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Complex Care > Week 6 TUES > Flashcards

Week 6 TUES Flashcards

Peds perfusion

1
Q

What is important to teach parents about cardiac catheterization

A

the catheter will be placed in the femoral artery

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2
Q

After a cardiac cath what is the most important intervention?

A

taking pedal pulses for the first 4 hours after

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3
Q

What apical pulse would warrant nurse w/ holding digoxin on a 6 month old?

A

80 bpm

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4
Q

explain “excess fluid volume” to families

A

cardiac problems cause the heart to not pump effectively, which causes swelling in the body

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5
Q

explain what hypoplastic left heart to a family means

A

problem where the left side of the heart didn’t develop properly

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6
Q

Health hx that makes nurse suspect CV disorder in a 6 wk boy

A

“he gets sweaty when he eats”

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7
Q

What is the best position for a child to be placed to promote optimal benefits w/ a structural defect while receiving O2 therapy?

A

Semi- fowlers

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8
Q

A nurse is caring for a child that just returned from cardiac catheterization where the catheter was placed through the left femoral artery. Upon assessment the nurse finds that the dressing is saturated and the patient is bleeding from the site. What is the first thing the nurse should do?

Check the patient’s vital signs
Notify the provider
Apply pressure 1 inch above the site
Change the pressure dressing

A

C!
Apply pressure 1 inch above the site
- peds lose blood very fast! the other things can be done after bleeding is controlled

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9
Q

The caregiver of a 4-week-old infant is tearful after finding out their child has been diagnosed with a congenital heart defect. Which statement by the caregiver needs further teaching?

“I should not be concerned if my child’s color changes with exertion.”
“My child will need routine follow-up with the cardiology clinic.”
“I will feed my child smaller meals more often.”
“I will notify my child’s provider if I notice my child has difficulty breathing.”

A

A!
- cyanosis during exertion is a sigh of a cardiac issue

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10
Q

You are preparing to administer IVIG to a 42 lbs. child with Kawasaki Disease. The order is to administer IVIG 2 g/kg/day. Which of the following is the correct total daily dose of IVIG for this patient? Round to the nearest whole number.

38 mg
38 g
84 mg
84 g

A

B!
38g
- Do the math!

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11
Q

The 4 chambers of the heart are formed in the first ______ weeks of gestation

A

2-8 wks

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12
Q

T or F the heart initially lies horizontally, then grows more vertically as child gets older

A

TRUE!

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13
Q

When does the foramen ovale, ductus arteriosus, and ductus venosus close?

A

at birth when newborns start breathing on their own

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14
Q

The right side of the heart carries what type of blood from the lungs and body

A
  • deoxygenated blood
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15
Q

The left side of the heart carries what type of blood from the lungs and the body

A
  • oxygenated blood
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16
Q

Altered perfusion risk factors in peds

A
  • prematurity
  • maternal pregnancy factors
  • chromosomal disorders
  • family hx of heart disease and CHD
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17
Q

Nurses role in reducing risk factors

A
  • ensuring adequate prenatal care
  • assess maternal medications
  • education on drugs and alcohol
  • education on reducing environmental exposures
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18
Q

Altered perfusion complications

A
  • growth and developmental delay
  • failure to thrive
  • decreased cognitive ability
  • death
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19
Q

T or F inequities don’t have an impact on congenital heart disease

A

FALSE!
- equalities do factor in
- we as nurses can do things to improve or work against inequities during practice

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20
Q

Altered perfusion assessment

A
  • detailed health hx> PMH, family
  • present illness
  • vital signs
  • physical assessment
  • know current medications
21
Q

extra or unusual sounds made by blood circulating through the heart’s chambers or valves, or through blood vessels near the heart.

A

Murmurs

22
Q

what are the characteristics of murmurs

A
  • location
  • relation to heart cycle
  • intensity> grades> 6 grades
  • quality> musical, harsh, blowing
  • variation w/ position
23
Q

Altered perfusion different test and labs

A
  • angiogram
  • holter monitor> cardiac monitoring
  • chest x-ray
  • echo
  • ecg
  • exercise stress test
  • hgb and hct
    -PO2
24
Q

What position is best for a pt after an angiogram?

A
  • flat and bedrest
25
Q

Common medical treatment for altered perfusion

A
  • oxygen therapy
  • chest physio and postural drainage
  • chest tube
  • pacing
  • meds
26
Q

Passage of oxygenated capillary blood through body tissues

A

perfusion

27
Q

What uses angiography to inject contrast dye to monitor the heart and vessels, a catheter is inserted through the vessel

A

Cardiac cath

28
Q

What medication increases contractility through lowering conduction and increasing force
- AFib, A Flutter, HF, SVT

A

Digoxin

29
Q

Structural issues that exist at birth

A

Congenital heart disease

30
Q

Disorders occurring at some point after birth

A

Acquired heart disease

31
Q

Congenital heart disease exemplars

A
  • tetralogy of falloy
  • coarcation of the aorta
  • VSD
  • hypoplastic left heart syndrome
32
Q

Acquired heart disease exemplars

A

Kawasaki Disease

33
Q

Tetralogy of fallot has 4 defects which include…..

A
  • VSD
  • Pulmonic stenosis
  • overriding aorta
  • right ventricular hypertrophy
34
Q

What exempler is the Decrease in oxygenated blood coming from the lungs, putting more work on the heart to get to the pulmonary system for oxygenation

A

Tetralogy of Fallot

35
Q

What exemplar is an opening between right and left ventricles, mixing deoxygenated and oxygenated blood together

A

Ventricular Septal Defect (VSD)

36
Q

What exemplar is a narrowing of the aorta causes an impact on the ability to adequately provide oxygenated blood to the body

A

Coarctation of the Aorta

37
Q

What exemplar includes the left side of the heart is severely under-developed including left ventricle and aorta. nonfunctional left side

A

Hypoplastic left heart syndrome

38
Q

Congenital heart defect nursing interventions

A
  • improve oxygen> #1
  • promote adequate nutrition
  • infection prevention
  • child/family education
  • child/family coping
39
Q

What exemplar is an aquired heart disease that is characterized by systemic vasculitis

A

Kawasaki Disease

40
Q

Treatment for Kawasaki disease

A
  • aspirin
  • IVIG
41
Q

s/s of Kawasaki disease

A
  • red, bloodshot eyes
  • fever lasting 5 days or more
  • red, swollen hands
  • red, swollen feet
  • rash involving entire body
  • red, cracked lips and red tongue
42
Q

Treatment for Hypoplastic left heart

A
  • prostaglandin> keep open PDA
  • heart transplant
  • multiple surgeries> palliative staged treatment
43
Q

s/s of Hypoplastic left heart

A
  • may be asymptomatic
  • poor feeding and tires easily
  • cyanosis/ cool skin
  • shock> once PDA closes
  • possible gallop, single heart sound, soft murmur
  • HIGH RR, Pulse, hypothermia
44
Q

Treatment of Coarctation of the aorta

A
  • balloon angioplasty
  • surgical repair
  • administer prostaglandin to help keep ductus arterious open!
45
Q

s/s of Coarctation of the aorta

A
  • irritable
  • dizziness, fainting
  • epistaxis> nosebleed
  • leg pain w/ activity
  • absent/ weak pulses in the lower extremities
  • bounding pulses in the upper extremities
  • notching on ribs
46
Q

Treatment of VSD

A
  • surgery> patch and sew holes
  • transplantation> if right to left shunt occurs
47
Q

s/s of VSD

A
  • HF s/s
  • tires easily with exertion/ feedings
  • poor growth
  • pulmonary infections
  • SOB, rapid breathing
  • color change or diaphoresis w/ feeding
  • edema in face/ fontanels
48
Q

Treatment of tetralogy of fallot

A
  • small frequent meals/ feedings
  • surgery to correct defects
  • shunt placements
49
Q

s/s of tetralogy of fallot

A
  • cyanosis w/ feeding, crying,a ctivity
  • hypoxemia, increased respirations, increased work of breathing
  • clubbing of fingers and toes
  • delayed growth and development
  • squatting position or fetal position to catch breath

Complex Care (26 decks)

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