Pediatric Perfusion

Question 1

When are the 4 chambers of the heart developed

Answer 1

2-8 weeks of gestation

Question 2

How is fetal oxygenation achieved

Answer 2

through the placenta

Question 3

What happens when a newborn starts breathing on its own

Answer 3

foramen ovale, ductus arteriosus, and ductus venosus close

Question 4

Change in heart positioning through childhood

Answer 4

heart initially lies horizontal then becomes vertical throughout development

Question 5

Infant HR and BP

Answer 5

90-160, 80/55

Question 6

Toddler/preschooler HR and BP

Answer 6

80-115, 90-110/55-75

Question 7

School age HR and BP

Answer 7

60-100, 100-120/60-75

Question 8

Adolescent HR and BP

Answer 8

60-100, 100-120/70-80

Question 9

Murmur assessment

Answer 9

location, relation to heart cycle, intensity (grades), quality (musical, harsh, blowing, pitch), variation with position (sound change with sitting, standing, lying)

Question 10

Murmur grade 1

Answer 10

very soft only heard with effort

Question 11

Murmur grade 2

Answer 11

soft but audible

Question 12

Murmur grade 3

Answer 12

moderately loud

Question 13

Murmur grade 4

Answer 13

loud with a thrill

Question 14

Murmur grade 5

Answer 14

very loud with a thrill

Question 15

Murmur grade 6

Answer 15

can be heard without stethoscope with a thrill

Question 16

Angiogram

Answer 16

assess heart structures and vessels, monitor blood flow, identify lesions

Question 17

Post angiogram considerations

Answer 17

must be on bedrest, observe puncture site, vital signs, pulses

Question 18

Holter monitor

Answer 18

24 hour view of arrhythmias

Question 19

What do echocardiograms diagnose

Answer 19

structural and valve defects

Question 20

What does cardiac catheterization measure

Answer 20

pressure and contractility, identify defects

Question 21

What should we monitor for after cardiac catheterizations

Answer 21

bleeding, arrhythmias, hematomas, thrombus, infection

Question 22

Cardiac catheterization nursing considerations

Answer 22

bedrest and straight legs for 4-8 hours after, dressing change 1 day after procedure, hold pressure 1 inch above the bleeding site

Question 23

Purpose of digoxin

Answer 23

increases contractility by lowering conduction and increasing force

Question 24

Indications

Answer 24

HF, a fib/flutter, SVT

Question 25

Normal digoxin levels

Answer 25

0.8-2

Question 26

What needs to be monitored with digoxin levels

Answer 26

potassium

Question 27

Digoxin toxicity s/s

Answer 27

n/v, diarrhea, lethargy, bradycardia

Question 28

When to hold digoxin (HR)

Answer 28

HR <60 in adults, <90 in infants

Question 29

Max time to give missed dose of digoxin

Answer 29

no more than 4 hours after dose was supposed to be given