Perfusion

Question 1

Describe screening a neonate for perfusion problems.

Answer 1

screen all healthy newborns after 24hr of age,
pulse ox on right hand and one foot,
>95% in both and <3% difference

Question 2

Describe Ventricular Septal Defect.

Answer 2

septum not fully formed, has a hole,
oxygenated blood gets shunted back to lungs

Question 3

Identify key features of Ventricular Septal Defect.

Answer 3

left-to-right shunt,
pulmonary HTN,
pt acyanotic (looks normal)

Question 4

Describe the progression of Ventricular Septal Defect.

Answer 4

holes that do not close on their own can lead to heart failure, shows s/s of HF around 4-8 weeks.

Question 5

s/s of Ventricular Septal Defect

Answer 5

murmur,
fatigue,
tachypnea,
increased work to breathe

Question 6

Identify labs for Ventricular Septal Defect.

Answer 6

polycythemia:
increased hct, hgb, RBCs

Question 7

Identify test to diagnose Ventricular Septal Defect.

Answer 7

chest X-ray (enlarged heart),
EKG (dysrhythmias),
echocardiogram (blood flow through opening),
cardiac cath

Question 8

Identify treatment for Ventricular Septal Defect.

Answer 8

for small holes allow spontaneous closure up to 2yo,
surgical repair of larger holes (patch sutured into place)

Question 9

Describe nutritional needs with Ventricular Septal Defect.

Answer 9

high calorie intake (150 kcal/kg/day),
frequent feedings with rest periods