Cardiac & Circulatory

Front 1

Conditions that have left-to-right shunting?

Back 1

VSD, ASD, TOF, COA

Front 2

Keeps a ductus arteriosis patent?

Back 2

Prostaglandin E (hormone)

Front 3

Occurs after a strep infection:

Back 3

Rheumatic fever

Front 4

List 5 things to monitor for a cardiac patient:

Back 4

1. I&O
2. HR
3. Lung sounds
4. BP
5. Daily wt

Front 5

Used to close a patent ductus arteriosis:

Back 5

Indomethacin (Indocin)

Front 6

Use a squatting position to resolve cyanotic condition:

Back 6

Tetralogy of Fallot (TOF)

Front 7

Dx by eliminating other conditions:

Back 7

Kawasaki's

Front 8

What is involved in the medical mgmt of a heart condition?

Back 8

1. Propranolol (Inderal)
2. Digoxin
3. Diuretics
4. Beta-blockers
5. ACE-Is
6. Ca Channel blockers
7. Low sodium diet
8. Monitor lytes (K, Na, Ca)
9. Exercise
10. Edema
11. Activity tolerance

Front 9

Conditions that block the flow from the left ventricle:

Back 9

AS, COA, MVP

Front 10

It shows the flow of blood through the heart:

Back 10

Echo, Cardiac cath

Front 11

It is treated w/ high doses of ASA and IV gamma globulin:

Back 11

Kawasaki's disease

Front 12

It shows the electrical activity of the heart:

Back 12

EKG

Front 13

It is important to palpate the pedal pulses for which condition?

Back 13

COA

Front 14

A trigger for this condition is dehydration or infection:

Back 14

Vaso-occlusive crisis

Front 15

Reversal of the aorta and pulmonary artery:

Back 15

TGV / TGA

Front 16

In an infant w/ a VSD: dyspnea, hepatosplenomegaly, and periorbital edema are clinical manifestations of:

Back 16

Heart failure

Front 17

When caring for an infant w/ CV alterations what are 3 health promotion activities?

Back 17

1. Provide periods of uninterrupted rest
2. Maintain a neutral thermal environment
3. Limit bottle feedings to 30min max

Front 18

A toddler is hospitalized w/ CHF and is receiving digoxin and lasix. She has vomited 2x / 4h. The nurse should:

Back 18

Get an order to draw a digoxin level

Front 19

Indications of a worsening condition of a child w/ CHF:

Back 19

1. Wt gain
2. Rales
3. Inadequate U/O

Front 20

The nurse finds that an infant pt's BP in her arms is much higher than in her legs, the nurse suspects which condition?

Back 20

COA

Front 21

When a pediatric client is having a hypercyanotic episode the nurse should first:

Back 21

Place the client in a knee-chest position

Front 22

What is the purpose of prophylactic penicillin before dental work in a child w/ a congenital heart defect?

Back 22

To prevent infective endocarditis

Front 23

How do you calculate the maintenance IV fluid rate for a patient w/ a cardiac disease?

Back 23

kg x 100mL / 24h = maintenance rate (mL/h)

Front 24

Which patient is at the greatest risk for CHF?

Back 24

Infant w/ PDA
- usually very small w/ wasted appearance
- tachypnea...even while asleep
- tachycardia...even while asleep

Front 25

How does digoxin work?

Back 25

Increases the contractility of the heart...thereby decreasing the HR

Front 26

Administration of digoxin: Must take apical pulse for 1 full min...hold for bradycardia:

Back 26

Infant < 100
Toddler < 70
School-age < 60

Front 27

Therapeutic range and s/s of Digoxin toxicity:

Back 27

Range (0.8-2 ng/mL)
1. Vomiting (early sign)
2. ABD pain
3. Anorexia
4. Diarrhea
5. Fatigue
6. Muscle weakness
7. Drowsiness

Front 28

Goals when treating CHF (in this order):

Back 28

1. Adequate cardiac output
2. Normal fluid and lyte values
3. Oxygenation
4. Nutrition

Front 29

What is a child undergoing a cardiac catheterization at risk for?

Back 29

1. Arrhythmia
2. Bleeding
3. Hematoma
4. Thrombus
5. Infection

Front 30

Which heart defect can spontaneously close by up to 5yrs of age?

Back 30

ASD

Front 31

What complications can occur from a VSD?

Back 31

1. Left-sided hear failure
2. Infective endocarditis
3. Aneurysms of the pulmonary arteries

Front 32

What heart defect requires medical mgmt w/ Indocin and /or surgical repair w/in the first yr of life?

Back 32

PDA

Front 33

When planning nursing care for a patient w/ a congenital heart defect it is important to:

Back 33

Organize tasks to interrupt as little as possible to conserve energy

Front 34

Normal blood flow:

Back 34

RA > RV > PA > Lungs
LA > LV > A > Body

Front 35

A child experiencing a 'tet' spell (hypoxic episode) is relieved by:

Back 35

Squatting or knee-chest position

Front 36

TGV is incompatible w/ life unless coexisting:

Back 36

VSD, ASD, and / or PDA

Front 37

TGV is a medical emergency and the child is given what to keep the ductus open?

Back 37

Prostaglandin E (PGE)

Front 38

A systemic inflammatory disesase that occurs as a result of group A beta-strep:

Back 38

Rheumatic fever

Front 39

s/s of rheumatic fever:

Back 39

1. Fever
2. Sore throat
3. Migratory joint pain, arthritis
4. Skin rash (trunk)
5. ^ ESR and ASO titer
6. Scarring of the mitral valve

Front 40

Medication therapy for rheumatic fever:

Back 40

1. ASA for 3-4wks
2. IM penicillin G every month (***check for allergies***)

Front 41

What is the mgmt of a vaso-occlusive crisis?

Back 41

1. Hydration
2. Oxygen
3. Bedrest
4. Clustering care
5. Pain mgmt
6. Monitor for infection
7. Folic acid
8. Possible transfusion

Front 42

After a cardiac catheterization, which intervention is of highest priority during the immediate post-procedure period?

Back 42

Apply direct pressure to the entry site for 15min...helps to develop clot and reduce bleeding