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53 Cards in this Set

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sx tx of a PDA?
ligation of the patent ductus arteriosus in closed-heart operation.
what med to tx PDA?

what meds to close pharmacologically?
Digoxin(<100bpm=hold)

Diuretics (Lasix), Indomethacin (Indocin) to achieve pharmacologic closure.
defect occurring when the ventricular septum fails to complete its formation between the ventricles, resulting in a left-to-right shunt.
VENTRICULAR SEPTAL DISORDER
s/s of VENTRICULAR SEPTAL DISORDER?
respiratory distress, tachycardia, tachypnea, pale, "failure to thrive
what does cxr show in VENTRICULAR SEPTAL DISORDER?
cardiomegaly with a large L atrium and ventricle
sx for VENTRICULAR SEPTAL DISORDER?
pulmonary artery banding to prevent heart failure and permanent correction with a patch later when the heart is larger
what meds for VENTRICULAR SEPTAL DISORDER?
Digoxin, and diuretics
what 3 heart defects result in increased Pulmonary Blood Flow?
Atrial Septal Defect (ASD)
Patent Ductus Arteriosus (PDA)
Ventricular Septal Defect (VSD)
is the baby w/increased Pulmonary Blood Flow cyanotic?
no
major problem w/increased pulmonary blood flow in newborn?
chf
increased pulmonary blood flow in newborn = shunting from ___ to ___
left to right
Decreased Pulmonary Blood Flow in newborn= shunting from ___ to ___
Right to left shunt
Decreased blood flow to the lungs=_____
cyanosis
TETRALOGY OF FALLOT: (TOF) is one of the cyanotic heart diseases what 4 problems make up?
VSD
Pulmonary Valve stenosis
Aorta overriding the septum
Right Ventrical hypertophic wall
which TOF is High on septum -- Right to left shunt
VSD
which TOF results in Pulmonary flow is decreased
Pulmonary Valve stenosis
which TOF is because of other 3?
Right Ventrical hypertophic wall
what risk factors for TOF?
maternal rubella, poor prenatal nutrition, maternal alcoholism (FAS), mother over 40 years old, diabetes. and use of thalidomide.
what are most of the s/s of TOF related to?
respiratory problems
what happens to growth in TOF?
decrease
what posits do kids take in tof? what do the posits cause?
Squatting seen in older children while knee chest postion is seen in infants, which decreases venous return by occluding the femoral vein by hip flexion
the posits in TOF decrease venous return by occluding the femoral vein by hip flexion and lead to___?
Decreased work load of heart and allows for higher O2 levels into aorta
describe the nails in TOF?
Clubbing
Compensentory Mechanics in TOF?
increased RBC or polycythemia
what posit to help w/TOF?
knee chest
what med for sedation in TOF?
morphine
what meds to relax the infundibulum (The outflow portion of the right ventricle) in TOF?
beta blockers(propanolol, esmolol_
what meds increase systemic vascular resistance in TOF?
phenylephrine
pt w/TOF is @ risk for what problems?
brain abesses and Endocarditisis
Hypoxic Blood flow in TOf is sluggish and increases risk of ____ and ___?
CVA and Embolisms
Episodes when cynaosis is occuring markedly
TOF spells
NSG int for TOF spells?
Flex knees/hips, O2
congenital hematologic disease that causes impaired circulation, chronic ill health and premature death
sickle cell
who gets sickle cell?
African populations and people from Puerto Rico, Turkey, India, the Middle East and the Mediterranean
describe rbc in sickle cell?
rigid and rough, forming an elongated sickle shape and impairing circulation by clumping together ("vaso-occlusive"
what can sickling?
give examples of when sickling occurs in sickle cell?
This happens ("sickling") during periods of hypoxia which can be provoked by infection, blood loss, strenuous exercise, high altitude, unpressurized aircraft, cold and vasoconstrictive drugs
which organ is affected earliest by sickling? what happens to it?
spleen
Becomes enlarged and fillled with sickle cells
what does a non functional spleen lead to?
infection(sickle cell kids 200-300 times more likely to get infection than normal kid)
what liver problems w/sickle cell?
enlarged b/c clumping RBC leading to bilirubin levels(jaundice), chirrous of the livef
what kidney problems in sickle cell?
Inability to concentrate urine, blood in urine
what bone changes in sickle cell?
X rays show charactersitic changes in bone. Increase risk of bone infection, usually salmonela
what bone is affected w/necrosis in sickle cell?
head of femur
what maybe the 1st s/s of hand foot syndrome?
infection of small bone of hands & feet with swelling;
s/s of sickle cell?
aching bones, jaundice, pallor, tachycardia, frequent infections, joint swelling and leg ulcers
how sickle cell is passed down?
by an autosomal recessive trait: the child inherits the gene that produces hemoglobin S from two healthy parents who carry the defective gene
If two parents have sickle cell trait, there is a ___% chance with each pregnancy that the child will?
25
where are the leg ulcers of sickle cell usually seen?
ankles
is sickle cell crisis painful?
yes
what might rbc be in sickle cell?
decreased RBC --5 to 11 g/dl
what labs to monitor for sickle cell?
check Hgb and Hct.) , elevated WBC and platelet counts, decreased ESR
why is ESR decsreased in sickle cell?
lowered by sickle shape
what does Hb electrophoresis show in sickle cell?
HbS, the wrong amino acid.
what to do to prevent sickle cell crisis?
iron and folic acid supplements, prevent dehydration, and analgesics for pain