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Advanced Health Assessment > week 4 module 12 special considerations > Flashcards

week 4 module 12 special considerations Flashcards

1
Q

fetal circulation

A

R. atrium -> foramen ovale -> L. atrium

R. ventricle -> patent ductus arteriosus not lungs

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2
Q

fetal/infant ventricle size

A

equal in weight and size because both pump blood systemically.

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3
Q

infants and dyspnea

A

look for enlargement of heart and position

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4
Q

Closure of PDA

A

closes by 48 hours

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5
Q

closure of foramen ovale

A

closes as pressure in L. atrium increases

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6
Q

bulging precordium in child

A

long-standing heart enlargement

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7
Q

sinus arrhythmia in child

A

a physiologic event

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8
Q

most acquired murmurs in children are a result of

A

kawasaki disease

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9
Q

still murmur

A 
causes by vigorous expulsion of blood from L. ventricle into the aorta
- inc. with activity
- dec. with rest
Most common in ages 3-7 
vibratory, groaning, or musical
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10
Q

SAFER

A

Children at high risk of underlying structural heart defect

  • Syndromic features: syndromes or chromosomal anomalies
  • Age: murmur in infant more likely pathologic
  • Family Hx: congenital heart defects have multifactorial inheritance (3-5% chance in offspring)
  • Evaluation of feeding and growth: feeding diff. sweating
  • Rheumatic fever/ PMH: kawasaki, rheumatic fever
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11
Q

systemic vascular resistance during preg

A

decreases

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12
Q

BP during preg

A

dec. in 2nd trimester, returns to nml in 3rd

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13
Q

heart sounds during preg

A

change with increased blood volume

  • audible splitting of S1 and S2
  • S3 may be heard after 20wks
  • systolic ejection murmurs may happen in 90%
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14
Q

blood volume during preg

A

inc. 40-50%
- > inc. workload of the heart
- returns to nml 3-4 wks after delivery

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15
Q

CO during preg

A

inc. 30-40%
peaks at 25-32wks
- returns to nml ~ 2wks after delivery

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16
Q

apical pulse and older adults

A

harder to find

  • inc. anteroposterior chest diameter
  • obesity
17
Q

S4 and older adults

A

sound is more common

- may indicate dec. L. ventricular compliance

18
Q

heart size and older adults

A

may dec. unless pt has HTN or CV disease

19
Q

older adults and CO

A

during exercise decreases 30-40%

20
Q

structural changes to heart in older adults

A

endocardium thickens
myocardium more rigid -> dec. contractility
fibrosis and sclerosis

21
Q

infants signs of CV issues

A 
tiring during feeding
breathing changes 
cyanosis 
Wt gain 
knee-chest position favored 
mothers health during preg
22
Q

children signs of CV issues

A 
tiring during play
naps
headaches
nosebleeds
joint pain
fever
ht and wt gain
physical and cognitive development
23
Q

S3 and children

A

normal

24
Q

defining murmurs

A 
timing and duration
pitch
intensity
pattern 
quality
location and radiation
respiratory phase variations
25
Q

Bounding pulses in infant

A

PDA

aortic regurgitation

26
Q

Thready pulses in infant

A

aortic stenosis

27
Q

congenital heart defects usually occur

A

within the first 8 weeks of gestation

28
Q

chromosomal abnormalities account for

A

nearly 10% of all cardiac malformations

29
Q

environmental or maternal conditions account for

A

2-4% of all CHD

  • lupus
  • diabetes
  • PKU
  • SLE
  • viruses
  • ETOH
  • anticonvulsant use
30
Q

pulmonary systolic ejection murmur

A

common in peds

slightly harsh systolic ejection murmur heard best at 2nd or 3rd ICS

31
Q

supraclavicular arterial bruit

A

common in peds

early systolic murmur heard above the clavicles

32
Q

physiologic peripheral pulmonary stenosis

A

common in peds
low-intensity systolic ejection murmur
upper-left sternal boarder, axillae, and back bilaterally
- in neonates up until 3-6months

33
Q

venous hum

A

humming continuous with murmur
usually at RUSB
will decrease or disappear when supine

34
Q

kawasaki disease

A

inflammation in walls of small and medium sized arteries throughout the body

35
Q

coarctation of the aorta

A

usually presents with other defects
Males:females 3:1
usually in thoracic portion of descending aorta
- must check femoral pulses

36
Q

hypertrophic cardiomyopathy

A

most common cause of death in competitive athletes

  • syncope
  • heart racing

Advanced Health Assessment (57 decks)

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