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PEDs Exam 2 > Week 1 Cardiac > Flashcards

Week 1 Cardiac Flashcards

1
Q

Characteristics of Murmurs

A

Sounds like a clunk, woosh, gallop
Intensity - refers to the loudness
Location- where are you hearing it the loudest
Quality - is it musical, blowing, wooshing
Radiation - radiating throughout the cardiac cycle
Timing- before or after s1 or s2
Pitch

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2
Q

Grades of a Murmur

A

Grade I – VI
I & II usually innocent
III- VI pathology

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3
Q

Signs of possible cardiac dysfunction in early infancy history

A 
Too good a baby
Falling asleep during feedings
Growth failure
Continued skin or mucous membrane abnormal coloring after first few days
Dusky babies (blue, mottled)
Sweating especially on the head
Increased BMR
Lower respiratory tract infections
Any genetic, chromosomal or renal abnormality
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4
Q

Route of peripheral edema in infants

A

begins first in the face with infants - then presacral region and then extremities
Edema of lower extremities is characteristic of ventricular HF in older children

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5
Q

What is thought to cause clubbing

A

Vasodilation

Increased growth factor d/t increased metabolic demand

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6
Q

At what point is clubbing normally seen

A

After one year

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7
Q

Causes of CHD

A

Maternal or environmental = 1% to 2%
Maternal drug use: FAS—50% have CHD
Maternal illness- Rubella in first 7 weeks of pregnancy → 50% risk of defects including PDA and pulmonary branch stenosis
CMV, toxoplasmosis, other viral illnesses → cardiac defects
IDMs(infant of diabetic mother) = 10% risk of CHD (VSD, cardiomyopathy, TGA most common)
Chromosomal/genetic = 10% to 12%
Multifactorial = 85%

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8
Q

What is the most common congenital cardiac anomaly

A

VSD

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9
Q

Increase pulmonary blood flow leads to

A

CHF

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10
Q

Decrease pulmonary blood flow leads to

A

cyanosis

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11
Q

obstructed left hearts leads to CHF or cyanosis?

A

CHF

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12
Q

obstructed right heart lead to CHF or cyanosis?

A

cyanosis

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13
Q

Treatment for endocarditis

A

Treat 2-8 weeks. If antbx unsuccessful»CHF develops, valvular damage

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14
Q

Clinical manifestation of Rheumatic heart disease which is used for diagnosis

A

Carditis
Polyarthritis usually inflammation of large joints → knees, hips, shoulders - can migrate
Erythema marginatum - rash usually appearing on trunk, red macula with a clear center
Subcutaneous nodules - little nodules of boney prominences will persist indefinitely
Aschoff bodies- inflamed hemorrhagic boluses in heart, blood vessels,

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15
Q

Kawasaki disease Treatment

A

IVIG within 1st 10 days of illness
ASA 80-100/day for fever may continue for 5-6 weeks
coumdin if child is at risk for aneurism
3-5mg/kg/day of antiplatelet

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16
Q

S/S of kawaskis

A

peeling skin on hand and feet, lips become dry cracked and swollen, swollen”strawberry” tongue, irritable, fever w/o etiology
Most common side effect is inflammation and damage of the coronary arteries and swelling of the walls.

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17
Q

5 types of cardiomyopathy

A 
Contractility of myocardium is impaired
Secondary cardiomyopathy
Dilated cardiomyopathy ventricles that stretch to accommodate increased volume
Hypertrophic cardiomyopathy
Restrictive cardiomyopathy
18
Q

Therapeutic management of cardiomyopthay

A 
Correct underlying cause if possible
Often treatment is aimed at managing CHF and dysrhythmias
Fluids
Anticoagulants
Managing symptoms
19
Q

Pharamalogica intervention of cardiomyopathy

A

Digoxin (works well in peds pop, improves contractibility)
Diuretics
Lasix/Furosemide, Thiazides

20
Q

K wasting or sparing Lasix/Furosemide, Thiazides, spironolactone

A

Lasix/Furosemide wasting K
Thiazides wasting K
spironolactone sparing K

21
Q

Dig toxicity S/S

A

nomiting, neuro signs, visual disturbances

22
Q

Most common tachy dysrhythmia

A

SVT

23
Q

RX for tachy dysrhythmia

A 
Vagal maneuvers are the least invasive → ice bag to the face
IV adenosine (rapid bolus) is drug of choice
24
Q

Is secondary or primary HTN seen more in ped pop

A

secondary

25
Q

HTN generally secondary to structural abnormality or underlying pathology
such as what 3

A

Renal disease
CV disease
Endocrine or neurologic disorders

26
Q

placement of leads

A 
Brown (anywhere) 
Black- upper left
red- lower left
green- lower right
white-upper right
27
Q

What to assess in children pre-cath

A

Really important to have baseline H&H, perfusion assessment
Skin assessment
Distal pulses/pedal or radial
Vital signs q 1 min. apical pulse

28
Q

What to assess in children post cath

A

Looking at perfusion, pulses in affected leg
Vs q. 15 min.
Pulses
Check for bleeding & assess dressing - q 15 minutes for first hour, every hour for next four, and every four hours for next 24. Hoping to see clean white gauze. Apply pressure if gauze is bloody - until someone can come to help. VERY IMPORTANT NOT TO LEAVE.
Keep quiet 4 – 6 hrs don’t want to affect the site - arterial blood bleeds a lot & quickly

29
Q

syncope can be due to

A

abnormal rhythm, mitral valve prolapse, aortic stenosis, long QT syndrome

30
Q

Any murmurs that post birth that persist past how many days should be explored further?

A

2-3days

31
Q

increase Pul blood flow, no cyanosis occurs in what 3 defects

A

ASD, PDA, VSD

32
Q

decrease pul blood flow with cyanosis occurs in what defect

A

tetralogy of fallot

33
Q

Obstruction out of the heart in what 3 disorders

A

PS, AS, Coaraction

34
Q

Mixed flow in what three disorder; may have hypozemia with or without cyanosise

A

hypoplastic left heart, transpotion of the great vessels, truncus arterosis

35
Q

carditis involves the

A

endocardium, pericardium and mycoradium; most commonly the mitral valve

36
Q

Diagnosis of systemic HTN in peds needs how many high bp readings

A

3

37
Q

HTN generally secondary to structural abnormality or underlying pathology, what are the top three

A

Renal, CV, endocrine or neurological.

38
Q

Post procedure, checking cardiac cath site

A

q 15 for first hour, then q1hr for the next 4, then q4 for 24 hours. Do not leave it is bleeding!

39
Q

where would you check for skin tutor?

A

chest, abd, and upper thighs

40
Q

how often do you monitor K in NG sx

A

Q4

PEDs Exam 2 (3 decks)

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