Peds Cardiac Panopto Flashcards
1
Q
Is Heart Disease Congenital or Acquired?
A
Both
2
Q
What does it mean if a disease is Congenital?
A
You can be born with it
3
Q
When does screening for Cardiovascular Alterations start?
A
During Pregnancy
4
Q
What can be used to screen for Cardiovascular alterations in a baby?
A
Ultrasounds + Fetal Echocardiograms + Physical Examinations
5
Q
Can Cardiac Alterations be diagnosed without standard screenings?
A
Yes
6
Q
What can Congenital Heart Disease impact for kids?
A
Milestone Achievement + Psychosocial Development
7
Q
What holds a kid with heart disease back in terms of psychosocial development?
A
They can’t play sports
8
Q
Being held back in terms of psychosocial development can result in an increased need for-
A
Specialized Services (Learning Assistance + Physical Therapy + Occupational Therapy)
9
Q
What is an Acquired Disorder?
A
A disorder that is developed over the course of time
10
Q
What are some acquired heart disorders in kids?
A
Hypertension + Dyslipidemia
11
Q
What is Dyslipidemia?
A
High Cholesterol
12
Q
A kid with an Acquired Heart Disorder needs to change their diet, how can you get them to buy into changing it for the better?
A
Not by getting rid of all of the unhealthy stuff completely, but by limiting it.
Encourage Fiber Intake.
Work with the kid.
13
Q
An imbalance of the HDL and LDL Cholesterol, Triglycerides, etc. =
A
Dyslipidemia
14
Q
This occurs at the same that Atherosclerosis occurs =
A
Dyslipidemia
15
Q
What are the different types of Dyslipidemia?
A
Primary Dyslipidemia + Secondary Dyslipidemia
16
Q
What is the difference between Primary Dyslipidemia and Secondary Dyslipidemia?
A
Primary can’t be controlled, it’s genetic (Congenital).
Secondary can be controlled, it’s Acquired.
17
Q
Are food diaries be beneficial for kids with Primary Dyslipidemia?
A
Yes
18
Q
What % of people aged 16 to 19 have Dyslipidemia?
A
20%
19
Q
What are the signs of Dyslipidemia in kids? How’s it diagnosed?
A
Often Asymptomatic, diagnosed via Lab Values
20
Q
What lab value can diagnose Dyslipidemia?
A
A Lipid Panel
21
Q
What lab values make up a Lipid Panel?
A
Total Cholesterol Level / HDL Level / LDL Level / Triglyceride Level
22
Q
When do kids need to begin getting a universal screening?
A
9 Years Old
23
Q
What are some pharmacological treatments for Dyslipidemia?
A
Statins + Cholesterol Meds
24
Q
Early diagnosis of Dyslipidemia is critical in order to prevent-
A
Further progression
25
Dyslipidemia can increase the risk of what mental or social issues?
Bullying, Depression, Suicidal Ideation, etc.
26
When should cholesterol screenings begin?
Age 9
27
Should a kid with Dyslipidemia also get cardiac screenings?
Yes
28
How active should a kid be everyday?
They should be active or play for 1 hour a day
29
What should a teenage girl be promoted whenever they use Statins or Cholesterol Medication?
The use of Contraceptives + Communication with providers for breast feeding and pregnancy (Also in case they need to change meds after pregnancy)
30
What are some good diets for kids with Dyslipidemia?
Mediterranean Diet (Lots of fruits & vegetables + Lean Meats)
CHILD Diet
31
Tobacco is the number one risk factor for almost anything that’s-
Cardiovascular Related
32
Kids with Dyslipidemia should avoid foods like-
Red Meat + Baked Goods + Fried Foods + Butter + Full Fat Dairy
(Because they’ve got a lot of Cholesterol)
33
How often should a lipid panel be given for a kid with Dyslipidemia?
Every 3 months
34
Is a Ventricular Septal Defect going to be Acquired or Congenital?
Congenital
35
What is a Ventricular Septal Defect?
It’s when there is an opening in the Ventricular Septum, causing the oxygenated blood and deoxygenated blood to mix
36
What is the severity of Ventricular Septal Defect based on?
The size of the opening between the Ventricles
37
What are the different types of Ventricular Septal Deficit (VSD)?
Small VSD
Moderate VSD
Large VSD
38
What is a VSD the result of?
Genetic and Environmental Factors
39
What are the risk factors for Ventricular Septum Defect?
Any Other Genetic Anomalies, Premature Birth, Family History
40
Is VSD common or uncommon?
Common
41
What are the symptoms of a Large VSD?
Tachypnea, Failure to Thrive, Fatigue, Heart Murmur, Heart Failure
42
What is the primary diagnostic tool for a VSD?
An Echocardiogram
43
Aside from an Echocardiogram, what other tools can be used to diagnose a VSD?
A CT Scan, Chest X-Ray, MRI, Cardiac Catheterization
EKG (For further evaluation)
44
What are the treatments for a Small VSD?
Monitor the pt, a Small VSD will sometimes close on it’s own
45
What are the treatment options for a Moderate to Large VSD?
Pharmacologic Management + Potential Surgical Repair (For severe or persistent cases they use a patch to surgically close the hole)
46
What is an Atrial Septum Defect?
It’s the same thing as a Ventricular Septal Defect, but instead of a hole forming on the Ventricular Septum, it’s on the Atrial Septum
47
What is the cause of an Atrial Septal Defect?
Unknown, but it’s linked with whether or not the pregnant mother catches Rubella + If the child has Down Syndrome or Horner’s Syndrome
48
What are the Maternal risk factors of an ASD?
Lupus, Advanced Age, Rubella, Diabetes, Substance Abuse during Pregnancy
49
This is diagnosed in about 1.6 in 1,000 live births =
ASD
50
ASD makes up what percentage of Congenital Heart Defects?
15%
51
How are the Atrial Septum Defects classified?
Small + Large
52
What kind of symptoms does a Small ASD have in a baby?
Often Asymptomatic until Adulthood
53
What are the symptoms of a Large ASD in a baby?
Babies will have a Failure To Thrive + Edema + Arrhythmia + Pulmonary Hypertension + Recurrent Infections
54
Which Cardiac Landmark can be used to detect a Large ASD during Auscultation? What would it sound like?
You can hear a soft Systolic Murmur in the Pulmonic Area
55
What is primarily used to diagnose an ASD?
A Transthoracic Echocardiogram
56
Aside from a Transthoracic Echocardiogram, what else can be used to diagnose an ASD?
Chest X-Ray + MRI + CT Scan + EKG
57
After a pt has been diagnosed with an ASD, what can be used to further assess the issue?
A Cardiac Catheter
58
How often should a kid with an ASD be having check-ups with a Pediatric Cardiologist?
Throughout their entire childhood
59
When is Surgical Closure recommended for pt’s with ASD?
If there’s any Pulmonary Hypertension or Right-Sided Heart Enlargement
60
When can the Spontaneous Closure of an ASD occur?
On it’s own around 2 Years Old, still needs to be checked up on regularly though to ensure that’s the case
61
What is a Tetralogy of Flow?
A Congenital Heart condition that is made up of 4 Heart Defects
62
What are the 4 Heart Defects that make up a Tetralogy of the Heart?
Pulmonary Stenosis + VSD + Right Ventricular Hypertrophy + an Overriding Aorta
63
What is Pulmonary Stenosis?
Narrowed Pulmonary Arteries (Gives the lungs less blood flow)
64
What does it mean to have an Overriding Aorta?
It means that the Aorta is receiving blood from both Ventricles
65
Is there any concrete causes with how a Tetrallogy of the Heart occurs?
No
66
There are associations between a Tetralogy of the Heart and what other diseases?
Chromosomal Abnormalities + Maternal Health Conditions
67
Risk factors of a Tetralogy of the Heart =
While Pregnant:
Viral Illnesses + Advanced Age + Substance Abuse + Poor Nutrition + Environmental Exposures (Pollution, Pesticides, Toxic Metals, Solvents)
68
Is a Tetralogy of the Heart a very common Cyanotic Heart Defect?
Yes
69
If a baby has a Tetralogy of the Heart, their skin can be-
Blue
70
There’s approximately how many births annually that have a Tetralogy of Flow?
1,660
71
What are the symptoms of a Tetralogy of the Heart?
Vary from Asymptomatic to Severe Cyanosis and Heart Murmur
72
When can a Tetralogy of the Heart be diagnosed?
It can have a Pre-Natal (Before Birth) diagnosis
73
What can be used to diagnose a Tetralogy of the Heart before the baby is born?
Ultrasound + Fetal Echocardiogram
74
What can be used to diagnose a Tetralogy of the Heart after the baby is born?
Chest X-Ray + ECG + Echocardiogram
75
What’re some treatments that can be used for a baby with a Tetralogy of the Heart?
They can be put in a Knee-To-Chest Position in a calm and quiet environment
Supplemental Oxygen + Pharmacological Interventions (If Needed)
76
When will a surgical repair typically be given to babies with a Tetralogy if the Heart?
Between 2-6 months old (Depends on Severity)
77
At what age are you staring to become at risk for depression, anxiety, and mental health disorders if you have a Congenital Heart Defect?
6 Years Old
78
There is little risk of Neurodevelopmental or Neurocognitive Delays is kids with a Congenital Heart Defect.
True or false?
False (Social + Educational Supports will be needed)
79
Congenital Heart Defects can be financially draining on the parents, why?
Because it’s likely going to be a life-long problem the kid will have to deal with
80
What does a Childlife Specialist do in a hospital setting?
They will provide a child with things that they can do while in the hospital to let them feel more normal (Whether it be special experiences, etc.)
81
Really important things to teach a family with a kid who has a Congenital Heart Defect would include:
How to do Daily Weights, Dietary Guidelines, Fluid Intake Monitoring, Surgical Site Infection (SSI) Preventions
82
How can a Tetralogy of the Heart impact a pregnancy?
Depends on if it’s a Repaired Tetralogy of the Flow or Unrepaired Tetralogy of Flow
83
Increased effort during breast feeding can be an indicator of a-
Congenital Heart Defect
84
What can a Reduced Cardiac Output cause?
Reduced Baroreceptor Stimulation + Reduced Renal Perfusion
85
What does a Reduced Baroreception Stimulation cause?
Activation of the Sympathetic Nervous System
86
What does an Activated Sympathetic Nervous System do to your cardiovascular system?
Vasoconstriction + Increased Cardiac Contractility + Increased HR
87
What does Vasoconstriction, Increased Cardiac Contractility, and an Increased HR all lead to?
Myocardial Toxicity
88
What does Myocardial Toxicity lead to?
Myocardial Dysfunction
89
What does a Reduced Renal Perfusion result in?
Activation of the Renal Angiotensin Aldosterone System (RAAS System)
90
What does Activation of the RAAS System lead to?
Vasoconstriction + Sodium & Water Retention
91
What does Vasoconstriction + Sodium & Water Retention lead to?
Myocardial Apoptosis / Fibrosis
92
What does Myocardial Toxicity and Myocardial Apoptosis/Fibrosis lead to?
Myocardial Dysfunction
93
What does Myocardial Dysfunction cause?
Reduced Cardiac Output
94
Can heart failure be a secondary condition due to other cardiac conditions such as Cardiomyopathy?
Yes
95
What is it called when a mother is exposed to something that puts the baby at risk of getting a Congenital Heart Defect?
Tetragenic Exposure
96
What are the symptoms of Heart Faliure dependent on?
Age and Underlying Diagnosis
97
What are the signs and symptoms of Heart Failure in Infants?
Tachypnea + Diaphoresis During Feeding + Irritability + Poor Weight Gain
98
What are the signs and symptoms of Heart Failure in kids under 5?
Abdominal Pain + Decreased Appetite + Fatigue + Cough + Poor Weight Gain
99
What are the signs and symptoms of Heart Failure in kids over 5? (Adolescence)
Poor Appetite + Angina + Palpitations + Exercise Intolerance + Edema + Breathing Difficulties + Abdominal Pain + Syncope + Sinus Tachycardia
100
An Adolescent with Heart Failure has Sinus Tachycardia on their EKG, why are they experiencing this?
It’s Compensatory
101
What lab testing should you do for a pt with Heart Failure?
A BNP (The Main Heart Failure Marker) + Troponin (Cardiac marker that go’s up during a MI).
CBC (Complete Blood Count) + Iron + Electrolytes
LFT (Liver Function Test)
Creatinine & BUN (Kidney Functioning)
102
Aside from Lab Testing, what other things can be done to detect Heart Failure?
Chest X-Ray + EKG + Echocardiogram
103
What is the treatment of Heart Failure tailored to?
The severity of the cause and severity of the heart failure
104
Why would a pt with Heart Failure want to take Diuretics?
For the Edema
105
What meds would be for Chronic Heart Failure?
Digoxin + ACE Inhibitors + Beta Blockers + Surgical Interventions (Heart Transplant, Pacemaker)
106
Delayed Motor Skills are possible result of Heart Failure.
True or False?
True
107
How often should a pt with Heart Failure exercise?
For 60 minutes as tolerated a day
108
What is Dependant Edema? Is it a sign of Heart Failure?
Yes, it’s like if you let your arms hang down and your hands swell
109
What is Hypoplastic Left Heart Syndrome?
It’s whenever the left side of the heart is underdeveloped
110
What are the indications of Hypoplastic Left Heart Syndrome?
Mild Cyanosis + Heart Failure + Lethargy + Cold Hands & Feet
111
When is Hypoplastic Left Heart Syndrome completed?
It’s done in 3 Stages soon after Birth
112
What are the 3 different procedures/stages that make up the surgery done for Hypoplastic Left Heart Syndrome?
Norwood Procedure
Glenn Procedure
Fontan Procedure
113
What are the different Classifications of Cardiomyopathy?
Dilated
Hypertrophic
Restrictive
114
Most common classification of Cardiomyopathy =
Dilated
115
What is Hypertrophic Cardiomyopathy like?
Autosomal genetic increase in heart muscle mass that leads to Abnormal Diastolic Functioning
116
What is Restrictive Cardiomyopathy like?
Rare; Prevents filling of the ventricles and causes a decrease in Diastolic Volume
117
Risk factors of Cardiomyopathy?
Genetic + Infection + Electrolyte Deficiencies + Metabolic Conditions + Collagen Diseases + Drug Toxicity + Dysrhythmias
118
Symptoms of Cardiomyopathy =
Tachycardia + Dysthymia + Dyspnea + Hepatosplenomegaly + Fatigue / Poor Growth + Angina + Syncope + Poor Feeding in Infants
119
What is Dysthemia?
Mild, Long-Lasting Depression
120
What is a Hepatosplonomegaly?
Enlarged Spleen and Liver
121
What are some complications that can possibly occur with Cardiomyopathy?
Infection + Blood Clot
122
Is a Cradiac Cath invasive?
Yes
123
How can you enter a Cardiac Cath into the body?
The Groin or Wrist
(The wrist is preferable)
124
What can you call the dye that is inserted into the heart via a Cardiac Cath?
A Contrast Medium
125
A Diaper Rash can necessitate cancelling a procedure because of Infection Risk if-
Femoral Access or Groin Access is Required
126
A pt is about to have a Cardiac Cath inserted, what allergies should they be checked for?
Iodine and Shellfish
127
Why can a pt not have a Cardiac Cath if they are allergic to Shellfish?
Because Media Contrast is a Shellfish-Based Product
128
Should you ever lie to a kid pt about their Developmental Level?
Nah
129
Before a Cardiac Cath is inserted, how long should the pt be NPO before the operation?
4-6 Hours
130
Before a baby has a cardiac catheterization, can they at least have food via a at-home feeding tube?
No
131
Why is it important to document the Dorsalis Pedis and Pedal Pulse before a Cardiac Cath?
So that if an occlusion or blood clot occurs after the cardiac catheterization is over, it can be spotted quickly
132
Aside from pulse monitoring, what things need to be monitored post-operatively after a Cardiac Cath?
Provide Continuous Cardiac Monitoring & O2 Sat Monitoring
133
What things need to be assessed post-operatively after a Cardiac Cath?
Bradycardia, Hypotension, Dysrhythmias, Hypoxia
134
Should you have to count a pt’s HR for 30 seconds or one full minute post-operatively?
1 full minute
135
After a kid has a cardiac catheterization, how long should they maintain their affected extremity in a straight position for? Why?
4-8 Hrs, to prevent bleeding
136
A kid has a Heart Catheterization, how should you start off their intake?
Have them consume clear foods and drinks first and move up from there, babies should drink water before drinking milk again
137
Can bathing a baby drop their 02 sat?
Yes
138
Crying should be kept to a minimum in Cyanotic Children. Why?
To avoid making it worse
139
What position can you put a cardiac pt in to decrease workflow to the heart?
Put them in a seat or hold them in a 45 degree angle
Keep them in a Semi-Fowler’s or Fowler’s position while awake
140
If an infant is unable to feed, what is it called whenever you give their food to them directly into their stomach by using a syringe on their stomach tube?
Gavage Feeding
141
Is it possible to need a higher density formula of milk for pediatric babies?
Yes
142
For a Pediatric Client, how often should their O2 Sat be monitored?
Every 2 Hours
