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Peds > Peds Cardiac > Flashcards

Peds Cardiac Flashcards

1
Q

what are the congenital heart diseases that occur due to decreased pulmonary blood flow?

A

Tetralogy of Fallot

Tricuspid Atresia

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2
Q

what are the congenital heart diseases that occur due to increased pulmonary blood flow?

A

▪ ASD
▪ VSD
▪ AV Canal
▪ PDA

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3
Q

what are the congenital heart diseases that occur due to obstructive blood flow?

A

▪ Coarctation of the
Aorta
▪ Aortic Stenosis
▪ Pulmonary Stenosis

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4
Q

what are the four defects associated with tetralogy of fallot?

A

▪ Right Ventricular Hypertrophy
▪ Overriding Aorta
▪ Pulmonary Stenosis
▪ VSD

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5
Q

what is a key symptom of tetralogy of fallot?

A

Hypercyanotic spells or “Tet
Spells”

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6
Q

how should you treat Hypercyanotic spells or “Tet
Spells”?

A

▪ Use a calm, comforting
approach
▪ Place in a knee-to-chest
position
▪ Provide supplemental
oxygen
▪ Administer Morphine (IV,
IM, or SQ)
▪ Supply IV fluids

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7
Q

what is tricuspid atresia?

A

▪ Tricuspid valve does not
develop in utero
▪ Blood does not go directly
into the right ventricle
▪ Deoxygenated blood passes
through the atrial septum
(PFO)
▪ Blood mixing at Pulmonary
Artery and Aorta

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8
Q

what is an atrial septal defect?

A

Hole in the wall dividing
the left and right atria

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9
Q

what symptoms would you expect to see in a kid with an atrial septal defect?

A

▪ Often asymptomatic
▪ Increased blood flow
results in SOB, fatigue, and
failure to thrive (FTT) over
time

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10
Q

what is a ventricular septal defect?

A

hole in the wall between the left and right ventricles

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11
Q

what symptoms would you expect to see in a kid with a ventricular septal defect?

A

▪ Asymptomatic if small
▪ Left to right shunt
▪ Loud, harsh murmur
▪ Increased flow to lungs leading
to PHTN
▪ Heart failure if not repaired
▪ FTT

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12
Q

what is an atrioventricular canal?

A

failure of endocardial cushions to fuse

tricuspid and mitral valves do not get separated

ASD and VSD are present

Left to right shunting

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13
Q

what is the second most common congenital heart defect?

A

patent ductus arteriosus

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14
Q

what is patent ductus arteriosus?

A

can occur to accommodate right and left shunting diseases

an extra blood vessel found in babies before birth and just after birth

persistent connection between aorta and pulmonary artery

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15
Q

what would you expect to see in a kid with a coarctation of the aorta?

A

Narrowing of the lumen of the aorta
▪ BP in all 4 extremities
▪ Upper will be higher than lower

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16
Q

what would you expect to see in a kid with aortic stenosis?

A

Restricted blood flow from left ventricle
to aorta
▪ Typically, asymptomatic
▪ FTT
▪ Faint pulses
▪ Easy fatigue
▪ Chest pain

17
Q

what would you expect to see in a kid with pulmonary stenosis?

A

▪ Restricted blood flow from right ventricle
to pulmonary artery
▪ Typically, asymptomatic
▪ FTT
▪ Faint pulses
▪ Easy fatigue
▪ Chest pain

18
Q

Nursing management of CHD

A

▪ Medications as
prescribed
▪ Improve Oxygenation
▪ Frequent assessments
▪ Semi-Fowlers
▪ Use oxygen sparingly*
▪ Weigh often
▪ Allow for activity and
rest
* Adequate Nutrition
* Family Coping/Education
* Infection prevention

19
Q

what are some common signs and symptoms we see in children with heart failure?

A

▪ Sweating during feeds
▪ Poor feeding
▪ Increase WOB
▪ Decreased UOP
▪ Poor cardiac output:
▪ Low BP
▪ Tachycardia
▪ Mottled, pale skin
▪ Fluid overload
▪ Edema
▪ Crackles in lungs

20
Q

who is at risk for getting infective endocarditis?

A

Patients with CHD, prosthetic valves,
and central lines place a child at risk

21
Q

what are the causes of infective endocarditis?

A

▪ Bacteria or fungi gain access to
epithelium
▪ Can carry to other parts of the body

22
Q

what are the symptoms associated with infective endocarditis?

A

▪ Vague flu-like
▪ Fatigue
▪ Anorexia or weight loss

23
Q

what is the treatment for infective endocarditis?

A

Antibiotics or antifungal–long course
▪ Approximately 4-6 weeks

24
Q

what happens during cardiomyopathy?

A

myocardium cannot contract properly

25
Q

what is the cause of cardiomyopathy?

A

most commonly idiopathic (condition that arises spontaneously and the cause is unknown)

26
Q

what can cardiomyopathy lead to?

A

heart failure

27
Q

what is usually the treatment for cardiomyopathy?

A

transplant

28
Q

nursing management for cardiomyopathy?

A

▪ Monitor for clots
▪ Vasoactive medications
▪ Diuretics
▪ Allow some activity, but promote rest*

29
Q

what causes acute rheumatic fever?

A

delayed sequela of group A strep infection

30
Q

when does rheumatic fever develop?

A

2-4 weeks after initial infection

31
Q

what does rheumatic fever do to the body?

A

▪ Affects joints, CNS, skin, and subcutaneous tissue
▪ Causes chronic, progressive damage to the heart and valves

32
Q

how do we diagnose rheumatic fever?

A

modified jones criteria

33
Q

what are the treatments for rheumatic fever?

A

antibiotics
NSAIDS
corticosteroids

34
Q

what is the definition of hypertension in kids?

A

> 95th % for gender, age, weight

35
Q

what do we see when assessing a kid with hypertension?

A

▪ Growth retardation
▪ Obesity

36
Q

what are the treatments for hypertension?

A

▪ Weight reduction
▪ Diet changes
▪ Increased activity
▪ Pharmacological treatment

37
Q

what are the signs and symptoms of a cardiac tamponade?

A

▪ Sudden cessation of chest tube
drainage
▪ Hypotension
▪ Muffled heart sounds
▪ Decreased systemic perfusion
▪ Narrowing pulse pressures
▪ Widening mediastinum on chest
x-ray
▪ Increased right and left atrial
pressures

38
Q

what are the pharm interventions for heart failure?

A

▪ Diuretics –decrease preload
▪ furosemide (Lasix) and spironolactone (Aldactone)
▪ Monitor labs and I/O’s closely

▪ Positive inotropic agents - contractility
▪ digoxin (Lanoxin)
▪ Hold digoxin for HR < 90 (infants) and < 60 (adolescents)
▪ Dopamine, Dobutamine, Epinephrine

▪ Vasodilators – decrease afterload
▪ Nitroglycerin, captopril (Capoten), nitroprusside (Nipride)

39
Q

Hold digoxin for HR < __(infants) and < ___(adolescents)

A

90, 60

Peds (4 decks)

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