Heart Defects (17.5%)

Question 1

Decreased Pulmonary blood flow defects (2)

Answer 1

Tetralogy of Fallot

Tricuspid Atresia

Question 2

Cyanotic 🖤 defects

4 Ts

Answer 2

Tetralogy of Fallot
Tricuspid Atresia

Transposition of Great Arteries
Truncus Arteriosus

Question 3

High Pulmonary Blood Flow Defect

3

Answer 3

Patent Ductus Arteriosus (PDA)
Atrial Septal Defect (ASD)
Ventricular Septal Defect (VSD)

Question 4

Obstructive Heart Defect disorders

3

Answer 4

Coarctation of the Aorta
Aortic Stenosis
Pulmonary stenosis

Question 5

Mixed heart Defect disorders

2

Answer 5

Transposition of the great vessels

Truncus Arteriosus

Question 6

Tetralogy of Fallot
(4 defects, infant:child assessment, murmur heard over?)

Blood flow?

Answer 6

Hole between L/R ventricle oxygenated and deoxygenated blood goes into aorta to body

Stenosis of the Pulmonary valve
R ventricular hypertrophy
VsD
Overriding aorta

Newborn-hypoxia/cyanotic
Child- tachypnea, cyanosis, poor growth, hypercyanotic spells, clubbing

Murmur heard over pulmonic area

Question 7

Tricuspid Atresia 
(Blood flow? 2 defects? S/S? Murmur heard?)

Answer 7

Decrease Pulmonary blood flow
(ASD/VSD)

No tricuspid valve or no R atrium

S/S: cyanosis, tachypnea, poor feeding, growth delay, continuous harsh systolic murmur LL eternal boarder (tricuspid)

Question 8

Patent Ductus Arteriosus (PDA)

Blood flow? S/S? Medication?

Answer 8

Oxygenated blood going into lungs through ductus Arteriosus increasing Pulmonary blood flow

S/S: asymptotic or bounding pulses, widened pulse pressure, machinery murmur during S/D, thrill in pulmonic area, tachy(cardia/pnea)

Question 9

Atrial Septal Defect (ASD)

Blood flow? S/S? Tx?

Answer 9

Oxygenated blood seeps through hole between L/R atrium and goes to lungs increasing pulmonary blood flow.

S/S: no symptoms
Poor growth, fatigue, systolic ejection murmur in pulmonic area, wide splitting S2 throughout all phases of respiration

Small close on own..if not closure patch

Question 10

Ventricular Septal Defect (VSD)

Blood flow? S/S?

Answer 10

Oxygenated blood flows through L/R ventricles back into the lungs increasing Pulmonary blood flow

S/S: no symptoms
Decrease activity, Pulmonary high BP, systolic murmur 3/4 intercostal space

Question 11

Coarctation of the Aorta

Blood flow? S/S?

Answer 11

Narrowing in the descending Aorta obstructs system blood flow to the body

S/S: asymptotic 
Lower BP in the LE-femoral pulses weak 
Higher BP in UE- brachial pulses bounding 
Extremities cyanotic
Poor feeding, FTT, Pale

Question 12

Aortic Stenosis

Blood flow? S/S?

Answer 12

Narrowing of the aortic valve obstructs blood flow to the systemic system

Mild asymptotic

Weak threads peripheral pulses, chest pain, systolic pressure high in R arm vs L arm

Question 13

Pulmonary Stenosis

Blood flow? S/S?

Answer 13

Narrowing above, below or at Pulmonary valve obstructing blood flow to pulmonary artery creating R ventricular hypertrophy

Dyspnea, chest pain, fatigue, loud systolic ejection murmur

Question 14

Transposition of the Great Vessels

Blood flow? S/S? Tx?

Answer 14

Pulmonary artery and Aorta artery is switched creating opposite effect of perfusion.

LIFE THREATENING surgery first 2 weeks of life

S/S: cyanosis, hypoxemia, tachypnea, fatigue

Question 15

Truncus Arteriosus

Blood flow? S/S? Tx

Answer 15

Single large vessel empties both ventricles and provides circulation for Pulmonary and systemic circulations

Chf within 2 weeks, tachypnea, dyspnea, retractions, FTT, high pulse pressure and bounding peripheral pulses

Surgical repair first month of life

Question 16

General interventions (6)

Answer 16

Frequent rest periods
Cluster Care
Crying to minimum 
Sodium/ fluid restriction 
Alternate feeding with high density formula 
Decrease work load of heart

Question 17

Post up cardiac cath interventions

5

Answer 17

Asses temp/color
Assess insertion site for hematoma/ bleeding
Encourage fluid remove due
Limit activity 24h
Affected exteremity straight fit 4-8 hours
Monitor for infection