Pediatric cardiopulm

Question 1

Acyanotic Lesions

Answer 1

increase pulmonary blood flow and fully oxygenated blood is shunted back into the lungs as well as to the body, left to right shunting

Question 2

Symptoms of acyanotic lesions:

Answer 2

sweating, increased RR, HF

Question 3

Most common problem in acyanotic lesions:

Answer 3

low partial pressure of oxygen (Po2) to periphery, low systemic SV and increased work on the heart

Question 4

Atrial Septal Defects

Answer 4

most commonly caused by a patent (open) foramen ovale, hole in atrial wall that usually closes after birth

Question 5

Patent Ductus Arteriosus

Answer 5

o often associated with prematurity or Down syndrome, too much blood may enter the lungs

Question 6

Symptoms of Patent Ductus Arteriosus

Answer 6

♣ tachycardia, increased respiratory distress, poor weight gain

Question 7

Ventricular Septal Defect

Answer 7

one or more small openings in the wall separating the ventricles, may lead to bacterial endocarditis, pulmonary vascular obstructive disease, aortic regurgitation, increased incidence of lower respiratory tract infections, or CHF

Question 8

Symptoms of ventricular septal defect:

Answer 8

♣ feeding problems, poor weight gain, restlessness, rapid breathing, irritability

Question 9

Atrioventricular Septal Defects

Answer 9

may involve failure of formation of any or all endocardial cushions

Question 10

Symptoms of Atrioventricular Septal Defects

Answer 10

pulmonary HTN, lung congestion, HF

Question 11

Coarctation of Aorta

Answer 11

o obstruction of L ventricular outflow because of a narrowing of the aorta

Question 12

Cyanotic Lesions involve right to left shunting

Answer 12

o involves right to left shunting
most of the blood bypasses the lungs
o decreased arterial oxygen saturation occurs as unoxygenated blood is returned to the body
o the body signals increased RBC formation because of the decreased arterial oxygen saturation levels and polycythemia results
o the body is at risk for cerebrovascular insult

Question 13

Tetralogy of Fallot

Answer 13

o pulmonary stenosis, VSD, overriding aorta, R ventricular hypertrophy

Question 14

Hypoplastic Left-Heart Syndrome

Answer 14

underdeveloped L ventricle, aortic and mitral valve stenosis or atresia (complete closure), coarctation of the aorta

Question 15

Transposition of the Great Arteries

Answer 15

pulmonary artery leaving the L ventricle and the aorta exiting the R ventricle with no communication between the systemic and pulmonary crculations

Question 16

Tricuspid Atresia

Answer 16

tricuspid valve is either not open or absent, obstruction of blood flow into the right enticle and the right ventricle is frequently underdeveloped

Question 17

Pulmonary Atresia

Answer 17

pulmonary valve fails to develop, obstruction of blood from the R side of the heart to the lungs

Question 18

Truncus Arteriosus

Answer 18

normal separation of the aorta and main pulmonary artery do not occur during fetal development

Question 19

Total Anomalous Pulmonary Venous Return

Answer 19

pulmonary veins attach to the R atrium or to other veins that drain into the R atrium

Question 20

Apnea of prematurity

Answer 20

cessation of breathing for 20 seconds or longer

Question 21

• Bronchopulmonary Dysplasia (BPD)

Answer 21

o Chronic respiratory disorder characterized by scarring of lung tissue, thickened pulmonary arterial walls, mismatched between lung ventilation and perfusion
o Persistence of respiratory symptoms after 1 month, abnormal radiographic findings, dependence on supplemental O2
o Mechanical ventilation is etiological factor

Question 22

0-3 months shape of thorax and direction of ribs

Answer 22

triangular

horizontal

Question 23

3-6 months months shape of thorax and direction of ribs

Answer 23

rectangular

horizontal

Question 24

6-12 months months shape of thorax and direction of ribs

Answer 24

rectangular

angled downward

Question 25

0-3 months primary muscles used for inspiration

Answer 25

diaphragm

Question 26

3-6 months primary muscles used for inspiration

Answer 26

diaphragm and acces. muscles

Question 27

6-12 months primary muscles used for inspiration

Answer 27

diaphragm and intercostals

Question 28

When is there no activation of accessory muscles during quiet breathing?

Answer 28

around 2 years

Question 29

High-frequency chest wall oscillation

Answer 29

o Patient dons a vest that contains an air bladder; generator that attaches to vest; uses air to inflate the vest, then provide high-frequency bursts of air

Question 30

Absolute contraindication to high frequency chest wall oscillation:

Answer 30

unstable head, neck, rib cage, back injury, active hemorrhage

Question 31

Relative contraindications to high frequency chest wall oscillation:

Answer 31

subcutaneous emphysema, recent epidural spinal infusion, recent skin grafts, burns, open wounds, transvenous pacemaker, suspected pulmonary TB, lung contusion, bronchospasm, complaint of chest wall pain

Question 32

When to stop exercise in children:

Answer 32

chest pain or discomfort
RPE greater than 17
dyspnea of 4
dizziness
visual changes
pale or ashen
new onset joint pain
HR greater than 80% man
O2 below 90%