Pediatrics Test 2: Cardiovascular Flashcards
In the newborn what does the firemen ovale do?
Natural opening as part of fetal circulation
In the newborn heart what is the job of the patent ductus?
Bypasses the system
Allows blood flow to be relieved from going to lungs
What direction does blood flow I. The newborn heart and why?
Right to left and pressure gradients cause this
What happens if too much blood goes to the lungs
Develop heart failure
What keeps the ductus open?
Prostaglandin E
What type of pressure does the blood flow too?
From high to low
Where in the heart is resistencia lower?
Pulmonary circulation rather then systemic
What are different tests for cardiac function?
Chest X-ray, EKG, cardiac echo, cardiac catherization
What can a chest X-ray show us?
Heart size and configuration
Pattern of blood flow
What can an EKG tell us?
Measures electrical activity of heart
What can a cardiac echo show us?
Detects structure and blood flow in heart
What is cardiac catherization and what can it show us?
Invasive procedure
Tells us oxygen saturation of blood at different parts in heart
Measures pressure changes
What are complications with cardiac catherization?
Active hemorrhage Low grade fever Nausea and vomiting Loss of Paul in cateterized extremity Dysrhythmia
What are nursing measures for cardiac catherization?
Per procedural height and weight Assess for signs on infection Preparation of child and patient Temperature and extremities color Vital signs
We. Does congenital heart disease cause rik or mortality
Unprepared heart defects
What immunizations are live when administered?
MMR
Rotavirus
Varicella
What are some nursing measures for congenital heart disease?
Recognize need to grieve
Help family
Educate need for social development
Facilitate peer support
What is heart failure?
Inability of heart to pump an adequate amount of blood to the systemic circulation at normal pressures to meet the metabolic demands of the body
What are signs and symptoms of impaired myocardial function in heart failure?
Tachycardia Sweating Decreas urine output Fatigue Anorexia Pale, cool extremities Weak peripheral pulse Cardio mealy Fi,ure to thrive
What are signs of pulmonary congestion in heart failure?
Tachypnea Dyspnea Crackles in lungs Retractions Flaring nares Exercise intolerance Orthopnea Gruntin
What are signs of systemic congestion in heart failure?
Hepatomegaly
Peripheral edema
Ascities
Neck vein distention
What is the treatment for heart failure?
Improve cardiac function to get blood from the system
Remove accumulated fluid and sodium
Decrease cardiac demands by decreasing activity
Improve tissue oxygenation and decrease oxygen consumption
Heart failure nursing measures
Safe administration of medications, have 2 nurses check
Encourage parents to stay with child for comfort and encourage rest
Smaller more frequent feelings
Minimize stress
Support and reassure
Digoxin: apical pulse
Greater then 90-110 beats per minute
Must do prior to giving
Digoxin: Apical pulse in older children
Greater then 70 beats per minute
Digoxin: therapeutic serum level
Narrow range
0.8 - 2 mcg/L
Digoxin. Signs of toxicity
Nausea Vomiting Anorexia Bradycardia Dysrhythmias
Digoxin: antidote
Digoxin immune fab
What is bacterial endocarditis?
Infection of the valves and inner lining of heart
What is the cause of bacterial endocarditis?
Streptococcus viridans
Clinical manifestation of bacterial endocarditis?
- insidious onset
*splinter hemorrhage under nails
*osler nodes: red, painful intra dermal nodes found on pads of phalanges - janeway lesion: painless hemorrhage area on palms and soles
unexplained fever
Anorexia
Malaise
Weight loss
Treatment for bacterial endocarditis?
High dose antibiotics for 2-8 weeks
Nursing measures for bacterial endocarditis?
Pantaloon education regarding prevention and early identification
SBE precautions of bacterial endocarditis
Administration of prophylactic antibiotics one hour prior to procedure know. To increase risk on entry of organisms
What is rheumatic fever?
Diffuse inflammatory systemic disease of the connective tissue that is an upper respiratory infection with streptococcus
What’s f the major manifestation of rheumatic fever?
Carditis: inflammation of heart muscle
Poly arthritis: multiple joint pain
Chorea: involuntary movement
Erythema marginatum: redness of trunk or proxymsk part of limbs
Subcutaneous nodules: non-tender swelling
What are minor manifestations of rheumatic fever?
Fever
Arthralgia
History of rf or rf heart disease
How do you make the diagnosis of rheumatic fever?
Diagnosis of 2 major manifestations or 1 major and 2 minor manifestations
How do you treat rheumatic fever?
Penicillin: antibiotic of acute infection
Salicylates: for inflammation, fever and discomfot
Bed rest
Education for compliance
Emotional support
