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Health and Illness 4 : Part2 > week 3 : cardiac care peds > Flashcards

week 3 : cardiac care peds Flashcards

1
Q

what can go wrong ?
name the 2 things that could go wrong ?

A

congenital heart effect ( CHD )
acquired heart disorders (AHD)

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2
Q

describe what congenital heart defect means ?

include some examples

A

anatomical abnormalities present at birth

examples :
ventricular septal defect (VSD )
tetralogy of fallot (4 heart defects)

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3
Q

what undergoes acquired heart disorders ( AHD ) : what is this description

give examples

A

disease or abnormalities that occur after birth

examples:
infection
autoimmune responses
environmental factors
family tendencies

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4
Q

what is this describing : child is born with a heart has not formed normally in utero

A

congenital heart defect ( CHD )

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5
Q

what is ventricular septal defect

A

when the child is born with an opening between the two ventricles, normally these chambers are not connected but with a vsd there is an opening.

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6
Q

true or false. VSD there is an opening and this can be very small opening, so for these children when there’s small opening there wont be alot of abnormalities cardiac functioning

A

true

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7
Q

true or false. Another kid could be born with a large opening or multiple opening between the ventricles - large opening allows blood move abnormally to the heart , left ventricle is under higher pressure than the right , blood moves from high to low pressure - oxygenated move to deoxygenated - more impact

A

true

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8
Q

tetralogy of fallot ( 4 heart defects )
what are the 4 defects

A

overriding aorta
ventricular septal defect
right ventricular hypertrophy
pulmonic stenosis

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9
Q

what is right ventricular hypertrophy

A

it is thicken - this right ventricle has large volume of blood flow
pump harder to try to keep up with workload

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10
Q

what is pulmonic stenosis

A

pulmonary vein is more narrow allowing less blood to leave the ventricle with each contraction
and so again that would contribute to increased volume in the right ventricle

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11
Q

when would acquired heart disorders ( ADH ) occur ?

A

during their childhood

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12
Q

recall that infection undergoes acquired heart disorders (AHD)

A

cardiac infection for example : after covid infection myocardititis , inflammation in the heart muscle

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13
Q

what undergoes environmental factors for ahd

A

exposure to environment that could be harmful to the heart pollution or chemicals or toxins

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14
Q

whats an example of autoimmune responses for ahd

A

strep infection can lead into rheumatic fever fever this usually involves endocardial or the inner lining of the heart - target heart valves

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15
Q

what is overriding aorta

A

in a normal heart, the left ventricle empties into the aorta now in tetralogy of fallot the aorta is actually open over the top of the vsd and so whenever the ventricles contract we get the blood from left and right ventricle entering the aorta - the issue with that deoxy blood is going to enter the into systemic circulation

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16
Q

CHD : what are the symptoms ?

A

vary between the asymptomatic and severe symptoms

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17
Q

what are the two major symptoms of CHD

A

cyanosis and heart failure

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18
Q

what is this describing : slight blue or purple tinged in membranes around the mouth, tips of finger, abdomen and chest

A

cyanosis

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19
Q

name the symptoms of CHD :

A

abnormality in vital signs - lower cardaic output- pulses weak heart and decreased in bp

tatchycardia
weak peripheral pulses - decreased bp

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20
Q

lack perfusion on the other parts of the body for infants CHD

A

usually incontinent - check their diapers working harder than normal - sweating

anorexia
decreased u/o
sweating ( inappropriate )
weakness/fatigue

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21
Q

chd : symptoms ( respiratory )

A

tatchypnea
dyspnea
flaring nares
wheezing
grunting

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22
Q

this is more common in babies and not adults

A

nose flarring

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23
Q

this is unique to babies - sound when they have hard time breathing

A

grunting

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24
Q

true or false. usually babies do not make any noises, grunting, usually not making noises but resp distress usually will make sounds

A

true

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25
Q

chd :the blue symptoms

A

wt gain
peripheral edema ( esp perioribital )
neck vein distention ( children )
ascites

26
Q

all signs of fluid overload, when fluid is being retained when heart cannot keep up ( fluid leave blood vessels and go into third spacing )

A

weight gain and ascites

27
Q

CHD - diagnostic tests
procedures for cardiac diagnosis

A

chest xray
ecg
encho
exercise test
cardaic mri
cardaic catherization ( angio )

28
Q

what are the important points to remember

A

stressful ( for child and parent )
important to communicate information at an age appropriate level for child and parent/care giver

29
Q

child must stay still or most tests (what do we utilize)

A

immobilizers
mild sedative
psychological preparation
distraction ( movie, music )

30
Q

the child is going to stay still in that time
immobilizers with cloths and velcro they do not hurt the infants ( keep the limbs still ) need still so clearer image
true or false?

A

true

31
Q

one of the complications of congenital heart defects is cyanosis or when the child suddenly turns blue due to lack of oxygen . Why is this occurring ?

A

this tends to happen when there are defects that reduce blood flow to the lungs or defects that cause a mixing
of deoxygenated and oxygenated blood.

32
Q

what is this describing : hyper cyanotic spells or tet spells can occur suddenly . Is this true or false

A

true

33
Q

true or false. teralogy of the fallot happens when the baby is in distress?

A

true

34
Q

what is cyanotic episode referred to ?

A

hypercyanotic spells

35
Q

CHD - cyanosis when does this often occur ?

A

often occur during blood draw or iv insertion ( child is upset )

36
Q

how will the nurses manage chd - cyanosis management

( nursing intervention )

A

place infant in knee chest position
administer 100 percent oxygen
giver morphine
remain calm

37
Q

why is the baby placed in a knee chest position during CHD - cyanosis

A

to reduce venous return to the leg which is desaturated

38
Q

this helps to keep the baby relax , its sedative and also causes significant vasodilation both the venous and arterial beds

A

morphine

39
Q

CHD : heart failure management
goal of care : improve cardiac function

what are the 3 meds

A

ace
beta blockers
digoxin

40
Q

improve cardiac function : when it comes to heart failure management : this is done primarily in the use of cardiac medication
slows the heart rate and lower the blood pressure and together decrease the cardiac workload

A

true

41
Q

nursing care for chd : heart failure management : improve cardia function

A

dose calculation
assess vital signs pre and post med admin
monitor for digoxin toxicity
assess patient response

42
Q

why would we check for dig toxicity?

A

because of the narrow theurepetic index

43
Q

what are the symptoms of dig toxicity

A

nausea, vomitting, as well as bradycardia and dysrthimias

44
Q

just read : it is important to watch the kids activity and energy level

A

true

45
Q

CHD: Heart failure management
goals of care : remove excess fluid

what are the interventions ?

A

diuretics
fluid restriction
na restricted diet

46
Q

what are the nursing care that undergoes removing excess fluid

A

dose calculation
vital signs
monitor ins and outs
monitor weight

47
Q

CHD : Heart failure management goals of care : decrease cardiac demands

when the heart is weak , we do not want to stress it: interventions and nursing care

A

keep infant temp normal
treat infections
reduce breathing effort ( semi fowlers )
sedate irritable child
provide restful environment

48
Q

true or false. we do not want the baby to get cold, why is that ?

A

because babies will be using a lot of energy ( starts shivering ) more clothing and blanket and room is good temp

49
Q

it is important to treat infections when it comes to decreasing cardiac demands, why

A

as they occur, this is stressful for their system, more energy and co diligent - swelling, redness, this should be reportedly immediately

50
Q

why would we want the baby to be in a semi fowlers position to decrease cardiac demands

A

working hard to breathe- allow expansion - allows fluid to go at the bottom of the lungs instead of spread out on the back of the lung an reducing oxygen exchange

51
Q

how does sedation help for babies?

A

could help them relax and decrease workload on the heart

52
Q

chd : heart failure management
goals of care : improve tissue oxygenation

interventions and nursing care

A

monitor oxygen saturation
administer supplemental oxygen as ordered ( cool humidity )

assess pt’s response to oxygen
reduce resp distress

53
Q

true or false. maintain mucous membrane by adding cool humidity when administering supplemental oxygen

A

true

54
Q

true or false. nutrition is often challenging -they lack energy an difficult time breathing , suck and usually starts crying- cant breathe

A

true

55
Q

what are the interventions for maintaining nutritional status

A

feed when well rested ( feed as soon as they wake up so they are well rested )

56
Q

true or false. frequent shorter feeds is recommended for babies. BONUS : WHY?

A

yes , because no longer than 30 minutes, harder to breathe if longer, give them breaks

57
Q

supplemental gavage feedings if required, when it comes to maintaining nutritional status

A

using ng tube into the stomach, and adminsitering formula that way

58
Q

why would we use calorie dense formula for babies when we want to maintain their nutritional status ?

A

because these babies have high metabolic rate, increase hr and resp rate

59
Q

CHD : surgical management. Is it true that Approximately 50% of children with a CHD will require some type of surgery.

similar to adults what are we assesing for ?

A

this is true.

bleeding and arthymias

60
Q

CHD : family education
nurses will teach families how to manage at home
what is it ?

A

medication ( esp signs of toxicity )
activity tolerance/rest
nutrition ( high calorie needs )
signs of deterioration ( what to do )

61
Q

just read this :
working or not working
important to recognize : dig toxicity

just like with adults : parents have to recongize too much and interventions to sit down for a while adn let heart recover

balance diet and eduate calories ( hgih metbaollic needs ) what to do whentehh are not eating or dinrking who to contanct

when to bring the child back further assesments :
activity tolerance getting worse
seeing more
sob more
coughing more
any sign cardiac output is detrorating

A

Health and Illness 4 : Part2 (9 decks)

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