Congenital Heart Diseases- Acyanotic

Front 1

What is the nursing care before a cardiac cath?

Back 1

- Mark distal pulses and check after procedure
- NPO, no IV fluids

Front 2

What is the nursing care after a cardiac cath?

Back 2

- Extend affected leg 4-6 hours
- Check pedal pulses and perfusion q 5-15 minutes
- V/S q 5-15 mins for 1st hour
- Assess for bleeding

Front 3

Congenital or acquired malformations or anomalies in any of the cardiac structures affect what 4 things?

Back 3

- Blood flow
- Blood pressure
- O2 sat
- Hemodynamic stability

Front 4

Congenital heart disease is one or more structural abnormalities that develop _______ birth.

Back 4

Before

Front 5

What are the 4 classifications of congenital heart disease?

Back 5

- Defects increasing pulmonary blood flow
- Obstructive defects
- Defects decreasing pulmonary blood flow
- Mixed defects

Front 6

Which classifications of defects are acyanotic?

Back 6

- Defects increasing pulmonary blood flow
- Obstructive defects

Front 7

Which classifications of defects are cyanotic?

Back 7

- Defects decreasing pulmonary blood flow
- Mixed defects

Front 8

Left to right shunting is acyanotic or cyanotic?

Back 8

Acyanotic

Front 9

Right to left shunting is acyanotic or cyanotic?

Back 9

Cyanotic

Front 10

Defects that increase pulmonary blood flow put a volume overload where?

Back 10

- Right side of heart
- Pulmonary arteries

Front 11

What are the consequences of L to R shunting?

Back 11

- CHF
- Pulmonary Hypertension
- Pulmonary Vascular Disease
- URI and LRI
- Respiratory failure

Front 12

What are the four defects that increase pulmonary blood flow?

Back 12

- Patent Ductus Arteriosus (PDA)
- Atrial Septal Defects (ASD)
- Ventricular Septal Defects (VSD)
- Atrioventricular Septal Defects (AVSD)

Front 13

For PDA, the cardiac workload is increased on what side of the heart?

Back 13

Left

Front 14

Is a continuous murmur heard in PDA?

Back 14

Yes

Front 15

What treatment is done for a PDA?

Back 15

- Diuretics and Digoxin
- Indomethacin
- Coil placement within PDA
- Surgery

Front 16

Indomethacin does what? What should you monitor?

Back 16

- Promotes ductal constriction
- monitor renal function and hemorrhage

Front 17

What should be done for 6 months after a coil placement for PDA?

Back 17

Endocarditis prophylaxis

Front 18

ASD leads to enlarged what in the heart?

Back 18

Right atrium or right ventricle

Front 19

Are murmurs heard in ASD? If so, when?

Back 19

- Yes
- Systolic murmurs in children but not infants and diastolic murmurs heard with large shunts

Front 20

True or False
Most ASD close on their own within the 1st year.

Back 20

True

Front 21

If ASD does not close within the first year, what is the treatment?

Back 21

Surgical repair within 2-5 years

Front 22

ASD that close on their own are usually located low, middle, or high?

Back 22

Middle

Front 23

ASD that take surgical repair are usually located low, middle, or high?

Back 23

Low and/ or high

Front 24

The S/S of VSD vary with?

Back 24

Size of defect and presence of other defects

Front 25

Are murmurs heard with VSD?

Back 25

Depending on size and degree of shunting:
- Loud and harsh during systole
- Diastole with gallop

Front 26

How is VSD treated if no spontaneous closure?

Back 26

Surgery

Front 27

What is AVSD usually associated with?

Back 27

Genetic syndromes such as Down's

Front 28

When do murmurs develop with AVSD?

Back 28

within the 1st weeks of life

Front 29

How is AVSD treated?

Back 29

- Digoxin, diuretics, and ACE inhib. for CHF symptoms
- Surgery to close defect and construct new valves

Front 30

What are the three obstruction defects?

Back 30

- Pulmonary stenosis (PS)
- Aortic Stenosis (AS)
- Coarctation of Aorta (COA)

Front 31

Pulmonary stenosis is when?

Back 31

There is a narrowing of the pulmonary artery, main branches, and/ or right ventricular outflow tract

Front 32

Severe pulmonary stenosis can lead to what staying open? causing what kind of shunting to happen?

Back 32

- Foreman ovale
- Leads to right to left shunting

Front 33

What are the S/S of pulmonary stenosis?

Back 33

- Asymptomatic
- Systolic ejection murmur and thrill
- Enlarged heart
- Exercise intolerance
- Severe: CHF, RV failure, cyanosis

Front 34

How is pulmonary stenosis treated?

Back 34

- Giving PGE 1 before surgery and until stable
- Balloon valvulopasty
- Surgical valvulopasty
- Surgical Shunt

Front 35

What does PGE 1 do?

Back 35

Keeps the ducts open until corrective surgery can be done

Front 36

What is aortic stenosis?

Back 36

Narrowing or obstruction in the path of blood leaving the left ventricle

Front 37

True or False
Aortic stenosis leads to decreased cardiac output and CHF.

Back 37

True

Front 38

What S/S are seen in neonates with aortic stenosis?

Back 38

- faint peripheral pulses
- poor peripheral perfusion

Front 39

What S/S are seen in older children with aortic stenosis?

Back 39

- Chest pain
- dizziness
- syncope
- sudden death

Front 40

What is the treatment for aortic stenosis?

Back 40

Surgery to decrease stenosis

Front 41

Coarctation of the aorta is when?

Back 41

Constriction or narrowing of the thoratic aorta near insertion site of ductus arterious

Front 42

With coarctation of the aorta, pulses in the upper extremities will be __________ than in the lower extremities.

Back 42

Stronger

Front 43

If someone has coarctation of the aorta, where would you take their blood pressure?

Back 43

Upper extremities

Front 44

What surgical treatment is done for someone with coarctation of the aorta? Can you take a B/P in this person's left arm after the surgery?

Back 44

- Subclavian flap procedure
- No, procedure negates pulse