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51 Cards in this Set
- Front
- Back
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How does the pressure change in fetal circulation before and after birth?
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Fetus:
high pulmonary pressure low systemic resistance Baby: Lungs open allowing dec pressures of the heart |
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Septal defect
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hole in the septum of the heart
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Atresia
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normal opening or tube in the body is closed or absent
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Atresia
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normal opening or tube in the body is closed or absent
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transposition
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any abnormal position of the organs of the body
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What are the types of heart disease?
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congenital heart disease
acquired heart disorders |
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What is congenital heart disease?
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present at birth (may not be diagnosed at birth)
anatomical |
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What is acquired heart disorder?
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occurs after birth
can be seen in a normal heart |
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What are common historys found in heart disease?
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risk is higher if parent or sibling has heart problems - worse if two close relatives have it
maternal DM - VSD, transposition, cardiomyopathy previous still birth lupus - bradycardia lithium- epstine's anomaly Dilantin - stenosis downs syndrome |
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What are the causes of heart disease?
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chromosomal abnormalities
85% multifactorial |
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What are important questions to ask a family with a cardiac peds pt?
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Family Hx
Murmurs Chromosomal abnormalities exercise intolerance feeding and weight gain difficulties |
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What are common physical characteristics of cardiac patients?
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respiratory problems
cyanosis clubbing of fingers chest deformities tachypnea/tachycardia inc WOB - bobbing head nutritionally compromised child |
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What should be assessed for cardiac patients?
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pulses
color - tongue hepatomegaly/splenomegaly HR murmurs (innocent can be caused by fever or anemia) |
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What are the grading of heart murmurs?
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Grade 1-6
1: very faint - requires concentration 6: extremely loud, heard without a stethoscope |
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How do you assess heart murmurs?
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Z method
listen front and back listen to at least 4 cardiac cycles |
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What are the types of cardiac caths?
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Diagnostic:
congenital defects Interventional: dilating stenotic valves closing abnormal connections stents Electrophysiology: assess conduction treat tachydysrhythmias |
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What is the pre-cath care?
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assess allergies
pre-cath pulses: mark diaper rash present? baseline O2 sedation teaching |
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What is the post-cath care?
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VS/ bed rest
arrthymias tamponade (muffled heart sounds) watch for bleeding Loss of pulse in extremity coolness of extremity BG levels fever/dehydration Hold pressure for 10mins at site elevate and wrap extremity |
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What education is needed for a cardiac cath?
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remove pressure dsg 1 day postop
avoid bath no strenuous exercise Tylenol for pain ASA for 6mo |
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What are the types of congenital disease?
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Increased Pulmonary Blood Flow
Obstruction of blood flow out of the heart Decreased pulmonary blood flow Mixed blood flow |
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What are the characteristics of increased pulmonary blood flow?
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Left to Right shunt
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What are the types of Increased Pulmonary blood flow?
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Atrial Septal Defect
Ventricular Septal defect Patent Ductus Arteriosis Atrioventricular Canal Defect |
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What occurs in the Atrial Septal defect?
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oxygenated blood is shunted from the Left Atrium to the Right Atrium
LA is hypertrophic |
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What occurs in the ventricular septal defect?
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theres a hole in the wall between the ventricles causing hypertrophy, and back up in lungs = CHF
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What is the AV canal defect?
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incomplete fusion of the endocardial cushion allowing flow through all the chambers
found in Downs syndrome |
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What is a Patent Ductus Arteriosis?
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failure of the ductus arteriosis to close in the first yr of life
increased pressure to the aorta and decreased pressure to the pulmonary artery |
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What are the s/s of obstruction of blood from the ventricles?
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L obstruction = CHF
R obstruction = cyanosis bounding pulses in arm because theres inc pressure above obstruction weak pulses in legs bec theres dec pressure below obstruction WATCH FOR ANEURYSM in pregnant people |
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What is known as cyanotic heart disease?
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Decreased blood flow
mixed blood flow both a type of congenital heart disease |
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Name the types of decreased blood flow?
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Tetralogy of Fallot
Tricuspid Atresia |
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What is TOF?
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Includes 4 defects:
VSD Pulmonary Stenosis Overriding Aorta Ventricular Hypertrophy - subvalvular bundle obstructing flow can have TOF spells: cries, turns blue, passes out |
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What are TOF spells preceded by?
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feeding
crying defication stressful procedure dehydration |
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WHat is the nursing management of TOF spells?
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place infant in the knee-chest position
calm approach 100% oxygen Morphine Hydration |
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What is tricuspid atresia?
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tricuspid valve doesn't form stopping flow from atrium to ventricle
mixed blood is sent to aorta for desaturated systemic flow VSD or DA allows pulmonary blood flow |
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What is the treatment for tricuspid atresia?
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surgery
glint shunt- inferior vena cava to pulmonary artery Prostigladin E - keeps DA open |
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WHat are the types of Mixed blood flow?
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Transposition of the Great Artery (TGA)
Total Anomolous Pulmonary Venous Return (TAPVR) Hypoplastic Left Heart Syndrome (HLHS) |
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What is a TAPVR?
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R atrium recieves all the oxygen that the L atrium normally recieves
Lethal and Rare |
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What is HLHS?
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L sided underdevelopment causing back up of flow
Foramen ovale allows mixing of L atrium and R atrium blood to supply the L ventricle and pulmonary artery PDA is the only reason for survival and when it closes palliative care is needed |
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What is CHF?
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inability of the heart to pump an adequate amount of blood to the systemic circulation to meet the needs of the body
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What are the causes of CHF?
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Impaired Ventricle:
Cardiomyopathy Dysrhythmias Severe Electrolyte imbalances Excessive Demands on the heart: Sepsis Severe Anemia |
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What are the s/s of CHF?
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Dyspnea at rest, distress with exercise
Periorbital edema tachypnea Tachycardia Hepatomegaly N/V Hypotension poor pulses decreased perfusion |
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What is the management for CHF?
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Diuretics - potassium sparing (aldactone) and lasix
ACE inhibitors: dilates and dec resistance Beta Blockers Digoxin: levels .8-2 Nutrition: NG no salt restriction |
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What are the acquired heart disease in children?
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Kawasaki Disease
Rheumatic Heart Disease Bacterial Endocarditis Cardiomyopathy |
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What is Kawasaki Disease?
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Viral disease causing acute systemic vascularitis in <5yo
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What are the s/s of Kawasaki disease?
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Acute:
unresponsive fever irritable Subacute phase: fever resolves lasts until all s/s gone Convalescent Phase: S/S gone Labs abnormal 6-8 weeks for recovery until all labs normal |
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What are the cx for kawasaki disease?
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MI
Coronary aneurysm |
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What are the treatments for Kawasaki Disease?
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IVIG: single dose in first 5 days
ASA: 6-8 weeks for fever then antiplatelet dose |
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What is Rheumatic Heart Disease and Tx?
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occurs 2-6 weeks post strep pharyngitis
take ALL antibiotics valve replacement |
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What is bacterial endocarditis?
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Infection of the inner lining of the heart caused by:
Strep aureous or viridans Candida Albicans |
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What are the s/s of bacterial endocarditis?
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fever
loud mumur w/l |
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What is cardiomyopathy and s/s?
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impaired muscle contraction caused by dilation, hypertrophy, or restriction
breathe harder and faster |
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What is important to know about heart transplants?
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3 mo wait is typical
heart lasts 12 yrs Age appropriate activities within 3mo |
