Perfusion

Question 1

What happens during the first breath?

Answer 1

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

Question 2

how to check perfusion

Answer 2

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

Question 3

Congenital heart defects:

Answer 3

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

Question 4

Acquired heart defects:

Answer 4

infection, autoimmune response, environment, familial tendencies

Question 5

LUB

Answer 5

S1
closure of the mitral and tricuspid valve

Question 6

DUB

Answer 6

S2
aortic and pulmonic closure

Question 7

Systole

Answer 7

ventricular contraction

Question 8

Diastole

Answer 8

ventricular relaxion

Question 9

S3

Answer 9

occurs right after S2
Ventricular gallop
“Kentucky”

Question 10

S4

Answer 10

right before S1
atrial gallop
“Tennessee”

Question 11

Where is the child heart located?

Answer 11

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

Question 12

Why are infants at a greater risk for heart failure?

Answer 12

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

Question 13

Focused heart assessment means:

Answer 13

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

Question 14

Hepatosplenomegaly

Answer 14

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

Question 15

Hwat is the purpose of the Cardiac Catheterization?

Answer 15

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

Question 16

WHat is done in the cardiac cetheterization?

Answer 16

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

Question 17

Nursing care for Pre Cath.

Answer 17

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

Question 18

Nursing care post Cath.

Answer 18

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

Question 19

4 categories of congenital heart defects:

Answer 19

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

Question 20

Atrial Septal Defect

Answer 20

hole in the atrium

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

Question 21

S+S Atrial septal defect:

Answer 21

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

Question 22

Treatment of Atrial Septal Defect:

Answer 22

Amplatzer Septal Occluder

Question 23

Ventricular Septal Defect

Answer 23

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

Question 24

Patent Ductus Arteriosus

Answer 24

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,

Question 25

Prostaglandins vs. NSAIDS

Answer 25

P= keep patent ductus arteriosus open NSAIDS= closes

Question 26

Tetrology of Fallot

Answer 26

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

Question 27

Right ventricular hypertrophy

Answer 27

muscle gets bigger bc its working harder

Question 28

Overriding aorta

Answer 28

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

Question 29

Pulmonic Stenosis:

Answer 29

Valve narrows, not enough blood going through

Question 30

Ventricular Septal Defect

Answer 30

causes deoxygenated blood backflow

Question 31

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

Answer 31

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

Question 32

Obstructive Defect

Answer 32

closed that should be open, narrowing to blood flow

Question 33

what is coarctation of the aorta

Answer 33

narrowing of aortic arch

Question 34

What does Coarctation of the Aorta cause?

Answer 34

obstruction of L ventricular blood flow, hypertrophy

Question 35

S+S Coarctation of the Aorta

Answer 35

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

Question 36

Hypoplastic Left Heart Syndrome

Answer 36

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

Question 37

S+S of impaired myocardial function:

Answer 37

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

Question 38

What is an innocent murmur?

Answer 38

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

Question 39

S+S pulmonary congestion:

Answer 39

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

Question 40

S+S systemic venous congestion:

Answer 40

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

Question 41

What is Rheumatic fever?

Answer 41

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

Question 42

What is the most common complication of Rheumatic Fever?

Answer 42

rheumatic heart disease

Question 43

Rheumatic Heart Disease Focused assessment:

Answer 43

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

Question 44

Kawasaki Disease

Answer 44

acute systemic vasculitis of unknown cause affecting children <5 yrs

Question 45

What does Kawasaki Disease affect?

Answer 45

skin, blood vessels, mucous membranes, lymph system

Question 46

Kawasaki Disease S+S

Answer 46

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