Wong: Pediatric Nursing - Cardiovascular

Front 1

Fetal Circulation: Ductus Venosus -

Back 1

Shunts blood past portal circulation

Front 2

Fetal Circulation: Ductus Arteriosus -

Back 2

Shunts blood past the lungs

Front 3

Fetal Circulation: Foramen Ovale -

Back 3

Shunts blood past lungs

Front 4

Cardiac Output:

Back 4

Volume of blood ejected from heart in 1 min.
CO = HR x SV

Front 5

Stroke Volume:

Back 5

Amount of blood ejected by heart in any 1 contraction

Front 6

Preload:

Back 6

Volume of blood returning to heart

Front 7

Afterload:

Back 7

Resistance against which ventricles must pump when ejecting blood

Front 8

Contractility:

Back 8

Efficiency of the myocardial fiber to act as a pump

Front 9

Subtle Symptoms of CV Dysfunction:

Back 9

Duskiness w/ feeding & exertion
Dyspnea w/ physical effort
Fatigue
Sweating w/ feeding
Excessive sweating
Expiratory grunt
Squatting
Clubbing (LT)
Failure to Thrive

Front 10

Diagnosing CV Dysfunction:

Back 10

Radiography
ECG
Echocardiography
Cardiac Catheterization

Front 11

Radiography:

Back 11

Permanent record of heart size and configuration, it's chambers and great vessels

Front 12

ECG:

Back 12

Detects arrhythmias, muscular damage, hypertrophy, effects of electrolyte imbalance

Front 13

Echocardiography:

Back 13

Uses high frequency sound waves obtained by a transducer to produce an image of cardiac structure

Front 14

Cardiac Catheterization:

Back 14

Uses radiopaque catheters placed in peripheral blood vessel and advanced into heart to measure pressures and oxygen levels in heart chambers & visualize heart structures & blood flow patterns.

Front 15

Defects of Increased Pulmonary Flow:

Back 15

Patent Ductus Arteriosus (PDA)
Atrial Septal Defect (ASD)
Ventrical Septal Defect (VSD)
Artioventricular Canal Defect (AVC)

Front 16

Defects of Increased Pulmonary Flow: Patent Ductus Arteriosus (PDA)

Back 16

Failure of the fetal ductus arteriosus (artery connecting the aorta and pulmonary artery) to close w/in the 1st weeks of life.

Front 17

Patent Ductus Arteriosus (PDA): Symptoms -

Back 17

May Be Asymptomatic
CHF
Full Bounding Pulses
Machine Like Murmur

Front 18

Patent Ductus Arteriosus (PDA): Treatment -

Back 18

Prostaglandin Inhibitors
Surgical Ligation

Front 19

Defects w/ Increased Pulmonary Flow: Atrial Septal Defect (ASD) -

Back 19

Abnormal opening RA and LA that allows blood from the higher pressure LA to the lower pressure RA. Larger the hole larger the problem.

Front 20

Atrial Septal Defect (ASD): Symptoms -

Back 20

May be Asymptomatic
CHF
Murmur

Front 21

Defects w/ Increased Pulmonary Flow: Ventrical Septal Defect (VSD) -

Back 21

Abnormal opening between the RV and LV. Blood goes from higher pressure LV to lower pressure RV.

Front 22

Ventrical Septal Defect (VSD): Symptoms -

Back 22

CHF
Murmur
Frequently assoc. w/ other defects

Front 23

Artioventricular Canal Defect (AVC): Symptoms -

Back 23

Mod - Sev. CHF
Murmur
Mild cyanosis w/ crying

Front 24

Defects w/ Decreased Pulmonary Flow:

Back 24

Tetralogy of Fallot
Tricuspid Atresia

Front 25

Defects w/ Decreased Pulmonary Flow: Tetralogy of Fallot -

Back 25

4 Classic Defects:
VSD
Aorta laying over VSD
Pulmonary Stenosis
Right Ventricular Hypertrophy

Front 26

Tetralogy of Fallot: Symptoms -

Back 26

Cyanosis
Murmur
Tet Spells

Front 27

Tetralogy of Fallot: Tet Spells -

Back 27

Acute spells of cyanosis w/ hyperpnea (deeper more rapid respirations). May occur during crying, defecating of feeding.

Front 28

Tetralogy of Fallot: Treatment of Tet Spells -

Back 28

Calm infant
Place in knee to chest position
Give blow by O2
Call for assistance
IV Morphine
Fluid Replacement

Front 29

Tetralogy of Fallot: Treatment -

Back 29

Surgical Repair

Front 30

Defects w/ Decreased Pulmonary Blood Flow: Tricuspid Atresia -

Back 30

Failure of tricuspid valve to develop resulting in lack of communication between RA and RV. PDA allows child to remain alive.

Front 31

Tricuspid Atresia: Symptoms -

Back 31

Cyanosis
Tachycardia
Dypnea
Hypoxemia
Clubbing (LT)

Front 32

Tricuspid Atresia: Treatment -

Back 32

Prostaglandin to maintain patency of PDA
Surgical Repair

Front 33

Tricuspid Atresia: Risk -

Back 33

Bacterial Endocarditis

Front 34

Obstructive Defects:

Back 34

Aortic Stenosis
Pulmonic Stenosis
Coarctation of the Aorta

Front 35

Obstructive Defects: Aortic Stenosis -

Back 35

Narrow aortic valve d/t thickened or deformed valve cusps.

Front 36

Aortic Stenosis: Symptoms -

Back 36

Murmur
Decreased CO2
Faint Pulses
Hypotension
Tachycardia
Poor Feeding
Exercise Intolerance

Front 37

Obstructive Defects: Pulmonic Stenosis -

Back 37

Narrowing at the entrance to the pulmonary artery.

Front 38

Pulmonic Stenosis: Symptoms -

Back 38

May be asymptomatic
Murmur
CHF
Cyanosis (severe)

Front 39

Obstructive Defects: Coarctation of the Aorta -

Back 39

Localized narrowing of the aorta near the ductus arterosis

Front 40

Coarctation of the Aorta: Symptoms -

Back 40

Increased pressure in head & upper extremities
Decreased pressure in body and lower extremities
*BP and Pulse vary between upper and lower extremities

Front 41

Mixed Blood Flow Defects:

Back 41

Transposition of the Great Vessels
Truncus Arteriosus
Hypoplastic Left Heart Syndrome

Front 42

Mixed Blood Flow Defects: Transposition of the Great Vessels -

Back 42

No communication between systemic and pulmonary circulation. PDA keeps patient alive.

Front 43

Transposition of the Great Vessels: Symptoms -

Back 43

Dependant on severity and PDA:
Cyanosis
CHF
Depressed Functioning

Front 44

Mixed Blood Flow Defects: Truncus Arteriosis -

Back 44

One artery arises from the heart and forms both aorta and pulmonary artery

Front 45

Truncus Arteriosis: Symptoms -

Back 45

May be asymptomatic
Variable cyanosis
Poor growth
Activity intolerance

Front 46

Mixed Blood Flow Defects: Hypoplastic Left Heart Syndrome -

Back 46

Underdevelopment of the left side of the heart.

Front 47

Hypoplastic Left Heart Syndrome: Symptoms -

Back 47

Mild Cyanosis
CHF until PDA closes

Front 48

Congestive Heart Failure:

Back 48

Inability of the heart to pump an adequate amount of blood to systemic circulation to meet body demands.

Front 49

CHF: Causes -

Back 49

Volume Overload
Pressure Overload
Decreased Contractility
High Cardia Output Demands

Front 50

CHF: Manifestation Classifications -

Back 50

Impaired Myocardial Function
Pulmonary Congestion
Systemic Venous Congestions

Front 51

CHF: Symptoms of Impaired Myocardial Function -

Back 51

Tachycardia
Inappropriate Sweating
Oliguria
Fatigue/Weakness
Restlessness
Anorexia
Weak Peripheral Pulses/Pale Cool Extremities
Hypotension
Gallop Rhythm
Cardiomegaly

Front 52

CHF: Signs of Impending Heart Failure -

Back 52

Increase in:
Weight
Pulse
Cyanosis

Front 53

CHF: Goals of Treatment -

Back 53

Improve Cardiac Function
Remove Accumulated Fluid and Sodium
Decrease Cardiac Demands

Front 54

CHF: Medications to Improve Cardiac Function -

Back 54

Digoxin
ACE Inhibitors

Front 55

CHF: Digoxin -

Back 55

Increases contractility
Slows conduction through AV node
Enhances diuresis

Front 56

CHF: Digoxin Toxicity -

Back 56

Bradycardia
Nausea
Vomiting
Visual Disturbances

0.8-2

Front 57

CHF: Digoxin Administration -

Back 57

2 RN's check dosage
1 min. apical pulse
Hold if pulse below 100
Monitor I&O
Between 0.8-2ug/L

Front 58

CHF: ACE Inhibitors -

Back 58

Blocks conversion of angiotension I to angiotension II.

EX:
Catopril
Enalapril
lisinopril

Front 59

CHF: Treatment of Fluid Accumulation -

Back 59

Diuretics
Fluid Restriction

Front 60

CHF: Treatment to Decrease Cardiac Demands -

Back 60

Minimize metabolic needs (avoid cold stress)
Treat infection
Reduce breathing effort (semi-fowlers)
Sedation
Rest
Frequent small meals
Administer ordered O2

Front 61

Hypoxemia:

Back 61

Arterial oxygen tension (or pressure) that is lower then normal. Identified by measuring arterial oxygen saturation (SaO2) or PaO2.

Front 62

Hypoxemia: 2 Physiological Changes -

Back 62

Polthycemia
Clubbing

Front 63

Hypoxemia: Polthycemia -

Back 63

Increased number of RBC's

Front 64

Acquired Cardiovascular Disorders:

Back 64

Bacterial Endocarditis
Rheumatic Fever
Kawasaki Disease

Front 65

Bacterial Endocarditis: Diagnosis -

Back 65

Echocardiogram
ECG
Blood Cultures

Front 66

Rheumatic Fever:

Back 66

An autoimmune illness resulting from a systemic inflammatory collagen disease that follows a group A beta hemolytic streptococcal infection.

Front 67

Rheumatic Fever: Aschoff Bodies -

Back 67

Inflammatory hemorrhagic bullous lesions in connective tissue, blood vessels, brain, joints, pleura

Front 68

Rheumatic Fever: Prevention -

Back 68

Screen all sore throats

Front 69

Rheumatic Fever: Treatment -

Back 69

Antibiotic
Aspirin
Bed rest
Long term antibiotic prophylaxis

Front 70

Kawasaki Disease:

Back 70

Mucocutaneous Lymph Node Syndrome. Acute systemic vasculitis of unknown cause.

Front 71

Kawasaki Disease: Diagnostic Criteria -

Back 71

Fever lasts 5+ days
5 of 6 of the following:
Bacterial conjunctivitis w/out exudate
Changes in oral mucosa (erythema, dryness, lip fissures, strawberry tongue)
Changes in extremities (peripheral edema, erythema of palms/soles, peeling of hands/feet)
Cervical lymphadenopathy
Polymorphous rash

Front 72

Hyperlipidemia:

Back 72

Increased amount of lipids. Play and important role in producing atherosclerosis leading to coronary artery disease

Front 73

Hyperlipidemia: Plaque Detection -

Back 73

May be seen as early as 2yrs old.