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Families > Peds- Exam 2 > Flashcards

Peds- Exam 2 Flashcards

1
Q

Congenital heart disease usually stems from

A

Anatomic abnormalities often present at birth
can overall lead to heart failure and hypoxemia

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2
Q

What is heart failure

A

when the heart can’t pump enough blood to meet our body’s demands or needs

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3
Q

Pediatric vs. adult cardio

A

Children’s hearts are smaller and have rapid growth and very fast heart rates.
Children are also most likely to have congenital heart defects

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4
Q

ASD

A

hole between the atria > oxygen-rich blood mixes with deoxygenated blood ->increased blood flow to lungs

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5
Q

VSD

A

the hole between ventricles> oxygenated blood from left ventricle going into the right ventricle and then lungs - > increase blood flow

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6
Q

PDA

A

very common, open blood vessel, blood flows between aorta and pulmonary artery causes excess blood flow to lungs

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7
Q

Tetralogy of Fallot

A

four issues that reduce blood flow to the lungs, causing oxygen-poor blood to circulate in the body

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8
Q

ASD Signs & Symptoms

A

Loud harsh murmur -> fixed split-second heart sounds (LUSB)
heart failure
often asymptomatic

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8
Q

Coarctation of the aorta

A

narrpwing of aorta, near ductus arteriousus, bounding pulses, fainting, nose bleeds, lower extremities weak pulses

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9
Q

CHD Risk Factors

A

Maternal: Infection, alcohol/ substance abuse, dm
Genetic: Hx, trisomy 21, presence of other congenital anomalies or chromosomal abnormalities

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10
Q

VSD Signs & symptoms

A

loud, harsh murmur heard at LSB
Heart failure
(VSD often closes spontaneously early in life)

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11
Q

PDA Signs & symptoms

A

Systolic murmur (machine hum) because of persistent blood flow of the aorta to the pulmonary artery (mostly heard in systole)

wide pulse pressure (systolic rises because of increased blood flow, diastolic remains relatively low

often asymptomatic

RALES- because of excess flow you’ll have pulmonary congestion

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12
Q

Tetralogy of Fallot

A

Cyanosis at birth -> progressive over the first year of life.

systolic murmur

Episodes of acute cyanosis and hypoxia (tet spell) respiratory distress

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13
Q

Treatments VSD

A

Nonsurgical
- Observe for spontaneous closure *
-Closure during cat procedure
- diuretics to manage symptoms
Surgical
- pulmonary artery banding
- complete repair with a patch
symptom and family specific

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14
Q

what causes a tet spell

A

caused by a sudden decrease in the amount of blood flowing to the lungs
because you have increased light to left shunting or decreased pulmonary blood flow.

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15
Q

expected findings for Coarctation of the aorta

A

-^ Pressure in arms
-Bounding pulses on upper extremities
-decreased blood pressure in lower extremities
-weak/ absent femoral pulses
-heart failure in infants
- cool skin of lower extremities

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16
Q

Treatments ASD

A

Nonsurgical
-Closure during cardiac cath
-Diuretics for symptom management
- low dose aspirin 6 months after procedure (cath)
Surgical
- patch closure
- cardiopulmonary bypass

17
Q

Treatments PDA

A

Nonsurgical
-Diuretics
- Indomethacin (promotes closing of PDA)
- poor feeding so work on extra calories

17
Q

Treatments of tetralogy of Fallot

A

Surgical (must be done within 1st year of life)
-shunt placement until able to undergo primary repair
-complete repair within the first year of life

18
Q

Treatment Coarctation of aorta

A

Nonsurgical
-infants & children: balloon angioplasty
-Adolescents: placement of stents
Surgical
-repair of defect recommended for infants less than 6 months of age

19
Q

Nursing Consideration
PDA

A
  • Monitor vitals
    -Medication administration (give indomethacin -> look for GI symptoms)
    -nutritional support ( provide extra calories and monitor growth)
    -Post-procedure care (education)
20
Q

Nursing Consideration
COA

A

-Vital signs (BP in both upper and lower extremities-> key indicator ^ in arms decrease in legs)
-Pulse checks (assess for bounding pulses in the upper, check for a weak or absent femoral pulse
-Skin temp. ( observe for cold lower extremities)
-symptom monitoring ( headaches, nosebleeds, heart failure, poor feeding)

21
Q

Nursing Consideration
VSD

A

-Monitor 4 Heart failure
(assess resp. distress, poor feeding, edema)
- Medication Management
(diuretic to manage fluid overload)
-Growth & Development
(make sure proper growth)
-Patient & Family Education
(educate on worsening signs & symptoms of heart failure, discuss follow-up care, etc.

22
Q

Nursing Consideration
ASD

A

-Assess heart sounds & Symptoms
(listen for murmurs, monitor for fatigue or resp. issues)
-Medication and post-procedure care
(administer diuretics, monitor for complications)
- educate and follow up
( explain signs of complications and the importance of low-dose aspirin (because of clotting risk and only if prescribed, stress follow-up appointments )

23
Q

How does Rheumatic Fever occur

A

usually happens after A strep infection.
-if not treated properly or recognized

24
Q

Labs for Rheumatic Fever

A

Sore throat = throat culture GABHS
Blood antistreptolysin O titer- most reliable diagnostic test
CRP-elevated in response to an inflammatory reaction
Erythrocyte sedimentation rate - response to inflammation

24
Q

Rheumatic fever diagnostic Jones criteria

A

Minor: fever, arthralgia
Major: carditis, subcutaneous nodules, polyarthritis, rash, chorea ( neurological)

25
Q

Signs & Symptoms for Rheumatic Fever

A

Recent upper resp. infection
fever (high 5 days- to a week)
pericardial friction tub
painful swelling in large joints
involuntary facial movements
pink, nonpruritic macular rash (trunk and inner surface if extremities)
^HR

25
Q

Jones Criteria

A

demonstrate at least 2 major criteria or one major 2 minors

26
Q

Medication for rheumatic fever

A

antibiotic prophylaxis - treatment will vary depending on the damage to the heart patient-specific can range from 5 years to indefinitely

27
Q

what medications are used to help with rheumatic fever

A

two daily doses of penicillin V
monthly IM injection of penicillin G
daily oral dose of sulfadiazine

28
Q

Nursing Consideration for rheumatic fever

A

rest during the acute phase, proper nutrition, seeking care for recurring infection, follow-ups with cardiologist,

29
Q

Kawasaki Disease

A

acute systemic vasculitis, inflammation in artery walls including coronary which supply blood to the heart muscle
AKA: mucocutaneous lymph node syndrome

30
Q

Kawasaki Expected findings Acute

A

Fever: 5 days - 2 weeks
Irritability: Bloodshot eyes
Strawberry tongue: tell-tale sign ( red tongue white coating/ bumps)
Oral Mucosa: red
swelling to extremities- hands and feet
Rash- no blistering
Painful Joints
Lymphedema- enlarged lymph nodes
Desquamation- perineum area
Cardiac- myocarditis decreases left ventricular function

31
Q

Kawasaki Expected findings Sub Acute

A

Fever
Irritability
Skin
Arthritis

32
Q

Kawasaki Expected findings Convalescent phase

A

Manifestations: no symptoms except altered laboratory findings
Resoluution: about 6-8 weeks from onset

33
Q

Nursing consideration Kawasaki

A

Monitor Vital signs
Assess heart failure
Track I&O, Daily weight
IV Fluids
Diet- , nonacidic due to pain liquid
Medication Consideration- IV Gamma Globulin: modulates immune response to prevent complications (Given within first 10 days of symptoms)
aspirin- anti-inflammatory, antiplatelet
*Comfort care: no hot baths, no scented soaps, offer lip balm, proper oral care

34
Q

Labs for Kawasakis

A

Labs: CBC, CRP, ESR ( might see elevated liver enzymes reflecting the extent of systemic inflammation)

35
Q

Diagnostics for Kawasaki

A

Chest X-ray, echo, EKG (looking for myocarditis and prolonged PR Intervals or non-specific st and t waves)
Lumbar puncture: looking for aseptic meningitis and inflammation

36
Q

Nursing Education for Kawasaki

A

-Maintain follow-up appointments,
-monitor for complications carditis, inflammation of blood vessels, Afib, irregular heartbeats, embolism

  • blood and urine testing
37
Q
A

Families (5 decks)

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