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Pediatrics 164 > Perfusion > Flashcards

Perfusion Flashcards

Exam 2

1
Q

What happens during the first breath?

A

pulmonary alveoli open
pressure in pulmonary tissue decreases
blood from R side of heart rushes to fill alveolar capillaries
decreased R side pressure
increased L side pressure increases

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2
Q

how to check perfusion

A

cap. refill, skin color/temp, level of consciousness, I&O, HR, O2 sat.,

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3
Q

Congenital heart defects:

A

in structures of great vessels, persistence of fetal structure, irregular rhythm, heart muscle deterioration

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4
Q

Acquired heart defects:

A

infection, autoimmune response, environment, familial tendencies

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5
Q

LUB

A

S1
closure of the mitral and tricuspid valve

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6
Q

DUB

A

S2
aortic and pulmonic closure

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7
Q

Systole

A

ventricular contraction

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8
Q

Diastole

A

ventricular relaxion

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9
Q

S3

A

occurs right after S2
Ventricular gallop
“Kentucky”

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10
Q

S4

A

right before S1
atrial gallop
“Tennessee”

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11
Q

Where is the child heart located?

A

<7 years, heart lies more horizontal, apex is higher in the chest
Below 4th intercostal space

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12
Q

Why are infants at a greater risk for heart failure?

A

immature heart is more sensitive to Vol. and pressure overload
less Dev. muscle fibers= limited functional capacity
less compliance, reduced stroke vol.

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13
Q

Focused heart assessment means:

A

Inspect- nutritional state, color, chest deformities, unusual pulsations, skin color changes when crying, sweating?, skin compared in all extremities, periorbital edema?
Palpate- chest, abdomen, peripheral pulses
Auscultation- HR, sounds, rhythm

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14
Q

Hepatosplenomegaly

A

R side under rib cage-liver
L side under rib- spleen
liver starts to drop down due to fluid buildup
Stop palpation if you feel the spleen

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15
Q

Hwat is the purpose of the Cardiac Catheterization?

A

information regarding O2 sat and pressure in the chambers, CO and function, vascular resistance, cardiac response to meds. and exercise

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16
Q

WHat is done in the cardiac cetheterization?

A

radiopaque catheter introduced into heart chambers through femoral vessel in children, radial in adults, umbilical in neonates
observed using fluoroscopy

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17
Q

Nursing care for Pre Cath.

A

bassline vitals, accurate height and weight, Hx allergies, ANY infection, assess/mark pedal pulses, NPO 4-6 hrs. before

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18
Q

Nursing care post Cath.

A

Pulse monitor, pressure dressing over cath. site, vitals, assess bleeding, assess neurovascular status of lower extremities, temp, cap refill, color of extremity, I&O, keep in bed for 6-8 hours after

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19
Q

4 categories of congenital heart defects:

A

increased pulmonary blood flow
decreased pulmonary blood flow
obstructed systemic blood flow
mixed systemic and pulmonary blood flow

20
Q

Atrial Septal Defect

A

hole in the atrium

oxygenated blood flows into the R side, too much blood in that side,
L-to-R shunt

21
Q

S+S Atrial septal defect:

A

RR up, HR up, resp. infections, diaphoretic, failure to thrive,

22
Q

Treatment of Atrial Septal Defect:

A

Amplatzer Septal Occluder

23
Q

Ventricular Septal Defect

A

hole in septum between ventricles
increased pulmonary blood flow, blood from R side goes to L side, very common in children, loud murmur,

24
Q

Patent Ductus Arteriosus

A

Blood shunts from L aorta to pulmonary artery R, increased pressure in lungs, pressure in aorta pushes back into the pulmonary vein, loud murmur, bounding radial pulse on exertion,

25
Q

Prostaglandins vs. NSAIDS

A

P= keep patent ductus arteriosus open
NSAIDS= closes

26
Q

Tetrology of Fallot

A

Pulmonary Stenosis, R ventricular hypertrophy, overriding aorta, ventricular septal defect

27
Q

Right ventricular hypertrophy

A

muscle gets bigger bc its working harder

28
Q

Overriding aorta

A

the vessel is inappropriately positioned, straddles L=R ventricle, deoxygenated blood flows back out into body

29
Q

Pulmonic Stenosis:

A

Valve narrows, not enough blood going through

30
Q

Ventricular Septal Defect

A

causes deoxygenated blood backflow

31
Q

When the child is hypoxic due to Tetrology of Fallot, will you give oxygen?

A

no. Giving O2 to these patients will not solve the problem, not an issue of the lungs, deoxygenated blood flows back out into the body

32
Q

Obstructive Defect

A

closed that should be open, narrowing to blood flow

33
Q

what is coarctation of the aorta

A

narrowing of aortic arch

34
Q

What does Coarctation of the Aorta cause?

A

obstruction of L ventricular blood flow, hypertrophy

35
Q

S+S Coarctation of the Aorta

A

high BP in upper extremities, low BP in lower extremities, bounding radial pulses, weak/absent popliteal and femoral pulses, nose bleeds, leg pain, fatigue, CHF

36
Q

Hypoplastic Left Heart Syndrome

A

L side of the heart is underdeveloped, hypoplasia of the aorta, keep PDA open

37
Q

S+S of impaired myocardial function:

A

Tachycardia, fatigue, weakness, restless, pale, cool extremities, decreased BP, decreased urine O

38
Q

What is an innocent murmur?

A

r/t the change in size of the heart to the thoracic cavity

39
Q

S+S pulmonary congestion:

A

tachypnea, dyspnea, respiratory distress, exercise, intolerance, cyanosis

40
Q

S+S systemic venous congestion:

A

peripheral and periorbital edema, weight gain, ascites, hepatomegaly, neck vein distension

41
Q

What is Rheumatic fever?

A

systemic inflammatory disease involving the joints, heart, CNS, skin, and subQ tissue.
follows A B-hemolytic streptococcal pharyngitis
antibodies cause lesions to dev. in joints, heart, and connective tissue

42
Q

What is the most common complication of Rheumatic Fever?

A

rheumatic heart disease

43
Q

Rheumatic Heart Disease Focused assessment:

A

jones criteria, fever, painful, swollen, red joints. Nosebleeds, skin rashes, SOB, chest pain, abnormal rhythm, abdominal pain

44
Q

Kawasaki Disease

A

acute systemic vasculitis of unknown cause affecting children <5 yrs

45
Q

What does Kawasaki Disease affect?

A

skin, blood vessels, mucous membranes, lymph system

46
Q

Kawasaki Disease S+S

A

Moderate to high fever (101-104) lasting at least 5 days unresponsive to antipyretics, Irritable, rash

47
Q
A

Pediatrics 164 (7 decks)

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