Exam 4 Cardio Flashcards

1
Q

Most common way to diagnose CHD?

A

Echo, can be done in utero

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2
Q

Cardiac Cath

A

Invasive, cath is guided with fluoroscopy to the heart, dye is injected and the path through the heart is followed

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3
Q

Complications of Catheterization

A

Hemorrhage, fever, n/v, loss of pulse in cathed extremity, transient dysrhythmias

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4
Q

Pre op cath

A

Sedation, NPO, check allergies, locate and mark pulses

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5
Q

Post op cath

A

ECG monitor rath and rhythm, BP, pulse ox, frequent monitoring of extremity (pulse, color, temp) I&O

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6
Q

What do you do if bleeding occurs at cath insertion site?

A

Do not remove dressing. Hold direct pressure 1 in above site, lay child flat, call doc

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7
Q

Leg position after cath

A

Keep straight for 4-8 hrs

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8
Q

Cath insertion post op care

A

Keep free from infection (apply diapers) keep clean and dry, pt may shower only. Avoid strenuous exercise, but may attend school

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9
Q

Two types of congenital heart dz

A

Congestive heart failure and Hypoxemia

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10
Q

Normal pressure flow of heart

A

Left side has a higher pressure than right side.

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11
Q

Normal resistance of circulation

A

Pulmonary circulation has less resistance than systemic circulation

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12
Q

Increased pulmonary blood flow leads to what

A

Congestive heart failure, acyanotic

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13
Q

Decreased pulmonary blood flow leads to what

A

Cyanosis

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14
Q

Obstruction to blood flow out of the heart leads to what

A

Congestive heart failure, acyanotic

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15
Q

Mixed blood flow leads to what

A

Cyanosis, varied s/s

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16
Q

The inability of the heart to pump an adequate amount of blood to the systemic circulation

A

Congestive heart failure

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17
Q

When does CHF occur in children?

A

Secondary to structural problems that cause increased blood volume and pressure in the heart

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18
Q

Right sided heart failure

A

Right ventricle can’t pump effectively into pulmonary artery

19
Q

Left sided heart failure

A

Left ventricle can’t pump effectively into systemic circulation

20
Q

Right sided heart failure causes increased pressure where?

A

In the right atrium and systemic venous circulation

21
Q

Left sided heart failure causes increased pressure where?

A

In the left atrium and pulmonary veins

22
Q

Manifestations of right sided heart failure

A

HTN, hypatosplenomegaly, edema

23
Q

Manifestations of left sided heart failure

A

Lungs become congested causing pulmonary edema

24
Q

Polycythemia

A

Increased number of RBC to increase the oxygen carrying capacity of blood. Increases blood viscosity and increases risk for clots

25
Q

Polycythemia occurs with what?

A

Hypoxia

26
Q

Abnormal opening between the atria which allows blood from the high pressure LA to shut into the RA

A

Atrial septal defect

27
Q

Abnormal opening between the right and left ventricle which causes left to right shunting

A

Ventricular septal defect

28
Q

A low atrial septal defect and high ventricular septal defect, clefts of the mitral and tricuspid valves causing blood to flow between all chambers of the heart

A

AV canal defect

29
Q

Failure of the fetal ductus arteriosus to close within the first few weeks of life, causing blood to flow from high pressure aorta to low pressure pulmonary artery

A

PDA

30
Q

Narrowing near the insertion of the ductus arteriosus leading to increased pressure to the hear and upper extremities and decreased pressure to the body and lower extremities

A

Coarctation of the aorta

31
Q

Narrowing of the aortic valve causing resistance to blood flow out of the LV, decreased CO, LV hypertrophy, and pulmonary vascular congestion

A

Aortic stenosis

32
Q

Narrowing at the entrance to the pulmonary artery causing RV hypertrophy and decreased pulmonary blood flow

A

Pulmonic stenosis

33
Q

VSD, pulmonic stenosis, overriding aorta, RV hypertrophy

A

Tetralogy of Fallot

34
Q

Tricuspid valve fails to develop resulting in no flow from RA to RV. Blood flows from an ASD or PFO to the left side of the heart. Blood flows through a VSD to the right side and to the lungs. Results in complete mixing of unoxygenated blood and oxygenated blood which leads to systemic desaturation. Varying amounts of pulmonary obstruction leads to decreased pulmonary blood flow

A

Tricuspid Atresia

35
Q

Pulmonary artery leaves the left ventricle and the aorta exits from the RV> no communication between systemic and pulmonary circulation. Need an associated defect (septal, PDA) in order for blood to mix

A

Transposition of the great vessels

36
Q

Underdevelopment of the left side of the heart leading to hypoplastic LV and aortic atresia. Blood flows from LA through a PFO to the RA>RV>PA. A PDA allows blood to flow to systemic circulation

A

Hypoplastic left heart syndrome

37
Q

An infection of the valves or lining of the heart

A

Bacterial Endocarditis

38
Q

Inflammatory dz that occurs after a strep infection. Self-limited illness that involves joints, skin, brain, and heart.

A

Rheumatic Fever

39
Q

What is the complication of RF?

A

Cardiac valve damage (Rheumatic heart dz, usually mitral valve)

40
Q

Acute systemic vasculitis of unknown cause. Self-limited but without intervention have 15-25% developing aneurysms. Extensive inflammation of arterioles, venues, capillaries. Segmental damage to muscular arteries leads to coronary aneurysms

A

Kawasaki Dz

41
Q

Acute stage of Kawasaki Dz

A

Abrupt onset of high fever, unresponsive to antipretics and abx, then gets other s/s, very irritable

42
Q

Subacute stage of Kawasaki Dz

A

Resolution of fever and lasts until all s/s have disappeared

43
Q

Convalescent phase of Kawasaki Dz

A

All s/s resolved but labs (ESRW) remain elevated, lasts until all are normal (6-8 weeks after onset)

44
Q

In which stage of Kawasaki Dz is the pt at risk for aneurysms?

A

Subacute. Monitor serial echo