Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nurs 3032 > Test #2 > Flashcards

Test #2 Flashcards

1
Q

congenital heart disease

A

-Anatomical: abnormal cardiac function
-Present at birth
Clinical course results in
-Heart failure
-Hypoxemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acquired heart disorder

A

Disease process or abnormalities that occur after birth
Infection
Autoimmune responses
Environmental factors
Familial tendencies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Risk factors for congenital heart disease

A

Maternal diabetes or lupus
Medications during pregnancy (eg dilantin)
Substance use during pregnancy
Infections during pregnancy (rubella)
Low birth weight from intrauterine growth restriction
High birth weight babies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ECG

A
  • Measure the electrical activity of the heart
  • heart rate and rhythm
  • abnormal rhythms or conduction, ischemic changes
  • Bedside cardiac monitoring with ECG is common in peds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

echo

A

ultra high-frequency sound waves to produce an image of the heart’s structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MRI

A

Visualizes the structures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

cardiac Cath nursing care

A

Pre
-Sedation
-NPO 4-6 hours before

Post
-Vital signs
- *pulse below cath site (equal and symmetrical)
- May be a bit weaker for the first few hours after
- Q15 min
- Hypotension → hemorrhage
- Bleeding, hematoma formation
- Fluid intake
- Blood glucose levels
- More for infants (give dextrose if low)
- The child’s usual diet can be resumed as soon as tolerated, beginning with sips of clear liquids and advancing as the condition allows
- The child should be encouraged to void to clear the contrast material from the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

congenital heart disease

A

-Incidence: 12 per 1000 live births
-CHD is a major cause of death in the first year of life (after prematurity).
-Critical congenital heart disease (CCHD) is more severe and usually requires intervention early in life
-Pulse oximetry screening recommended review
-Done 24 hours after birth
-Test pulse ox from right hand
- >5% difference indicates problem
-The most common anomaly is ventricular septal defect (VSD).
-Often associated with other anomalies/chromosome abnormalities (trisomy 21, 13, 18).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Acyanotic hemodynamics

A

increased pulmonary blood flow
obstruction from the ventricles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Cyanotic hemodynamics

A

-decreased pulmonary blood flow
-mixed blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

increased pulmonary blood flow

A

-Atrial septal defect
-Ventricular septal defect
-patent ductus arteriosus
-antrioventrcilar canal defect

Abnormal connection between two sides of heart
Blood flows from higher pressure left side → lower pressure right side
Increased blood volume on right side of heart → Increases pulmonary blood flow
Decreased systemic blood flow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Obstruction from ventricles

A

-coarctation of aorta
-aortic stenosis
-pulmonic stenosis

Anatomic narrowing of blood vessel exiting the heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Decreased pulmonary blood flow

A

-Tetralogy of Fallot
-Tricuspid Atresia

Blood has difficulty exiting right side of heart via pulmonary artery
Pressure on right side increases, greater than left-sided pressure
Desaturated blood shunts to the left side of heart and in systemic circulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Mixed Blood Flow

A

-Transposition of great arteries
-total anomalous pulmonary venous return
-Truncus arteriosus
-Hypoplastic left heart syndrome

fully saturated systemic blood flow mixes with the desaturated pulmonary blood flow, causing a relative desaturation of the systemic blood flow.
Pulmonary congestion occurs because the differences in pulmonary artery pressure and aortic pressure favour pulmonary blood flow.
Cardiac output decreases because of a volume load on the ventricle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Clinical Consequences of Congenital Heart Disease

A

Hypoxemia
Polycythemia and clubbing
Hypercyanotic spells (tet spells/blue spells) –> Give 100% O2, morphine, IV fluid replacement, knee to chin position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

signs of digoxin toxicity

A

Nausea, vomiting, anorexia, bradycardia, dysrhythmias

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

chest xray

A

provides information on the heart size and pulmonary blood flow patterns, providing a baseline for future comparisons.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the leading cause of death after heart transplantation?

A

rejection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Vesicoureteral reflex

A

-Retrograde flow of urine from bladder to upper urinary tract (kidneys)
-Primary reflux related to anatomical abnormalities
-Secondary reflux related to acquired condition (eg. high bladder pressure, persistent PVRs or voiding dysfunction)
-Reflux increases chance for febrile UTI
-Reflux with infection is the most common cause for pyelonephritis
-Prevention with antibiotic prophylaxis
-Occasionally requires surgery
-Managed with daily low dose antibiotic until toilet independence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

nursing care for post op gender assignment surgery

A

-Tub baths often discouraged for 1 week after surgery
-Keep surgical site clean, monitor infection
-Some older children’s activities, such as pushing, lifting, playing with straddle toys or in sandboxes, swimming, and engaging in rough activities, may be restricted after some types of surgical repairs.
-Activities of infants and toddlers are not limited.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

dialysis

A

-The process of separating colloid and crystalline substances through a semipermeable membrane
-blood filtrate is circulated outside the body by hydrostatic pressure exerted across a semipermeable membrane with simultaneous infusion of a replacement solution.
-generally reserved for use in AKI, severe fluid overload, inborn errors of metabolism, or after bone marrow transplant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

peritoneal dialysis

A

-The preferred method of dialysis for children
-Abdominal cavity acts as semipermeable membrane for filtration
-Warmed solution enters peritoneal cavity by gravity, remains for period of time before removal
-The fluid and accumulated toxic wastes are then drained from the peritoneal cavity and a new cycle of fresh dialysis solution is reinstilled.
-Can be managed at home in some cases
-Performing this form of dialysis in the home can be empowering for families, especially adolescents.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

hemodialysis

A

-Requires surgical creation of a vascular access and special dialysis equipment
-Vascular access may be one of three types: fistulas, grafts, or external vascular access devices.
-Best suited for children who can be brought to facility three times/week for 4 to 6 hours
-Achieves rapid correction of fluid and electrolyte abnormalities
-can cause adverse effects in association with this rapid change, such as muscle cramping, headaches, nausea and vomiting, and hypotension
-Disadvantages
-School absence
-Strict fluid and dietary restrictions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Kidney Transplant

A

-Preferred treatment for children with ESRD
-From living related donor
-From cadaver donor
-Primary goal is long-term survival of grafted tissue
-Role of immunosuppressant therapy
-Prednisone, tacrolimus, cyclosporine, mycophenolate
-Taken indefinitely
-Rejection of the transplanted kidney is the most common cause of transplant failure.
-Rejection is treated aggressively with immunosuppressant medications and can often be reversed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

signs of increased ICP in infants

A

Tense, bulging fontanel
Separated cranial sutures
Macewen sign (cracked-pot sound on percussion)
Irritability and restlessness
Drowsiness, increased sleeping
High-pitched cry
Increased fronto-occipital circumference
Distended scalp veins
Poor feeding
Crying when disturbed
Setting-sun sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

symptoms of increased ICP in children

A

Headache
Nausea
Forceful vomiting
Diplopia, blurred vision
Seizures
Indifference, drowsiness
Decline in school performance
Diminished physical activity and motor performance
Increased sleeping
Inability to follow simple commands
Lethargy

27
Q

late signs of increased ICP

A

Bradycardia
Decreased motor response to commands
Decreased sensory response to painful stimuli
Alterations in pupil size and reactivity
Flexion or extension posturing
Cheyne-Stokes respirations
Papilledema
Decreased consciousness
Coma

28
Q

earliest indicator of changes in neuro status

A

level of consciousness

29
Q

obtundation

A

A severe reduction in LOC; the child arouses with very strong stimulus but is close to a comatose state

30
Q

stupor

A

Remaining in a deep sleep, responsive only to vigorous and repeated stimulation or moaning responses to stimuli

31
Q

persistent vegetative state

A

Permanently lost function of the cerebral cortex; eyes following objects only by reflex or when attracted to the direction of loud sounds, all four limbs spastic but can withdraw from painful stimuli, hands showing reflexive grasping and groping, face grimacing, some food may be swallowed, groaning or crying but without uttering any words

32
Q

GCS score indicating severe head injury and deep unresponsive coma (possibly brain death)

A

3 or less

33
Q

Neurological determination of death

A

-Complete cessation of brain function (no activity on EEG)
-Irreversibility of condition
-Absence of brain reflexes
-Absence of respiratory effort
-Etiology can cause neurological death

34
Q

Widely dilated and fixed pupils suggest

A

-herniation of the brain
-neurosurgical emergency

35
Q

decorticate/flexion posturing

A

seen with severe dysfunction of the cerebral cortex or with lesions to corticospinal tracts above the brainstem

36
Q

deceberate/extension posturing

A

sign of dysfunction at the level of the midbrain or lesions to the brainstem

37
Q

absence of corneal reflexes and presence of tonic neck reflex are associated with

A

severe brain damage

38
Q

evoked potentials (auditory and visual)

A

-Visual evoked potentials can aid in evaluating visual abnormalities from the retina to the visual cortex
-auditory evoked potentials are useful for assessing hearing acuity and brainstem function
-Both are particularly useful for detecting demyelinating diseases such as pediatric multiple sclerosis and neoplasms

39
Q

emergency management of the Unconscious Child

A

Patent airway, breathing, and circulation
Reduction of ICP
Treatment of shock
Stabilize spine if required

40
Q

non pharm techniques for kids with neurological issues

A

-Pain control
-a quiet, dimly lit environment
-limit visitors
-prevent any sudden, jarring movements, such as banging into the bed
-proper positioning
-prevention of the patient’s straining (coughing, vomiting, suctioning, and defecating)

41
Q

indications of ICP monitoring

A

-GCS of less than 8
-GCS evaluation greater than 8 with respiratory assistance
-Deterioration of condition
-Subjective judgment regarding clinical appearance and response

42
Q

gold standard ICP monitor

A

Intraventricular catheter
-A drainage bag attached to the system is kept at the level of the ventricles and can be lowered to decrease ICP.

43
Q

primary head injury

A

injuries that occur at time of trauma, include skull fracture, contusions, intracranial hematoma, and diffuse injury

44
Q

complications of head injuries

A

hypoxic brain damage, increased ICP, infection, cerebral edema

45
Q

most common head injury

A

concussion

46
Q

linear skull fracture

A

single fracture line, does not cross suture lines, majority of childhood fractures

47
Q

depressed skull fracture

A

bone is broken into several fragments that are pushed inward

48
Q

comminuted skull fracture

A

multiple associated linear fractures, may suggest maltreatment

49
Q

basilar skull fracture

A

involves bone at base of skull, very serious, racoon eyes, bleeding in ears, CSF from nose or ears

50
Q

open skull fracture

A

communication between skull and scalp, increase risk of infection

51
Q

growing skull fracture

A

skull fractures with underlying dural tear that fails to heal properly

52
Q

epidural hemorrhage

A

-Bleeding between dura and skull to form a hematoma
-Brain compression occurs rapidly
-Clinical picture - momentary unconsciousness → normal period → lethargy and coma

53
Q

subdural hemorrhage

A

-Bleeding between dura and arachnoid membrane
-Frequently result from birth trauma, falls, THI-CM
-S/S - irritability, vomiting, increased head circumference, bulging fontanels in infants, lethargy, or seizures

54
Q

acute symptomatic seizure

A

Associated with head trauma or meningitis

55
Q

remote symptomatic seizures

A

Prior brain injury such as head trauma, encephalitis, meningitis, or stroke

56
Q

cryptogenic seizure

A

no clear cause

57
Q

idiopathic seizure

A

genetic

58
Q

Focal (partial) seizures

A

-Local onset and involves a relatively small location of the brain
-Person maintains awareness but may not be able to talk
-Uncommon in kids under 8

59
Q

generalized seizures

A

-Involves both hemispheres without local onset
-Loss of awareness
-Generalized tonic clonic most common

60
Q

general absence seizure

A

Staring, no alterations in muscle tone (last 5-10 secs)

61
Q

atonic seizure

A

Sudden momentary loss of muscle tone (fall down)
Common in morning after waking up

62
Q

unknown onset seizure

A

-6-8 months of life
-Cognitive impairment
-Possible series of sudden, brief, symmetrical, muscular contractions
-Head flexed, arms extended, and legs drawn up
-Eyes sometimes rolling upward or inward
-May be preceded or followed by a cry or giggling

63
Q

management of seizures

A

-Medication therapy: antileptic
-Ketogenic diet: shifts from glucose metabolism to fat
-Vagus nerve stimulation: 12 and older
-Surgical therapy: if caused by hematoma, etc
-Treatment for status epilepticus: ABCs, Ativan
-Reduce harm during seizure
-Assess seizure activity (timing)
-If vomiting occurs, turn child to one side
-ABCs
-Assess for triggering factors

64
Q

key reflexes that demonstrate healthy neurological status in young infants

A

moro reflex
tonic neck reflex
withdrawal reflex

Nurs 3032 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions