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66 Cards in this Set
- Front
- Back
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When inspecting a child, what signs would you see for congenital heart disease?
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FTT, poor weight gain, cyanosis, pallor, distorted chest configuration, bounding pulsations, dyspnea, squatting, fatigue, clubbing of fingers.
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What are some diagnostic tests for congenital heart disorders?
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X ray, ECG, holter monitor, echocardiogram, MRI, cardiac cath.
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What types of cardiac catheterization for children is there?
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Diagnostic, interventional, elctophysiology.
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What is important to post op care of a child after cardiac catheterization?
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Keep the leg straight.
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What are some complications with cardiac catheterization of children?
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Acute hemorrhage, n/v, loss of puse in the catheterized extremity, reaction to contrast dye, low cardiac output, clots.
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What can cause low cardiac output in a child post op cardiac catheterization?
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Diuresis, dehydration, and hypovolemia.
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What can cause clots in a child post op cardiac catheterization?
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Increased circulation HGB leads to thickening of the blood.
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Pre op, what should a nurse assess for in cardica catheterization?
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Allergies to iodine, shellfish, and maintain NPO status.
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What are normal circulation o2 levels in a normal fetus?
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60-70%.
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What are the 4 shunts of fetal circulation?
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1.Umbilical vein
2.Ductus Venosum 3.Foramen Ovale 4.Ductus Arteriosus |
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What does the ductus venosum bypass?
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The liver.
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What does the foramen ovale do?
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Shunts blood from R->L atrium bypassing the lungs.
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What does the ductus arteriosus do?
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Shunts blood from the pulmonary artery to aorta bypassing the lungs.
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When does the foramen ovale close?
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Within 1-2 hours.
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When does the ductus arteriosus close?
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10-15 hours.
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What triggers the ductus arteriosus to close?
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Increased o2 concentrations and loss of curculation prostaglandins.
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What is congenital heart disease?
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Primarily anatomic abnormalities present at birth that result in abnormal cardiac function.
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What are acyanotic cardiac defects?
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They result in the recirculation of oxygenated blood.
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What are cyanotic defects?
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Unoxygenated blood is mixed with oxygenated blood or sent directly to circulation.
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What is patent ductus arteriosus (PDA)?
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Hypoxemia and increased circulation prostaglandins causes vasodilation and allows vessel to stay open.
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What happens in PDA?
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Blood is shunted back through pumonary circulation. Blood flows from aorta to pulmonary arter; increases pumonary vascular congetsion.
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Can PDA be repaired in adulthood?
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Yes.
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What congenital heart diseases are acyanotic?
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PDA, ASD, VSD,CoA.
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What are some s/s of PDA?
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May develop CHF, murmur.
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What is the treatment for PDA?
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Fluid restriction, diuretics, indocin. Surgical ligation of PDA or coils to occlude the PDA.
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What is atrial-septal defect (ASD)?
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An opening between left and right atriums.
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What are the s/s of ASD?
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The same as PDA?
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What is the treatment for ASD?
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Surgical repair with a Dacron patch or septal occluder.
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When might ASD be found?
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In adulthood.
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What is the most common congenital heart defect?
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Ventricular Septal Defect (VSD).
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What is the problem in VSD?
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An opening between left and right ventricles.
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What happens in VSD?
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Shunting left to right causing recirculation through pulmonary artery to lungs.
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What is the treatment for VSD?
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Cardiac catheterization to identify the area of defect and then a complete repair with patch.
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What is CoArctation of the Aorta (CoA)?
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A localized narrowing of he aorta.
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What happens in CoA?
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Increased pressure proximal to the defect and decreased pressure distal to the defect.
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What are the s/s of CoA?
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High blood pressure and bounding pulses in arms, weak or absent femoral pulses and cool lower extremities with lower BP, dizziness, headach, and fainting.
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What is the treatment for CoA?
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Surgery in the first 2 years of life. Resection of the coarted portion or enlargement of the constricted section and also balloon angioplasty.
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What congenital heart defects are cyanotic?
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Tetrology of Fallot, transposition of the great vessels (TGV), and hypoplastic left heart syndrom (HLHS).
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What is Tetrology of Fallot?
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Shunting from left to right or right to left.
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What is wrong in Tetrology of Fallot?
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VSD, an overriding aorta, pumonis stenosis, and right ventricular hypertrophy.
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What are some clinical manifestations of Tetrology of Fallot?
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May be acutely cyanotic at birth. There may also be acute episodes of cyanosis and hypoxia.
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How is Tetrology of Fallot traeated?
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Surgical and palliative care.
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How are tet spells in children handled?
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In infants, knee-chest position. For older children, squat.
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What is Transposition of the great vessels (TGV)?
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The pulmonary artery leaves the left ventricle and the aorta exits from the right ventricle with no communication between the systemic and pulmonary circulations.
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What are some s/s of TGV?
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Cyanosis at birth, CHF, tachypnea, poor feeding, no murmur, hypoxia, and unresponsive to aggresive oxygenation.
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How is TGV treated?
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Prostaglandin administration and no o2 to keep PDA open. Treat the CHF. Surgical repair. Life does not exist if not repaired.
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What is Hypoplastic Left Heart Syndrome (HLHS)?
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Underdevelopment of the left side of the heart leads to hypoplastic left ventricle and aortic atresia.
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What are the s/s of HLHS?
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Critically ill within hours of life, cyanosis, CHF, murmur, tachycardia, tachyphea, peripheral pulses, vasoconstriction of extremities, enlarged heart, metabolic acidosi. Fatal w/o intervention.
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How is HLHS treated?
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Must maintain PDA. Administer prostaglandin E, balloon atreal septostomy (temporary). Surgical treatment, cardiac transplantation.
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What is necessary post-op for pain meds in the children with congenital heart defects?
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You must wean them from the pain meds.
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What is important when lifting a child post op heart surgery?
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Do not pick up under the arms.
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What are some s/s of CHF in children?
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They may develop slowly.
Tachycardia, decreased urin output, dyspnea, cyanosis, weight gain, peripheral edema, difficulty feeding, fatigue, restlessness. |
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How is CHF in children treated?
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Improve cardiac function with meds
Digoxin ACE Inhibitors Remove accumulated fluid and sodium. Cecrease cardiac demands, improve tissue oxygenation, and maintain nutritional status. |
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What are some signs of dig toxicity in children?
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Bradycardia, dysrythmias, n/v, and anorexia.
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What are two common ACE Inhibitors?
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Captopril, enalapril.
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How can you remove accumulated fluid and sodium in children with CHF?
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Use diuretics. May need to supplement potassium. Restrict sodium.
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What is Bacterial Endocarditis?
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An infection of the valves and inner lining of the heart.
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What are the s/s of bacterial endocarditis?
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Anorexia, malaise, weight loss, increase sed rate, increased WBC, murmur, mimics flu like symptoms.
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What are some complications of child bacterial endocarditis?
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Cardiac disease, can progress to septic shock and multi-system failure.
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What is the treatment for bacterial endocarditis?
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High dose long term, antibiotics, treat symptoms, and educate.
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What is rheumatic fever?
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Inflammatory disease of heart, hoints, CNS, subcutaneous tissue. Cardiac valve damage is the most significant complication.
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What are the s/s of rheumatic fever?
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Carditis, arthritis, fever, elevated sed rate, and elevated C-reactive protein.
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What is the treatment for rheumatic fever?
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Long term antibiotics, anti-inflammatory agents, treat symptoms, and prevent recurrence.
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What is Kawasaki Disease?
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Acute systemic vasculitis of unknown cause.
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What are the s/s of Kawasaki disease?
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Fever for 5 days or more, bilateral conjuctival inflammation w/o exudation, changes in the oral musous membrane (strawberry tongue), changes in the stremities-peripheral edema, erythema of the palms and soles and peeling of the feet.
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What is the treatment of Kawasaki disease?
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IVIG, ASA best in first 10 days.
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