Congenital Heart Disease And Valvular Heart Disease Nursing

Front 1

What are the two consequences from congenital heart diseases?

Back 1

congestive heart failure and hypoxemia

Front 2

What are abnormalities that occur after birth and can be seen in the normal heart or in the presence of congenital heart defects?

Back 2

Acquired heart disorders- result from a various of factors such as: infection, autoimmune responses, environmental factors and familial tendencies.

Front 3

What is an electrocardiogram?

Back 3

A monitor used to detect heart rate and rhythm through a graphic display of an ECG tracing and digital display.

Front 4

What is an echocardiogram?

Back 4

A diagnostic test used to discover any heart abnormalities by using sounds to produce an image of the heart's structure. Allows for diagnostic testing instead of performing a cardiac cath.

Front 5

What are different types of cardiac catheterization?

Back 5

Diagnostic- Used to detect any abnormalities before corrective surgery
Interventional- Involves placing a balloon catheter to dilated stenotic valves or vessels.
Electrophysiology studies- Catheters with small elctrodes to detect the impulses of the heart to evaluate dysrhythmias

Front 6

What assessments should the nurse make before cardiac cath.?

Back 6

Accurate height and weight
Allergies- b/c most contrast solutions contain iodine
Assess any s/s of an infections b/c a simple diaper rash could be a reason to cancel the procedure
Mark and check pulses, in order to assess them after surgery.

Front 7

What are some risks factors for congenital heart defects?

Back 7

Maternal rubella during pregnancy
Maternal alcoholism
Maternal age over 40
Maternal type 1 diabetes
Fetal exposure to drugs ex: Accutane
Genetic factors

Front 8

What are two classifications of heart diseases?

Back 8

Acyanotic and Cyanotic (if cyanosis is present)

Front 9

What are the hemodynamic classifications of heart diseases?

Back 9

Increased pulmonary blood flow
Decreased pulmonary blood flow
Obstructive defects
Mixed defects

Front 10

What are examples of a defect with increased pulmonary blood flow?

Back 10

Atrial septal defect
Ventricular septal defect
Patent ductus arteriosus
These anomalies cause blood flow from the left side of the heart where there is greater pressure to the right side of the heart, in result there is an increase of pulmonary blood flow at expense of systemic blood flow.

Front 11

What some examples of obstructive defects?

Back 11

Coarction of the aorta
Aortic stenosis
Pulmonic stenosis
With these defects there is a narrowing anatomically causing the ventricle or great artery before the obstruction pressure to increase and after the obstruction pressure is decreased.

Front 12

What are some examples of defects with decreased pulmonary blood flow?

Back 12

Tetralogy of Fallot
Tricuspid atresia
With these defects there is obstruction of blood flow and an anatomic defect such as ASD or VSD. Pressure on the right side exceeds pressure on the left and unoxygenated blood enters systemic circulation. These patients are cyanotic and hypoxemic.

Front 13

What are some examples of mixed defects?

Back 13

Transposition of the great arteries
Total anomalous pulmonary venous return
Truncus arterious
Hypoplastic left heart syndrome
With these defects desaturated and saturated blood mix causing desaturated blood to enter systemic circulation. Cardiac output is decreased due to ventricular overload and pulmonary congestions occurs.

Front 14

Which hemodynamic classifications are cyanotic?

Back 14

Decreased pulmonary blood flow
Mixed blood flow

Front 15

Which hemodynamic classifications are acyanotic?

Back 15

Increased pulmonary blood flow
Obstructive defects

Front 16

What are some medications used to improve cardiac function?

Back 16

Digoxin-used to increase cardiac output, reduce edema, decrease heart size and decrease venous pressure
ACE inhibitors, (catopril and vasotec)- Used for vasodilation to decrease pulmonary and systemic resistance which decreases BP, reduction in afterload
Beta blockers- causes decreased rate, BP and vasodilation

Front 17

What is the number one sign of digoxin toxicity?

Back 17

Bradycardia- Children HR less than 70 and Infant less than 90 is bradycardia
Sudden Anorexia

Front 18

What is it important for the nurse to do before and after administration of ACE inhibitors?

Back 18

Because this medication reduces cardiac afterload, it is important to monitor blood pressure before and after administration

Front 19

A child with heart failure should avoid cardiac demands, what teaching can the nurse do to ensure this?

Back 19

Teach patient to limit physical activity (bed rest), maintain body temp., treat any infections, reduce effort to breath by placing the child in semi-fowlers position and sedate irritable child.

Front 20

What is a good feeding schedule for infants with heart failure?

Back 20

Because these patients have increased nutritional demands, a feeding schedule every three hours is sufficient.

Front 21

What are two physiologic changes due to chronic hypoxemia?

Back 21

Polycythemia and clubbing of the fingers

Front 22

What is Prostaglandin E used for?

Back 22

Used when infants are cyanotic due to a closing ductus arteriosus which provides pulmonary blood flow. This medication dilates blood vessels and allows blood to become oxygenated through the DA.

Front 23

What are ways to treat a hypercyanotic spell?

Back 23

Knee to chest position
Employ a calm and comforting approach
Administer 100% oxygen by blow-by
Administer morphine
Begin IV fluid expansion

Front 24

What is bacterial endocarditis?

Back 24

Also know as inefective endocarditis is an infection of the valves and the inner lining of the heart