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Exam 3 - cardio Flashcards

1
Q

when do major changes in the circulatory system occur

A

at birth, after the first breath

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2
Q

what is congenital heart disease

A

primarily anatomic abnormalities present at brith that result in abnormal cardiac function

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3
Q

congenital heart disease results in ____ and ___ ___ ___

A

hypoxemia; congestive heart failure

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4
Q

most common congenital heart defect

A

ventricular septal defect

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5
Q

cause of CHD

A

unknown

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6
Q

CHD risk factors

A

DM
poorly controlled maternal PKU
alcohol consumption
family hx - parent or sibling

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7
Q

CHD is associated with ___ syndrome

A

Downs

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8
Q

what are the 2 main factors affecting blood flow

A

pressure: greater pressure = greater flow
resistance: greater resistance = less flow

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9
Q

where is pressure normally greater?

A

L side of the heart

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10
Q

what are the 3 conditions associated with increased pulmonary blood flow

A

atrial septal defect
ventricular septal defect
patent ductus arteriosus

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11
Q

what is ASD

A

opening between atria causing blood to shunt to the R

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12
Q

what are the effects of ASD

A

L atrial hypertrophy

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13
Q

s/sx of ASD

A

asymptomatic
systolic murmur

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14
Q

is ASD found at birth

A

no, usually a few years old

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15
Q

ASD treatment

A

usually resolves on its own
patch via sx if too large

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16
Q

what is VSD

A

shunt from L to R ventricles, leads to increase pulmonary vascular resistance and L ventricular hypertrophy

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17
Q

what is not uncommon with VSD

A

CHF

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18
Q

what is PDA

A

blood returns to pulmonary artery bc it did not close as it should have after birth

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19
Q

when should PDA close after birth

A

within 10-16 hours

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20
Q

drug of choice for PDA treatment

A

indomethacin (smooth muscle relaxant)

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21
Q

PDA causes an increase workload on the heart which can lead to ___ ___

A

pulmonary edema

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22
Q

what are the 2 conditions that lead to obstructive blood flow

A

aortic stenosis
pulmonic stenosis

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23
Q

what is the result of aortic stenosis

A

decrease CO
decrease BP
tachycardia
difficulty feeding

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24
Q

aortic stenosis can lead to what 2 things

A

MI
L ventricular HF

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25
aortic stenosis treatment
angioplasty
26
pulmonic stenosis s/sx
loud systolic murmur cyanosis mild CHF
27
pulmonic stenosis treatment
angioplasty
28
what 4 problems must occur for tetralogy of fallot dx
VSD pulmonic stenosis R vent. hypertrophy overriding aorta (abnormal positioning)
29
what are tets spells
hypercyanotic spells
30
when do tets spells occur
crying defecating
31
s/sx of tets spells
hypoxia pale tachypnea irritable
32
what has occurred in the heart for mixed blood flow
pulmonary artery = L ventricle aorta = R ventricle
33
babies with mixed blood flow are severely ___ at bith
cyanotic; referred to as blue babies
34
physiological responses to CHD
murmurs decrease exercise tolerance dyspnea tachycardia cyanosis/hypoxia polycythemia HF growth is affected recurrent respiratory infections
35
s/sx of HF
difficulty feeding poor weight gain mild tachypnea tachycardia cardiomegaly galloping rhythm poor perfusion edema liver, sleep enlargement mottling, cyanosis, pallor
36
CHF: feeding interventions
relaxed environment small, frequent feedings upright position monitor: tachypnea, diaphoresis, feeding intolerance (vomiting)
37
when should an NGT be considered
unable to consume appropriate amount during 30 minute feeding q3h
38
causes of IE
bacteria fungus virus strep, staph are most common
39
IE is usually resulted from
poor hygiene or invasive produre
40
s/sx of IE
fever nausea fatigue CP arthralgia change in heart murmur
41
how to Dx IE
CBC echo ESR CRP blood cultures
42
IE prophylaxis
Amoxicillin 1 hour prior to: dental procedures tonsilletomy adenoidectomy surgery/sx of respiratory or intestinal mucosa
43
s/s of fast pulse rate
won't feed well irritable pale mottled poor perfusion cool extremities diminished pulses older children will c/o dizziness, activity intolerance
44
what will correct fast pulse rates
adenosine vagal maneuver
45
when can a slow pulse rate occur
after sx congenital r/t heart block
46
what is rheumatic fever
diffuse inflammatory condition of connective tissue involves heart, joints, subq tissue, brain, blood vessels
47
what is the most serious complication of rheumatic fever
rheumatic heart disease results in permanent damage to cardiac valves (commonly mitral and aortic)
48
when does rheumatic fever usually occur
2-6 weeks after untreated or partially treated strep infection
49
how long can rheumatic fever last
up to 3 months
50
review side 31
review slide 31
51
what is used to Dx rheumatic fever
Jones criteria must be at least 1 major or 2 minor manifestations
52
rheumatic fever treatment
10 days of PO PCN or 1 dose of PCN IM ASA corticosteriods cephalosporins or erythromycin if PCN allergy
53
mattress placement with rheumatic fever
on the floor d/t fall risk r/t syndenham chorea
54
review slide 34
review slide 34
55
Kawasaki disease is common in ___ less than __
boys; < 2 frequently seen in children < 5 rarely dx after 8 y/o
56
cause of Kawasaki disease
unknown
57
kawasaki disease is aka
mucocutaneosu lymph node syndrome
58
what is the major cause of acquired heart disease in children
kawasaki disease
59
complication of kawasaki disease
coronary artery aneurysum
60
how long does the acute phase of kawasaki disease last
10 days
61
kawasaki disease is characterized by what
high fever persisting longer than 5 days
62
is a fever responsive to abx with kawasaki disease
No
63
kawasaki disease acute phase s/sx
high fever > 5 days bilateral, nonpurulent conjunctivitis strawberry tongue cracked lips swellings: hands, feet erythema: palms, soles generalized erythematous rash enlarged cervical lymph nodes tachycardia extreme irritability
64
how long is the subacute phase of kawaski disease
11-25 days
65
s/sx of kawasaki disease subacute phase
fever disappears, most symptoms resolve continued irritability anorexia desquamation of fingers, toes arthritis arthralgia severe thromybocytosis HF, dysrhythmias, coronary aneurysms
66
when is an echo done with kawasaki disease
at Dx repeat in 2 weeks again 6-8 months
67
how long does the convalescent stage last with kawasaki disease
until ERS returns to normal
68
convalescent stage s/sx with kawasaki disease
most have disappeared Beau's lines
69
what is the focus with kawasaki disease
preventing, reducing coronary artery damage
70
when is ASA and IVIG therapy most prevalent with kawasaki disease
when given within 10 days of fever onset
71
how long will a child be on ASA after kawasaki disease dx
2 months
72
review slide 30
review slide 39
73
ASA should be administered with what
milk or food
74
how long to delay MMR, varicella vaccine after Kawasaki IVIG
11 months
75
s/sx of IVIG adverse reaction
flushing chest tightness chills dizziness N/V diaphoresis hypotension
76
kawaski interventions
hydration (ice pops) high calorie food sponge baths keep environment clean
77
BP must be high on __ different occasions for HTN dx
3
78
HTN is seen in ___ r/t to obesity
adolescents
79
educations measures to prevent HTN
weight reduction dietary modifications relaxation techniques
80
IV infusion of HTN meds must be done ___ ___
very slowly monitor for sudden hypotension
81
what must be maintained for IV infusion of HTN meds
art line
82
define cardiomyopathies
diseased heart muscle NOT r/t CHD, CAD, or other systemic cause
83
hypertrophic vs. restrictive cardomyopathy
H: hypertrophic ventricles, impaired filling **common in athletes who suddenly die R: infiltration of muscle of abnormal material **often congenital
84
when to assess baseline lipids
around 9-11; again around 19-20
85
digoxin therapeutic level
0.8-2
86
apical pulse range for infants and > 2
I: 90-110 > 2: 70
87
when are therapeutic ranges measured with digoxin
6 hour after dose
88
should digoxin doses be verified with another nurse
yes
89
hypercyantic spells treatment
knee to chest position calm approach 100% O2 by mask morphine IV IVF to prevent dehydration
90
how much fluid should be consumed daily to prevent dehydration
150 mL/kg/day
91
sx: children under 5 worry about what
what will happen when they wake up
92
sx: school aged children fear what
anesthesisa
93
sx: 9-10 year olds fear what
death

Pediatrics (12 decks)

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