perfusion

Question 1

cardiac catheter interventions

Answer 1

invasive procedure
baseline vitals
O2
Hx of allergies (iodine/shellfish)
assess pressure dressing for bleeding
keep in bed for 6-8hrs
assess I/Os (contrast has diuretic effect)

Question 2

Increased pulmonary blood flow defects

Answer 2

ASD- atrial septal defect
VSD- ventricular septal defect
PDA- patent ductus arteriosus
AV canal- atrioventricular canal defect

Question 3

s/s left to right shunt / increased pulmonary blood flow

Answer 3

primary s/s: heart failure

decreased intake
increase calorie use (poor weight gain)
tachypnea
frequent URI’s
decreased compliance of lungs
abnormal openings (murmur)

Question 4

atrial septal defect

Answer 4

oxygenated blood is shunted from left side to right side
hole between two arterial chambers

Question 5

ventricular septal defect

Answer 5

increased pressure in left ventricle forces blood into right ventricle
hole between two ventricular chambers

Question 6

patent ductus arteriosus

Answer 6

blood shunts from left aorta to right pulmonary artery
returns to lungs and causes increased pressure in lung

LOUD murmur & bounding radial pulses

Question 7

decreased pulmonary blood flow defects

Answer 7

tetrology of fallot
right to left shunt

Question 8

s/s of decreased pulmonary blood flow

Answer 8

primary s/s: cyanosis

decreased exercise intolerance
TeT spells - heart spasms
CVA
poor weight gain

Question 9

tetrology of fallot defects

Answer 9

P ulmonary stenosis (backup of pressure in pulmonary artery)
R ventricular hypertrophy (right side works harder to get blood into narrowed area)
O verriding aorta (venous blood enters aorta - from L and R ventricles)
V sd (blood from right side goes into aorta)

Question 10

obstructed defects

Answer 10

pulmonary stenosis
aortic stenosis
coarctation of the aorta

Question 11

coarctation of the aorta

Answer 11

narrowing of aortic arch - obstruction of left ventricular bloodflow
lower extremities are diminished and effected

increased BP in upper extremities
decreased BP in lower extremities
delayed cap refills
pulmonary edema
leg pain/fatigue
nose bleeds
CHF

Question 12

mixed defects

Answer 12

hypoplastic left heart syndrome

left side of heart is underdeveloped

leads to CHF

Question 13

hypoplastic left heart syndrome

Answer 13

mixing of oxygenated and deoxygenated blood

PDA must stay open w use of prostaglandin E

Question 14

congestive heart failure

Answer 14

impaired myocardial function
pulmonary congestion
systemic venous congestion

Question 15

s/s congestive heart failure

Answer 15

tachycardia
fatigue
weakness
pale
cool extremities
exercise intolerance
cyanosis
weight gain
neck vein distention
decreased urine output
peripheral/periorbital edema
enlarged heart and liver

Question 16

CHF infant nutrition

Answer 16

save energy for feedings
high caloric formula soft nipple
smaller frequent feedings, NG feedings

Question 17

CHF medications

Answer 17

digoxin - slows and strengthens HR
check dose with another RN
hold if HR is under 90 bpm in infant or 70bpm in older children
digibond - digoxin antidote
no repeat dose
not given with food

Question 18

digoxin toxicity

Answer 18

nausea
vomiting
anorexia
bradycardia
dysrhythmias

Question 19

ACE inhibitors

Answer 19

betablockers - decreases BP and HR

monitor BP before and after administration
observe for hypotension
can cause renal dysfunction w/ diuretics

Question 20

rheumatic fever

Answer 20

J oints - severly painful
O carditis (mitral)
N odules - overbones, nontender
E rythema marginatum (rash)
S yndenham’s chorea (neuro movement disorder)

Question 21

kawasaki manifestations

Answer 21

extremely high temp, untreatable lasts for 5 days
C
R ash
A denopathy
S trawberry tongue
H ands/feet - desquamation

Question 22

treatment of kawasaki

Answer 22

IVIG within first 10 days- single infusion 10-12 hrs
aspirin for 2 weeks after IVIG