Other cardiac Flashcards
cardiac tamponade SS
- JVD
- DECREASED or MUFFLED heart sounds
- peripheral pulses weak or gone or fall sharply after inspiration (pulsus paradoxus)
- pericardial friction rub
- tachycardia
- tachypnea
- “tightness in chest”
cardiac tamponade
-compression or the heart produced by the accumulation of blood or other fluid in the pericardial sac
cardiac tamponade NI
- bed rest
- HOB 45
- monitor VS
- peripheral pulses
- CO frequently
- ECHO to confirm DG
- prep for emergency pericardiocentesis
myocarditis
- inflammatory process involving myocardium = heart dilation, thrombi, infiltration of blood cells, degeneration of muscle
- Tx like IE, limit activity up to 6 mos.
Tetralogy of Fallot
-ASD, Pulm Stenosis, overriding aorta (out of RV), RV hypertrophy
–desaturated blood enters systemic system by shunting right to left across the VSD or into overriding aorta
-linked to Trisomy 21
Tetralogy of Fallot CM
- cyanosis
- “TET SPELLS” hypercyanotic
- pulmonic murmur
- poor growth
- clubbing fingers, squatting
- extreme fatigue
- chronic hypoxemia
- harsh systolic murmur w/ palpable thrill
- “BOOT-SHAPED HEART”
Tetralogy of Fallot
MEd Tx
- Tx anemia
- manage hypercyanotic episodes
- surgery requires bypass
- PGE to maintain PDE
- for poor Sx candidates . palliative (increase pulm flow)
tricuspid atresia
Nondevelopment of the tricuspid valve, patent foramen ovale or ASD, underdeveloped RV, VSD of varying size, pulm artery located in normal position or transposed with the aorta, pulmonary stenosis of varying degree
Desaturated blood enters the right atrium, shunts R to L through a patent foramen ovale into the LA; desaturated blood mixes w/ saturated blood in the LA, proceeds into the LV and into aorta; some blood shunts through the VSD to the RV and into the pulmonary artery to the lungs; if PDA open, some blood will flow from the aorta to the pulmonary artery; lesser pulmonary stenosis can contribute to pulmonary congestion
Tricuspid atresia
CM
- CENTRAL cyanosis (profound)
- tachypnea
- systolic murmur (tricuspid)
- polycythemia
- poor growth
- single seconf heart sound
- PDA
Hypoblastic Left Heart syndrome
- inadequate development of L side of heart— one effective ventricle– small LV
- PDA allows for systemic circulation from main PA
- most of pulmonary venous return is shunted to RA
Hypoblastic Left heart CM
- HF, tachypnea, poor feedign , cyanosis
- severe if PDA closes (hypoxia, decreased CO, acidosis, shock), systemic hyperperfusion
- infant: GRAYISH BLUE, dyspnea & HoTN
Transposition of the Great vessels
- pulmonary artery leaves the LV & the aorta leaves the RV – 2 parallel but separate circuits
- septal defect or PDA req for mixing to occur
CHD with CXR “egg on its side”
Transposition of the great vessels
CMs of Transposition of Great vessels
- poor growth
- varying degrees of cyanosis
- hypoxemia despite O2 admin
- progressive desaturation and acidosis = HF
pulmonary HTN
- elevated pressure in blood vessels of the lungs
- occurs in CHD in infants
- leads to RHF (cor pulmonale) and cyanosis
- can give fluids for polycythemia
- need Tx soon or can req heart & lung transplant
hypoxemia peds
- cyanosis 5 g/dl unsat HGB
- polycythemia –thick blood, maintain hydration to prevent CVA
- clubbing of fingers
- hypercyanotic spells “Tet spell” (calm infant, knee-chest , 100% O2 mask, morphine SC or IV
what conditions are ok to give aspirin in younger children?
- Kawaski’s disease
- rheumatic fever
- juvenile arthritis
normal fetal circulation
The inferior vena cava empties blood into the right atrium. The trajectory (direction) of the blood flow, as well as the pressure in the right atrium, propels most of this blood through a second fetal structure, the foramen ovale, into the left atrium. This richly oxygenated blood travels through the left ventricle into the aorta, feeding the coronary arteries and the brain—the two most oxygen-needy organ systems.
Blood returning from the upper body enters the right atrium through the superior vena cava. This blood is primarily directed through the tricuspid valve and the right ventricle into the pulmonary artery. Resistance in the pulmonary circulation is very high because the lungs are collapsed and filled with fluid. A very small amount of blood flows through the branch pulmonary arteries to provide oxygen and nutrients to the pulmonary tissue. Most of the blood flows through a third fetal structure, the ductus arteriosus, to the descending aorta. This blood is then distributed to the organ systems and tissues in the lower portion of the body and returns to the placenta for gas exchange through two umbilical arteries
normal anatomy of the heart
Complications of pacemaker therapy
- local infection
- bleeding/hematoma at lead entry site
- pneumo or hemothorax
- ventricular ectopy/ tachycardia
- perforation of myocardium or septal walls
- phrenic nerve, diaphragmatic or skeletal muscle stimulation
- cardiac tamponade
- failure to sense of capture
Sign of cardiac tamponade
muffled heart sounds
Nurse care after pacemaker
- mon EKG and CO
- avoid lifting arms above head, heavy lifting until pacer site is healed
- report hiccups
Pacemaker patient teach
- keep large magnets away
- avoid MRI, radio/transmission towers
- alert airport security
- Wear med alert bracelet
- transtelephonic monitoring
- follow up appts
- avoid direct blows or pressure
- microwave OK
- monitor pulse
arterial lines use
- to monitor BP continuously
- for pts in critical condition- shock, mult-organ failure. trauma
- transducer converts BP measurements into wave form on screen
