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Pathology 2 > Pedatric Cardiology & Shock > Flashcards

Pedatric Cardiology & Shock Flashcards

1
Q

Bradycardia

A

Most often occurs secondary to hypoxia
Treatment: a/w, O2
Other causes include congenital HB, beta blocker OD, calcium channel blockers OD, Digoxin OD

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2
Q

What can increased ICP cause

A

Bradycardia, should be suspected in children with:
-ventricular shunts
-Hx of head injury
-suspected child abuse

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3
Q

When do we begin compression

A

If the pulse is less than 60

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4
Q

SVT with adequate perfusion

A

-doesn’t vary with activity
Heart rate >220 in infants and >180 in children
-consider adenosine

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5
Q

SVT with poor perfusion

A

Vaal maneuvers (no delay)
Adenosine
Cardioversion

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6
Q

Wide complex tachycardia with adequate perfusion

A

-ALS
Amiodarone
Cardioversion

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7
Q

Wide complex tachycardia with poor perfusion

A

Cardioversion
Pharmacological intervention

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8
Q

Infant chest compressions

A

2 fingers just below intermammary line
2 thumbs encircling technique
100-120 compressions per min

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9
Q

Best sign of effective ventilation

A

Chest rise

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10
Q

Best sign of effective circulation

A

Output with each compression

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11
Q

What percent O2

A

100%, there is no risk in using 100% short term

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12
Q

Fluid resuscitation

A

20cc/kg

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13
Q

What is shock

A

The abnormal condition in which inadequate oxygen and metabolic substrates fail to meet the demands of the tissue

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14
Q

What is compensated shock

A

Tissue perfusion maintained and blood pressure preserved

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15
Q

Decompensated shock

A

-hypotensive
-unable to maintain organ perfusion

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16
Q

Signs of compensated shock

A

-tachycardia
-cool, pale, diaphoretic skin
-delayed cap refill
-weak peripheral pulses/narrow pulse pressure
-vomiting

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17
Q

A child can be in severe shock and still maintain what

A

B/P

18
Q

Hypotension is a sign of?

A

Irreversible organ injury and impending arrest

19
Q

Hypovolemic shock causes

A

Most common cause of shock in children
-diarrhea
-Hemorrhage
-Vomiting
-burns

20
Q

Hypovolemic shock

A

-the result of absolute deficiency in intravascular blood volume
-characterized by decrease in preload due to reduced stroke volume and cardiac output

21
Q

Signs and symptoms of hypovolemic shock

A

-Tachypnea
-Tachycardia
-Normal-low bp (narrow pp)
-weak/absent peripheral pulses
-delayed cap refil
-cool pale diaphoretic
-changes in mental status

22
Q

Treatment for hypovolemic shock

A

-20cc/kg bolus
-Reassess for signs of response to fluid therapy
-Repeat boluses until improvement
-blood products usually given after 2-3 boluses

23
Q

Distributive shock

A

Inappropriate distribution of blood volume with inadequate organ and tissue perfusion

24
Q

Common forms of distributive shock

A

-septic shock
-anaphylactic shock
-neurogenic shock

25
Q

Physiology of Distributive Shock

A

Cardiac Output can be increased, normal or decreased
Tissue perfusion is compromised due to poor distribution of blood flow

26
Q

Signs of distributive shock

A

Tachypnea
Tachycardia
Blood pressure will differ depending on type and severity
Warm flushed pale skin
Changes in mental status

27
Q

Septic shock

A

The most common form of distributive shock
WBC’s stimulate release of inflammatory mediators (cytokines)
Cytokines produce vasodilation and increased capillary permeability
Can lead to multi organ system failure

28
Q

Treatment for septic shock

A

-rapid aggressive fluid admin
-Antibiotics
-Determine response to Tx

29
Q

Anaphylactic Shock

A

Results from severe reaction to drug, food, vaccine or other antigen
Acute multi system response characterized by vasodilation, increased capillary permeability and bronchoconstriction

30
Q

Signs and symptoms of anaphylactic shock

A

-anxiety
-agitation
-N/V
-Urticaria
-Angioedema
-Resp distress
-Hypotension
-Tachycardia

31
Q

Treatment for anaphylactic shock

A

-Epi
-Ventolin
-Antihistamines
-cortico steriods
Fluid therapy

32
Q

Nerougenic shock

A

Results from injury to the head or spine that disrupts sympathetic NS inner action of heart and blood vessels

33
Q

Signs and symptoms of neurogenic shock

A

-Hyptotension with widen pp
Normal HR or bradycardia
Diaphragmatic breathing

34
Q

Treatment for neurogenic shock

A

Position patient flat or head down
Attempt fluid therapy
Vaspressors

35
Q

Cardiogenic shock

A

-Primary disruption of the hearts pumping ability
In infants and young children, normally secondary to:
-Arrhythmias
-Congenital Heart Defects
-Myocardititis

36
Q

Treatment

A

Cautious fluid resuscitation
Mechanical ventilation PRN

37
Q

Obstructive shock

A

Condition of impaired cardiac output caused by physical obstruction of blood flow

38
Q

Causes of obstructive shock

A

Cardiac tamponade
Tension pneumothorax
Massive pulmonary embolism

39
Q

Obstructive shock

A

Results in low cardiac output, inadequate tissue perfusion and compensatory increase in systemic vascular resistance
Similar in presentation to hypovolemic shock
Progressive JVD

40
Q

Treatment for obstructive shock

A

Treat the cause

Pathology 2 (13 decks)

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