Pediatrics Test 2: Cardiovascular

Question 0

In the newborn what does the firemen ovale do?

Answer 0

Natural opening as part of fetal circulation

Question 1

In the newborn heart what is the job of the patent ductus?

Answer 1

Bypasses the system

Allows blood flow to be relieved from going to lungs

Question 2

What direction does blood flow I. The newborn heart and why?

Answer 2

Right to left and pressure gradients cause this

Question 3

What happens if too much blood goes to the lungs

Answer 3

Develop heart failure

Question 4

What keeps the ductus open?

Answer 4

Prostaglandin E

Question 5

What type of pressure does the blood flow too?

Answer 5

From high to low

Question 6

Where in the heart is resistencia lower?

Answer 6

Pulmonary circulation rather then systemic

Question 7

What are different tests for cardiac function?

Answer 7

Chest X-ray, EKG, cardiac echo, cardiac catherization

Question 8

What can a chest X-ray show us?

Answer 8

Heart size and configuration

Pattern of blood flow

Question 9

What can an EKG tell us?

Answer 9

Measures electrical activity of heart

Question 10

What can a cardiac echo show us?

Answer 10

Detects structure and blood flow in heart

Question 11

What is cardiac catherization and what can it show us?

Answer 11

Invasive procedure
Tells us oxygen saturation of blood at different parts in heart
Measures pressure changes

Question 12

What are complications with cardiac catherization?

Answer 12

Active hemorrhage 
Low grade fever
Nausea and vomiting
Loss of Paul in cateterized extremity
Dysrhythmia

Question 13

What are nursing measures for cardiac catherization?

Answer 13

Per procedural height and weight
Assess for signs on infection
Preparation of child and patient
Temperature and extremities color
Vital signs

Question 14

We. Does congenital heart disease cause rik or mortality

Answer 14

Unprepared heart defects

Question 15

What immunizations are live when administered?

Answer 15

MMR
Rotavirus
Varicella

Question 16

What are some nursing measures for congenital heart disease?

Answer 16

Recognize need to grieve
Help family
Educate need for social development
Facilitate peer support

Question 17

What is heart failure?

Answer 17

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

Question 18

What are signs and symptoms of impaired myocardial function in heart failure?

Answer 18

Tachycardia
Sweating
Decreas urine output
Fatigue
Anorexia
Pale, cool extremities 
Weak peripheral pulse
Cardio mealy
Fi,ure to thrive

Question 19

What are signs of pulmonary congestion in heart failure?

Answer 19

Tachypnea
Dyspnea
Crackles in lungs
Retractions
Flaring nares
Exercise intolerance
Orthopnea
Gruntin

Question 20

What are signs of systemic congestion in heart failure?

Answer 20

Hepatomegaly
Peripheral edema
Ascities
Neck vein distention

Question 21

What is the treatment for heart failure?

Answer 21

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

Question 22

Heart failure nursing measures

Answer 22

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

Question 23

Digoxin: apical pulse

Answer 23

Greater then 90-110 beats per minute

Must do prior to giving

Question 24

Digoxin: Apical pulse in older children

Answer 24

Greater then 70 beats per minute

Question 25

Digoxin: therapeutic serum level

Answer 25

Narrow range

0.8 - 2 mcg/L

Question 26

Digoxin. Signs of toxicity

Answer 26

Nausea
Vomiting
Anorexia
Bradycardia
Dysrhythmias

Question 27

Digoxin: antidote

Answer 27

Digoxin immune fab

Question 28

What is bacterial endocarditis?

Answer 28

Infection of the valves and inner lining of heart

Question 29

What is the cause of bacterial endocarditis?

Answer 29

Streptococcus viridans

Question 30

Clinical manifestation of bacterial endocarditis?

Answer 30

• 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

Question 31

Treatment for bacterial endocarditis?

Answer 31

High dose antibiotics for 2-8 weeks

Question 32

Nursing measures for bacterial endocarditis?

Answer 32

Pantaloon education regarding prevention and early identification

Question 33

SBE precautions of bacterial endocarditis

Answer 33

Administration of prophylactic antibiotics one hour prior to procedure know. To increase risk on entry of organisms

Question 34

What is rheumatic fever?

Answer 34

Diffuse inflammatory systemic disease of the connective tissue that is an upper respiratory infection with streptococcus

Question 35

What’s f the major manifestation of rheumatic fever?

Answer 35

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

Question 36

What are minor manifestations of rheumatic fever?

Answer 36

Fever
Arthralgia
History of rf or rf heart disease

Question 37

How do you make the diagnosis of rheumatic fever?

Answer 37

Diagnosis of 2 major manifestations or 1 major and 2 minor manifestations

Question 38

How do you treat rheumatic fever?

Answer 38

Penicillin: antibiotic of acute infection
Salicylates: for inflammation, fever and discomfot
Bed rest
Education for compliance
Emotional support