
brain damage
hemorrhage or anemia