Iv Test # 2 Peds Cardio

Front 1

Digoxin, Lasix & Capoten are used to treat _______ in children

Back 1

heart failure

Front 2

1- baby's heart dev betw ___ wks
2- fetal circulation has 3 major shunts. They are:
I3- In normal heart, pressure is greater on ___ side than on ___ side.
4- Resistance in pulmonary circ is ____ than the systemic circ

Back 2

1- 4-8
2- Foramen ovale, ductus arteriosus, ductus venosus; all close shortly after birth
3- left, right
4- less

Front 3

coarctation of aorta means ____ of aorta

Back 3

narrowing
- results in diminished lower extremity BP (pulses), and hypertension (high blood pressure) in the arms and head

Front 4

1- Acyanotic is ____ shunting of oxygenated blood is recirculated through lungs
2- Cyanotic is ____ shunting of blood which causes unoxygenated blood to enter systemic circ

Back 4

1- left to right
2- right to left

Front 5

Tetralogy of Fallot causes___ pulmonary blood flow, R ventricular hypertrophy and shunting of blood from_____

Back 5

decreased; R to L

Front 6

1- Symptoms of cyanotic child?
2- Medical mgmt of cyanotic child?

Back 6

1- child tires easily; difficulty feeding
2- give diuretic (lasix); give vasodilator (such as ACEI, "pril", vasopril); provide rest periods and limited play

Front 7

Transposition of the great arteries means___

Back 7

reversal of aorta and pulmonary artery, ie, aorta arises from R ventricle and pulmonary artery from L ventricle

Front 8

Risk factors to have a baby with a cardiac problem?

Back 8

- family hx of heart defects
- presence of other gene defects, downs syndrome
- if mom had rubella of CMV
- older mom (over 40), diabetic, alcoholic

Front 9

S&S of cyanotic baby?

Back 9

- tachycardia: > 160/min as body tries to compensate for lack of oxygen
- tachypnea- as HR incr, so does Resp rate
- cyanosis
- clubbing of fingers
- polycythemia- too many RBCs due to not enough oxygen; blood becomes very thick-- greater stroke risk

Front 10

1- Acute episodes of cyanosis and hypoxia are called ____
2- How do you relieve these episodes (nursing interventions)?

Back 10

1- TET spells or Blue spells
2- if baby is crying, pick up and place infant in knee to chest position (squatting); give 100% oxygen by blow-by; give morphine; begin IV fluid

Front 11

1- `CHF?
2- Dx by?

Back 11

1- failure of heart to pump enough blood
2- dx by tachypnea, dec urine output

Front 12

what are 3 main symptoms of any baby with heart problem?

Back 12

1- tachycardia
2- sweating
3- decreased urine output--- as heart fails as pump, and doesn't perfuse kidneys

Front 13

meds for heart failure?

Back 13

1- Digoxin - glycoside to slow & strengthen heart rate
2- Potassium - to replace loss from diuretic.
3. Propranol ( Beta Blocker) to reduce cardiac oxygen demands
4. Lasix
5. Enalapril- ACEI dec afterload, dilates vessels

Front 14

Rules for Digoxin?

Back 14

1- hold if pulse <110 in small child; in 8+ yr old child, hold if pulse<70
2) if child vomits after 1st dose, don't give 2nd dose
3- give 1 hr before or 2 hrs after feeding

Front 15

Signs of Digoxin toxicity?

Back 15

1- bradycardia
2- dysrhythmias, ie irregular HR
3- anorexia
4- N & V

Front 16

Nursing dx for ht failure for kids?

Back 16

- activity intolerance r/t tachycardia and hypoxia
- ineffective breathing pattern r/t tachypnea

Front 17

interventions for hrt failure for peds?

Back 17

- humidified oxygen & monitor O2 stat
- position for comfort
- give digoxin & diuretics (look at potassium when giving diuretics)
- low sodium formula
- strict I & O, daily weights

- give rest periods

Front 18

Cardiac cath takes 1-2 hrs. Must prepare a child according to age ex:
only tell 4 yr old 1 day before;
tell 12 yr old more ahead of time

Back 18

T

Front 19

Child is always NPO 4-6 hrs before cardiac cath
- Cath can be R- sided if going up vein

Back 19

- Cath of R-side heart is via a vein in the neck; requires 4-6 hrs bedrest
- Cath of L-side heart is via the femoral artery in leg; minimum of 8 hrs of bedrest

Front 20

Post Cath care?
- If child starts to bleed, apply pressure above/below site?

Back 20

- above
- ck pulses for equality & symmetry; don't want weaker pulse in side you did cath; means bleed
- check for bleeding
- ensure adequate hydration (esp if polycythemia)

Front 21

you get rheumatic fever after an untreated ____ infection
- What organs does rheumatic fever affect?

Back 21

strep throat aka GABHS infection; this is why you treat all strep; Rheumatic fever mainly affects children ages 6 -15, and occurs approximately 20 days after strep throat or scarlet fever
- heart, joints, skin, and brain

Front 22

if your heart valves are damaged due to rheumatic fever, you must get antibiotics before dental surgery. This is called?

Back 22

endocarditis prophylaxis

Front 23

Kawasaki disease?

Back 23

Kawasaki disease is a rare condition in children that involves inflammation of the blood vessels
- more common in children< 5 yrs old
- 15-25% will develop coronary artery aneurysms which leave you prone to heart attacks.
- not spread person to person

Front 24

symptoms?

Back 24

- often begins with a high and persistent fever greater than 102°F, often as high as 104°F.
- A persistent fever lasting at least 5 days is considered a classic sign.
- The fever may last for up to 2 weeks and does not usually go away with normal doses of acetaminophen (Tylenol) or ibuprofen.
- Extremely bloodshot or red eyes (without pus or drainage)
- Bright red, chapped, or cracked lips
Red mucous membranes in the mouth
Strawberry tongue, white coating on the tongue, or prominent red bumps on the back of the tongue
Red palms of the hands and the soles of the feet
Swollen hands and feet

Front 25

describe the 2 phases of Kawasaki disease?

Back 25

1- Acute phase - abrupt high fever and most of the other symptoms
2- Subacute phase- starts with resolution of fever and all symptoms of disease have disappeared
- the child is at greatest risk for developing aneurysms in this phase

Front 26

Treatment of Kawasaki disease?

Back 26

Intravenous gamma globulin is the standard treatment. It is given in high doses. The child's condition usually greatly improves within 24 hours of treatment with IV gamma globulin.

High-dose aspirin is often given along with IV gamma globulin.

Front 27

Causes of Kawasaki disease?

Back 27

Kawasaki disease occurs most frequently in Japan, where the disease was first discovered. In the United States, after congenital heart defects, Kawasaki disease is the leading cause of heart disease in children. Most of these patients are younger than age 5. The disease occurs more often in boys than in girls.

Kawasaki disease is a poorly understood illness. The cause has not been determined. It may be an autoimmune disorder. The disorder affects the mucus membranes, lymph nodes, walls of the blood vessels, and the heart.

Kawasaki disease can cause inflammation of blood vessels in the arteries, especially the coronary arteries. This inflammation can lead to aneurysms. An aneurysm can lead to a heart attack, even in young children, although this is rare.