Heart Disorders Flashcards
3 defects that increase pulmonary blood flow
Ventricular septum defect vsd
Atrial septal defect asd
Patent ductus arteriosus
Hole in septum between right and left ventricle that results in increased pulmonary blood flow flow (left to right shunt)
Ventricular septal defect
A hole in septum between right and left atria that results in increased pulmonary blood flow
Atrial septal defect
Condition where normal fetal circulation conduit between pulmonary artery and aorta fails to close causing increased pulmonary blood flow (left to right shunt)
( The fetal duct between the pulmonary artery and the aorta does not close)
Patent ductus arteriosus
**common in premies
Do vsd require surgery or close on their own?
Close
On their own
Loud hard murmur, heart failure, closes on it own early in life
Ventricular septal defect
Loud hard murmur with fixed split second heart sound, heart failure, asxs sometimes
Atrial septal defect
Machine him systolic murmur, wide pulse pressure, bounding pulse, asxs sometimes, heart failure, rales
Patent ductus arteriosus
3 types of obstructive defects
Pulmonary stenosis
Aortic stenosis
Coarctation of aorta
Type of heart defect where blood flow exiting the heart meets an area of narrowing (stenosis) which causes obstruction of blood flow resulting in decreased cardiac output
Obstructive defects
Narrowing of pulmonary valve or pulmonary artery that result in obstruction of blood flow from ventricles
Pulmonary stenosis
Systolic ejection murmur, asxs sometimes, cyanosis with worsening narrowing, cardiomegaly, heart failure
Pulmonary stenosis
Narrowing of aortic valve
Aortic stenosis
Aortic stenosis in infants vs children
Infant- faint pulse, hypotension, tachycardia, poor feeding
Children- intolerance to exercise, dizziness, chest pain, possible ejection murmur
Narrowing of lumen of aorta, usually at or near the ductus arteriosus that results In Obstruction of blood flow from aorta
Coarctation of aorta
Elevated bp in arms, bounding pulse in upper extremities, decreased bp in lower extremities + weak absent pulses lower, heart failure in infants, dizziness, headache, fainting, nosebleeds
Coarctation of aorta
2 heart defect that decrease pulmonary blood flow
Tricuspid atresia
Tetralogy of fallot
These type of defects have hypercyanotic spells
Defects that decrease pulmonary Bld flow - tricuspid atresia and tetralogy of fallot
Complete closure of tricuspid valve resulting in mixed blood flow. + atrial septal opening defect that allows blood to enter left atrium
(Tricuspid valve is closed and septal defect )
Tricuspid atresia
Infants va children sxs tricuspid atresia
Infants: cyanosis, dyspnea, tachycardia
Children: hypoxemia, clubbing of fingers
4 defects of tetralogy of fallot
Pulmonary stenosis
Ventricular septal defect
Overriding aorta
Right ventricular hypertrophy
What does your heart sound like with tetralogy of fallot
Systolic murmur
3 types of mixed defect
Transposition of great arteries
Truncus arteriosus
Hypoplastic left heart syndrome
Digoxin hold parameters infant vs child
Infant <90
Child < 70
Antidote for digoxin
Digoxin immune fag
Sxs of digoxin toxicity
Bradycardia, dysthymia, n/v, anorexia, visual disturbances
What class of drugs are catopril and enalapril ?
Why use them for heart stuff?
Ace inhibitor
Reduce after load by causing vasodilation
Nursing actions for furosemide
Potassium wasting diuretic
High k diet
I/O
Monitor hypokalemia, nausea, vomitting, dizziness
Daily weight
Where do triglycerides come from?
Made by body from carbohydrates
End product of fat ingestion
What is HDL?
Good!
Low level cholesterol/triglyceride and high protein
What is LDL?
Bad!
High level cholesterol, low level triglycerides, moderate protein
2 treatments for all 3 Increased Pulmonary Blood Flow heart defects + 1 special for PDA
ASD, VSD, PDA: may close spontaneously, cardiac cath
PDA- indomethacin
treatment for Obstruction to blood flow heart conditions? (2)
- cardiac cath
* balloon angioplasty = opens narrow area
these type of defects result in dexoygenated blood entering the body circulation
Decreased pulmonary blood flow
- Tetralogy of Fallot
- Tricuspid atresia
symptoms of tetraology of fallot
- TET spells
- Murmur
- Client blue with crying, feeding, play
- Chronic hypoxia (clubbing)
type of defect where
◦ aorta connected to right ventricle ◦ pulmonary artery connected to left ventricle
Transposition of the great arteries :Mixed Blood Flow Defect
defect where Failure of septum to form
Truncus arteriosus :: Mixed Blood Flow Defect
defect with Underdeveloped left side of heart
Hypoplastic left heart syndrome: Mixed Blood Flow Defects
how do you do a Critical Congenital Heart Screening?
what do we do if results are abnormal?
pulse ox on newborn on right hand and both feet. Look for differences- want <3%
• need to be above 90% on the hand
• repeat if difference >3% - if difference persists –> refer to specialty care
S/S of congestive heart failure (7)
- Tachycardia
- Tachypnea
- Weight gain
- Poor Feeding/Growth
- Fatigue
- Decreased output
- Orthopnea
considerations for feeding CHF babes?
- Feed every 3 hours
- Polycose to add calories
- cluster care- not feeding every hour
when do we hold digoxin in an adult?
<60 / min
patient/ parent education for digoxin?
◦ make sure parents can check radial or apical pulse before discharge
The disease causes Weakening of the walls of blood vessels due to acute systemic vasculitis/ inflammation
Kawasaki Disease
3 phases of kawaski disease
acute, subacute, convalescent
tell me what happen in the acute phases of kawaski
• acute- high fever unresponsive to antipyretics, eyes red (no drainage), bright red chapped lips, strawberry tongue with red bumps, irritability inflammation in throat, swelling in hands and feet, palms and soles red, non-blistering rash, joint pain bilaterally, myocarditis, LV function decreased, pericardial effusion
tell me what happen in subacute phase of kawaski
• subacute- fever will break, subsiding of other s/s, irritability, peeling of skin around nails/palms/soles
how long can sxs of kawaski persist?
sxs 8 weeks
will labs be normal during convalescent phase of kawaski?
no- altered for 6-8 week
2 treatments for kawaski
aspirin high dose
iv immunoglobulin
how do we handle administering IV immunogobblins
◦ treat as blood administration
◦ potential for infusion reaction
◦ want immunoglobulin to be clear- not cloudy- discard if cloudy!
◦ exp date/ lot # recorded
when is it most effective to admin IV immunogobblins for kawaski?
w/in 1st 10 days of illness onset
if you immunogobblin is cloudy can you give it?
NO- needs to be clear
monitor for infusion _______ with IV immunogobblins
reaction
