Exam #3 Flashcards by Rhonda Vazquez

Systole

the phase of the heartbeat when the heart muscle CONTRACTS and pumps blood from the chambers into the arteries.

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Diastole

the phase of the heartbeat when the heart muscle RELAXES and allows the chambers to fill with blood.

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Cardiac Output

the volume of blood pumped by the hear per minute

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Preload

is the end diastolic volume that stretches the right or left ventricle of the heart to its greatest dimensions

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Afterload

is the pressure in the wall of the left ventricle during ejection of blood

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Contractility

is the strength of the heart’s contraction during systole

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Which is the last vital sign to change?

Blood Pressure `

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Cardiac Indicators:

poor feeding
tachypnea/tachycardia 
failure to thrive/poor weight gain/activity intolerance 
developmental delays 
\+ prenatal history 
\+ family history for cardiac disease

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Cardiac Disorders: Postoperative care

Monitor the Respiratory system
Prevent pooling of lung secretions
Post cardiac surgery syndrome
Post perfusion syndrome

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Altered hemodynamics: Acyanotic

No cyanosis= normal color
Problem pumping blood from the Left ventricle to the body
Increase blood flow problems and obstruction of blood flow from the ventricles

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Acyanotic: INCREASED blood flow disorders:

Atrial Septal defects
Ventricular Septal defects
Patent Ductus Arteriosis
Atrioventricular canal

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Acyanotic: OBSTRUCTION of blood flow from ventricle disorders:

Coarctation of Aorta
Aortic Stenosis
Pulmonic Stenosis

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Altered Hemodynamics: Cyanosis

Decreased oxygen causing blue or grey discoloration

issues with right ventricle and lungs, decreased O2 in lungs

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Cyanotic: DECREASED pulmonary blood flow disorders:

Tetralogy of Fallot

tricuspid atresia

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Cyanotic: MIXED blood flow disorders:

Transposition of the Great arteries
Total anomatous pulmonary venous return
Truncus arteriosus
Hypoplastic left heart syndrome

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Congential (in utero) incidence of cardiac disorders:

5-8 per 1000 live births

2-3 are symptomatic in the first year of life

Most common anomaly is:

Ventricular Septal Defect (VSD)

Children with Chronic Heart Disease often have another recognized anomaly such as:

Trisomy 21, 13, 18

13,18 are not compatible with life

Congential defects: S/Sx of INCREASED blood flow

Increased fatigue
heart murmur
increased risk for endocarditis 
CHF 
Growth Retardation

Seen in: PDA, ASD, and VSD

Ventricular Septal Defect (VSD):

is a hole in the wall separating the tright and left ventricles.
In normal development, the wall between the chambers closes before the fetus is born, so that by birth, oxygen-rich blood is kept from mixing with the oxygen-poor blood.

Patent Ductus Arteriosus (PDA):

abnormal blood flow occurs between the aorta and the pulmonary artery.
Marked by Right ventricular hypertrophy
Before birth, the aorta and the pulmonary artery—are connected by a blood vessel called the ductus arteriosus. This vessel is an essential part of fetal blood circulation.

Congenital defects: OBSTRUCTION of blood flow

Pulmonary stenosis
Aortic Stenosis
Coarctation of the aorta

Pulmonary Stenosis:

obstruction to blood flow from the right ventricle to the pulmonary artery. This obstruction is caused by narrowing (stenosis) at one or more points from the right ventricle to the pulmonary artery.

Aortic Stenosis:

occurs when the heart’s aortic valve narrows, preventing the valve from opening fully, obstructing blood flow from your heart into your aorta and to your body.
When the aortic valve is obstructed, your heart needs to work harder to pump blood to your body.

Coarctation of the Aorta:

the aorta narrows where the ductus arteriosus inserts. Aortic coarctation is considered when a section of the aorta is narrowed by a constricting band

S/Sx of Coarctation of the Aorta:

Increased BP HA Vertigo EDEMA

Congenital Defect: MIXED blood flow

``` CYANOTIC conditions: Transposition of great arteries Total anomalous pulmonary venous return truncus arteriosus Hypoplastic left heart syndrome ```

Transposition of the Great Vessels:

arteries leaving the heart are reversed (transposed), changes the way blood circulates through the body. Shortage of oxygen in blood flowing from the heart to the rest of the body. Corrective surgery soon after birth is the usual treatment for transposition

Congential defect: DECREASED pulmonary blood flow | Tetralogy of Fallot:

``` 4 defects: A large ventricular septal defect (VSD) Pulmonary stenosis, Right ventricular hypertrophy Overriding aorta both ventricles ``` ***deletion of chromosome 22***

Congenital Defects: S/Sx of DECREASED blood flow | Tetralogy of Fallot:

Cyanotic Squat Cyanosis Clubbing Syncope TETS spells

Therapeutic management for CHF:

Rest Oxygen Medications

Complications of CHF:

inability of the heart to pump adequate blood into systemic circulation Right or Left sided failure Heart muscle damage ***Give Digoxin to help the heart pump***

Goals for CHF:

#1 Improve cardiac function remove accumulated fluids/sodium decrease cardiac demand improve tissue oxygenation

Kawasaki Disease:

inflammation in the lining of the mucus membranes Unknown cause 75% are in children

S/Sx of Kawasaki Syndrome:

``` Fever > 102.2 for > 5 days Strawberry tongue Red, cracked lips Enlarged lymph nodes Skin peeling, red soles and palms Conjunctival redness Lethargic and Irritable Coronary Artery Aneurysm Colicky abdominal pain Rash on trunk and perineal area ```

Tx for Kawasaki Syndrome:

1 baby ASA and Ibuprofen to decrease clotting ability | IV IG - human juice

Endocarditis

infection of the heart muscle

Cardiopulmonary Arrest: Assessment:

Airway Breathing Circulation

Cardiopulmonary Arrest: Secondary measures:

gain IV access administer medications provide psychological support- keep parents involved