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Peds > Module 9: Care of a Child with a Cardiovascular System Disorder > Flashcards

Module 9: Care of a Child with a Cardiovascular System Disorder Flashcards

1
Q

Congenital Heart Disease

A
  • incidence: 5-8/1000 of live births
  • 2-3 infants out of 1000 infants will be symptomatic
  • major cause of death in the first year of life
  • recurrent respiratory infections are common
  • cyanosis is not always present
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2
Q

What causes congenital Heart Disease

A
  • maternal risk factors
  • genetic or family history
  • association with chromosomal abnormalities, syndromes or congenital defects in other systems (down’s)
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3
Q

polycythemia

A

many red blood cells being produced in attempt to compensate for the lack of oxygen

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4
Q

cardiac catheterization

A

a radiopaque catheter is passed through the femoral artery directly into the heart and large vessels; shows BP w/in the heart, blood samples can be obtained to determine oxygen content

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5
Q

chest x-ray film

A

a radiograph image of the body struck, shows abnormalities in the shape and position of heart

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6
Q

electrocardiogram

A

tracing of heart action by electrocardiography, detects variations in heart action and shows the condition of the heart muscle; may also be used as a monitoring device during cardiac catheterization

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7
Q

PDA - patent ductus arteriosus (acyanotic)

A
  • blood crosses from the pulmonary artery to the aorta and avoids the deflated lungs
  • initially asymptomatic
  • may hear a murmur
  • pulmonary hypertension over time
  • Treatment:
    • > surgery
    • > Nsaids - decrease production of prostaglandins and try to close the pda
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8
Q

VSD - Ventricular Septal Defect (acyanotic)

A

associated with down’s syndrome and FASD

  • 30-50% will close spontaneously during childhood
  • always blood to flow from left ventricle to right due to pressure
  • blood to the body is oxygenated, to the lungs its mixed, but coming back from lungs is fully oxygenated
  • Treatment:
    • > surgery
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9
Q

ASD - Atrial Septal Defect (cyanotic)

A
  • foramen ovale does not close after birth
  • associated with FASD and down’s syndrome
  • abnormal opening b/w the right and left atria, blood containing oxygen from the left atrium is forced to the right
  • 10-15% of all congenital heart defects
  • Treatment:
  • > spontaneous closure sometimes occurs
  • > surgical repair
  • > nonsurgical closure during cardiac catheterization can sometimes be accomplished
  • > low-aspirin dose therapy is usually prescribed for 6 months after repair
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10
Q

Coarctation of the aorta

A
  • congenital
  • constriction of the aorta
  • treatment:
    • surgery
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11
Q

Nursing interventions Post Op for Coarctation of the aorta

A
  • vital signs
  • care of chest tube
  • monitor of I.V. and fluids
  • measure accurate intake and output
  • provide care of N.g tube if in situ
  • monitor for signs of CHF, hypertension, bleeding
  • 4 limp bps before and after any procedure or surgery
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12
Q

Assessment for Infants with Cardiovascular Problems

A
  • nutritional status
  • colour
  • chest deformities
  • unusual pulsations
  • heart rate and rhythm
  • peripheral pulses
  • characteristics of heart sounds
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13
Q

Decrease Pulmonary Blood Flow (cyanotic)

A
  • tetralogy of fallot
  • accounts for 10% of congenital heart disease
  • cyanosis is a major characteristic feature of this type of congenital heart anomaly due to non-oxygenated blood in circulation
  • there are four defects associated with tetralogy
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14
Q

Tetralogy of Fallot

A
  • the four defects associated with tetralogy of fallot are:
    1. stenosis of pulmonary artery (constriction) partly blocks flow of venous bid into the lungs
    2. hypertrophy of Rt ventricle (more muscular than normal)- occurs because of stenosed area - enlarges as heart is working harder to pump the blood through the narrowing
    3. ventriculoseptal defect - vid
    4. overriding aorta - aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle as in normal heart; blood from both ventricles mayy be distributed systemically
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15
Q

What can happen in a tet’s spell

A
  • wide spread cyanosis, when increased crying
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16
Q

tetralogy defects can cause:

A
  • venous blood enters the aorta resulting in cyanotic appearance
  • narrowing of pulmonary artery causes CHF due to increased force required to move blood through narrowed orifice
  • polycythemia (making more RBC’s to assist with oxygenation) occurs in response to hypoxia
17
Q

Tetralogy of Fallot S&S:

A
  • cyanosis which increases with age
  • clubbing fingers
  • squatting to catch breath
  • feeding problems
  • failure to thrive
  • frequent respiratory infections
  • dyspnea on exertion
  • fatigue, limited energy
  • growth delay
  • polycythemia
  • ruddy red colour in hands and face
  • dizzy
  • weak
  • increased bp
  • headache
18
Q

tetralogy treatment

A
  • complete the repair involved closure of VSD, resection of the stenosis with a patch to enlarge the right ventricular outflow tract
  • surgery done b/w 1-3 yrs
  • prognosis if fairly good
  • 95% improve after surgery
19
Q

Lesions that Obstruct Blood Flow

A
  • caused by stenosis or narrowing
  • one example of stenosis or narrowing obstruction is coarctation of the area
  • may be diagnosed immediately after birth or in late childhood, prognosis beyond 40 yrs of age is poor if not corrected early
20
Q

General Nursing care of interventions for pt with heart defects/disease

A
  • teach good oral hygiene to prevent possible bacteria and bacterial endocarditis, good nutrition to prevent anemia
  • discuss plan for immunizations
  • provide rest
21
Q

Congestive Heart Failure

A

Right sided CHF:
- moves unoxygenated blood to the pulmonary circulation; a failure results in backup of blood in the systemic venous system

Left sided CHF:
- moves oxygenated blood from the pulmonary circulation into the system circulation; failure results to backup into the lungs

S&S:
- cyanosis, pallor, rapid respiration, rapid pulse, feeding difficulties, a weak cry, excessive perspiration, failure to gain weight, edema and frequent respiratory infections

22
Q

Kawasaki Disease

A
  • vasculitis; self-limiting in 5-10 days
  • an acute febrile illness primarily of young children, under 5
  • no known cause - there may be a genetic predisposition
  • not contagious
    Diagnosis:
    • made by clinical S&S
      S&S:
  • onsent abrupt fever that does not respond to antipyretics or antibodies
  • conjunctivitis without discharge
  • fissured lips,
  • strawberry tongue
  • inflammed mouth and pharyngeal membranes
    Treatment:
  • IV immune globulin administered early in illness can prevent the development of coronary artery pathology
  • aspirin for antithrombus

Peds (8 decks)

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