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39 Cards in this Set

  • Front
  • Back

result in increased pulmonary blood flow

ventricular septal defect (VSD)


atrial septal defect


patent ductus arteriosus

results in decreased pulmonary blood flow

Tetralogy of Fallot


tricuspid atresia

results in obstruction to blood flow

Coarctation of the aorta


Pulmonary stenosis


Aortic stenosis

results in mixed blood flow

Transposition of the great arteries


Truncus arteriosus


Hypoplastic left heart failure

s/s of ventricular septal defect

-loud, harsh murmur heard at the left sternal border


-heart failure


-many of these close spontaneously

s/s of atrial septal defect

- loud harsh murmur with a fixed split second heart sound


-heart failure


-possibly asymptomatic

s/s of patent ductus arteriosus

- murmur (machine hum)


- wide pulse pressure


- bounding pulses


- possibly asymptomatic


- heart failure

a condition in which the normal fetal circulation conduit between the pulmonary artery and the aorta fails to close

(PDA) patent ductus arteriosus

s/s pulmonary stenosis

- systolic ejection murmur


- possibly asymptomatic


- cyanosis varies with defect, worse with severe narrowing


- heart failure

a narrowing of the pulmonary valve or of the pulmonary artery

pulmonary stenosis

s/s aortic stenosis in infants

- faint pulses


- hypotension


- tachycardia


- poor feeding tolerance

s/s aortic stenosis in children

- intolerance for exercise


- dizziness


- chest pain


- possible ejection murmur

a narrowing of the lumen of the aorta, usually at or near the ductus arteriosis

coarctation of the aorta

s/s coarctation of the aorta

- elevated BP in the arms


- bounding pulses in the upper extremities


- decreased BP in the lower extremities


- cool skin of lower extremities


- weak or absent femoral pulses


- heart failure in infants


- dizziness, HAs, syncope or nosebleeds in older children

a condition in which the aorta is connected to the right ventricle instead of the left ventricle and the pulmonary artery is connected to the left ventricle. A septal defect or a PDA must exist in order to oxygenate blood

transposition of the great arteries

s/s transposition of the great arteries

- murmur depending on presence of associated defects


- severe to less severe cyanosis depending on the size of the associated defect


- cardiomegaly


- heart failure

a complete closure of the tricuspid valve that results in mixed blood flow. An atrial septal opening needs to be present to allow blood to enter the left atrium

tricuspid atresia

s/s tricuspid atresia in infants

- cyanosis
- dyspnea
- tachycardia


s/s tricuspid atresia in children

- hypoxemia


- clubbing of fingers

four heart defects:


1-pulmonary stenosis


2- ventricular septal defect


3- overriding aorta


4- right ventricular hypertrophy

Tetralogy of Fallot

s/s Tetralogy of Fallot

- cyanosis at birth-progressive cyanosis over the first year of life


-systolic murmur


- episodes of acute cyanosis and hypoxia (blue spells)

a failure of septum formation, resulting in a single vessel that comes off of the ventricles

Truncus arteriosus

s/s truncus arteriosus

- heart failure


- murmur


- variable cyanosis


- lethargy


- fatigue


- poor feeding habits

left side of the heart is underdeveloped. An atrial septal defect (ASD) or patent foramen ovale allows for oxygenation of the blood

Hypoplastic left heart syndrome

s/s hypoplastic left heart syndrome

- mild cyanosis


- heart failure


- lethargy


- cold hands and feet


- once patent ductus arteriosus closes, progression of cyanosis and decreased cardiac output result in eventual cardiac collapse.

s/s impaired myocardial function d/t heart


failure

  • sweating

  • tachycardia
  • fatigue
  • pallor
  • cool extremities w/ weak pulses
  • hypotension
  • gallop rhythm
  • cardiomegaly

s/s pulmonary congestion d/t heart failure

tachypnea / dyspnea


retractions / nasal flaring / grunting


wheezing


cyanosis


cough


orthopnea


exercise intolerance

s/s systemic venous congestion d/t heart failure

hepatomegaly


peripheral edema


ascites


neck vein distension


periorbital edema


weight gain

s/s hypoxemia

cyanosis


poor weight gain


tachypnea


dyspnea


clubbing


polycythemia

s/s hypercyanotic spells

AKA blue spells or Tet spells


acute cyanosis and hyperpnea

digoxin Lanoxin

improves myocardial contractility

withhold digoxin

infant's pulse is < 90 / min


children's pulse is < 70 / min

digoxin toxicity

- bradycardia


- dysrhythmias


- N/V or anorexia

captopril (Capoten)

ACE inhibitor reduces afterload by causing vasodilation

enalapril (Vasotec)

reduces afterload by causing vasodilation resulting in decreased pulmonary and systemic vascular resistance

which drugs indicate monitoring of BP before and after administration

captopril (Capoten)


enalapril (Vasotec)

which medication indicates the need to monitor for hyperkalemia

captopril and enalapril

metoprolol or carvedilol (Coreg)

beta blockers which decrease heart rate and BP and promote vasodilation

nursing considerations for furosemide or chlorothiazide

encourage diet high in K


monitor I and O


monitor for hypokalemia, N/V and dizziness


monitor daily weight