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Pediatrics > Exam 2: Cardiac > Flashcards

Exam 2: Cardiac Flashcards

1
Q

acyanotic

A

increased pulmonary blood flow

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2
Q

cyanotic

A

decreased pulmonary blood flow

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3
Q

What are the main signs of cardiovascular dysfunction and heart failure in infants

A

diaphoresis
difficulty with feeds
cyanosis
feeding intolerance
poor weight gain or weight loss
poor growth
edema
tachycardia
tachypnea
increase WOB
organomegaly

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4
Q

What are the main signs of cardiovascular dysfunction and heart failure in children

A

fatique
less energy than peers
activity intolerance
cyanosis
mottling
increased WOB
Edema
Organomegaly

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5
Q

The blood flow is present on about postconceptual day

A

17

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6
Q

The 4 chambers of the heart and arteries are formed during gestational weeks

A

2 to 8

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7
Q

In utero, oxygenation of the fetus occurs via

A

the placenta (umbilical vein)

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8
Q

The ________________, an opening between the atria allowing blood to flow from the right to left atrium, shunting oxygen rich blood directly to the brain/body

A

foramen ovale

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9
Q

The _____________, allows blood flow between the pulmonary artery and the aorta, shunting blood away from the pulmonary circulation

A

ductus arteriosus

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10
Q

Most PFO and PDA (fetal shunts) functionally close within

A

24 to 48 hours

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11
Q

Acyanotic heart lesions: _____ to ______ shunting occurs

A

left to right

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12
Q

Acyanotic heart lesions: results in altered

A

hemodynamics and volume overload to the right side of the heart and lungs

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13
Q

Acyanotic heart lesions: cardiac workload _______ to manage the additional pressure overload and volume

A

increases

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14
Q

Acyanotic heart lesions: major consequence

A

CHF

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15
Q

Acyanotic heart lesions: types (4)

A

PDA
ASD
VSD
AVSD

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16
Q

Patent ductus arteriosus: most common in

A

premature infants

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17
Q

Patent ductus arteriosus: manifestations

A

machine-like murmur
bounding pulses
cardiomegaly
signs of HF
widened pulse pressure

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18
Q

Patent ductus arteriosus: management

A

indomethacin (pharm closure)

surgical ligation

cath and placement of vascular plug device

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19
Q

Atrial septal defect: _____ to ______ shunting through opening in the atrium

A

left to right

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20
Q

Atrial septal defect: RA _______ and pulm blood flow _______

A

enlarged; increases

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21
Q

Atrial septal defect: manifestations

A

often asymptomatic
murmur
signs of HF

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22
Q

ventricular septal defect: shunting from

A

left ventricle to right ventricle

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23
Q

ventricular septal defect: __________ pulmonary blood flow and pulmonary ________

A

increased; hypertension

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24
Q

ventricular septal defect: manifestations

A

loud, harsh murmur
palpable thrill
increased risk of pulm infection
CHF

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25
Q

Atrioventricular septal defect: abnormal development of both

A

septal and AV valves (endocardial cushion defect)

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26
Q

Atrioventricular septal defect: associated with

A

genetic syndromes (e.g. Down Syndrome)

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27
Q

Atrioventricular septal defect: __________ pulmonary blood flow and pulm hypertension

A

increased

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28
Q

Atrioventricular septal defect: Manifestations

A

heart failure
systolic pulmonary flow murmur
intermittent cyanosis
failure to thrive

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29
Q

Cyanotic heart lesions: _______ to ________ shunting occurs

A

right to left

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30
Q

Cyanotic heart lesions: pulmonary blood flow may rely on

A

PDA

31
Q

Cyanotic heart lesions: bypassing the

A

lungs

32
Q

Cyanotic heart lesions: cardiac workload _______ to compensate and manage

A

increases

33
Q

Cyanotic heart lesions: major consequence

A

hypoxemia, ventricular strain, cyanosis, pulmonary hypertension, hypoxic events/CNS injury, chronic illness

34
Q

Cyanotic heart lesions: clinical sign

A

even with O2 admin, the saturations may not return to normal

35
Q

Cyanotic heart lesions: types (3)

A

TOF
pulmonary atresia with IVS
tricuspid atresia

36
Q

Cyanosis: drop below

A

85%

37
Q

Teratology of fallots: 4 lesions include

A

ventricular septal defect
pulmonary stenosis
overriding aorta
RV hypertrophy

38
Q

Teratology of fallots: manifestations

A

boot shape heart
murmur
hypercyanotic spells (tet spells)

39
Q

Teratology of fallots: managment

A

pharm: prostaglandin infustion (prostin)

vasoconstrictors to increase systemic resistance

calm infant, squatting knees to chest

40
Q

Obstructive defects: types (3)

A

pulmonary stenosis
aortic stenosis
coarctation of the aorta

41
Q

pulmonary stenosis: signs of

A

right sided HF, systolic ejection murmur

42
Q

Pulmonary stenosis: management

A

dilate valve, or replace valve

43
Q

Aortic stenosis: Manifestations

A

EKG changes with exercise
systolic ejection murmur with thrill/click
sudden death with activity
cardiomegaly
may be asymptomatic

44
Q

Aortic stenosis: management

A

valvuloplasty
valve replaced

45
Q

Coarctation of the aorta: near the

A

ductus arteriosus insertion

46
Q

Coarctation of the aorta: associated with

A

bicuspid aortic valve, turner’s syndrome

47
Q

Coarctation of the aorta: manifestations

A

poor lower extremity perfusion

pulse and BP differences between upper and lower extremities

systolic murmur

hypertension

48
Q

Mixed defects: examples (3)

A

truncus arteriosus
hypoplastic left heart syndrome
transposition of the great arteries

49
Q

Goal of therapy for pharmacology

A

improve cardiac function, remove/decrease excess fluid, decrease cardiac demand, improve oxygenation

50
Q

Digoxin

A

inotrope

improve contractility/efficiency, decrease HR

nursing considerations: monitor K and Ca, monitor digoxin level, monitor for signs of toxicity (vomiting, visual disturbances, bradycardia, ECG changes)

51
Q

Lasix

A

diuretic

decrease preload

nursing consideration: monitor K, strict intake/output

52
Q

Enalapril, captopril

A

ACEin

decrease afterload

53
Q

Types of cardiomyopathy: dilated

A

may be caused by infection or toxins, dilation without hypertrophy

54
Q

Types of cardiomyopathy: hypertrophic

A

stiffness of ventricular walls and impaired filling, genetic disorder

sudden death in athletes
may need pacemaker

55
Q

Types of cardiomyopathy: restrictive

A

impaired filling, abnormal muscle makeup

56
Q

Kawasaki disease: risk for

A

increased platelet and risk for thrombus, MI, death

57
Q

Kawasaki disease: most concerning

A

coronary artery aneurysm and thrombus

58
Q

Kawasaki disease: clinical manifestations

A

fever over 5 days, strawberry tongue, rash on trunk, fissured lips

59
Q

Rheumatic fever: origin

A

autoimmune

60
Q

Rheumatic fever: manifests after

A

untreated/partially treated GABS (strep, pharyngitis)

61
Q

Rheumatic fever: diagnosed based on

A

jones criteria

62
Q

Rheumatic fever: most concerning complication

A

rheumatic heart disease/permanent damage to mitral and aortic valves

63
Q

Infective endocarditis: clinical manifestations

A

nonspecific anorexia, malaise, fatigue
arthralgia
petechiae
vegetation noted on echo

splinter hemorrhages
osler nodes
janeway lesions
roth spots

64
Q

Shock: causes

A

hypovolemia, distributive, cardiogenic, septic

65
Q

Shock: early comp signs

A

tachycardia, tachypnea, vasoconstriction to maintain CO

66
Q

Shock: decompensated state

A

delayed cap refill, change in LOC, weak pulses, cool extremities, hypotension

67
Q

HR normal ranges for a newborn (awake; resting) and 1wk -3 mo (awake; resting)

A

Newborn 100-180 ; 80-160

1wk - 3 mo 100-220 ; 80-200

68
Q

RR normal ranges for 0-3 mo and 3-6 mo

A

0-3: 34-57
3-6: 33-55

69
Q

T/F all cardiac patient admissions require BP x 4 extremities

A

True

70
Q

S/D = BP
S-D = ____

A

pulse pressure

71
Q

Widened pulse pressure can occur in a patient with ______

narrowed pulse pressure can occur in a patient with ________

A

PDA; Aortic valve stenosis

72
Q

Normal PP

A

30 to 40

73
Q

normal blood flow is

PDA flow is

A

right to left

left to right (aorta to PA)

74
Q

What is indomethacin

A

prostaglandin inhibitor that is used to help close PDA in premature infants

Pediatrics (4 decks)

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