Peds test # 2 - Cardiac

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sam10h
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147439
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Peds test # 2 - Cardiac
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2012-04-13 19:44:30
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Nursing
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Peds teste # 2 - Cardiac
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  1. the heart is either rotated or displaced to the right or is a complete mirror image
    Dextrocardia
  2. Dextrocardia with the stomach placed to the right & liver to the left
    Situs inversus
  3. Acts as reservoir for blood returning to heart from veins
    Atria
  4. collection point for blood returning from systemic circulation for reoxygenatins in the lungs
    right atrium
  5. receives freshly oxygenated blood from lungs via pulmonary veins
    left atrium
  6. pumps unoxygenated blood to the lungs from pulmonary arteries
    right ventricle
  7. pumps oxygenated blood to the systemic circulation via the aorta
    left ventricle
  8. pumps blood to the lungs & thru out the body
    ventricles
  9. blood tight wall that separates left heart from right heart
    cardiac septum
  10. has 3 cusps/flaps; separates RA from RV
    tricuspid valve
  11. has 2 cusps/flaps; separates LA from LV
    biscupsid valve
  12. separates right ventricle from pulmonary arter
    pulmonic valve
  13. separates left ventricle from aorta
    aortic valve
  14. carries oxygenated blood out of left venticle to body
    aorta
  15. carries unoxygenated blod from upper body to right atrium
    superior vena cava
  16. carries unoxygenated blood from lower body to right atrium
    inferior vena cava
  17. carries unoxygenated blood from RV to lungs
    pulmonary artery
  18. returns oxygenated blood from lungs to LA
    pulmonary veins
  19. atrial depolarization causing atrial contraction
    P wave
  20. PR interval
    initial stimulation of atria to initial stimulation of ventricles
  21. QRS complex
    ventricular depolarization
  22. Ventricular repolarization; ventricles return to a resting state
    ST segment and T wave
  23. carries blood through the lungs where it is reoxygenated
    Pulmonary circulation
  24. carries blood from heart to the body and returns to the heart
    systemic circulation
  25. occurs when the heart can no longer meet the metabolic demands of the body at normal physiologic venous pressures; most frequently occurs due to increased volume load or increased pressure load
    CHF
  26. The causes of right sided heart failure includes: (3)
    RV-end diastolic pressure rises; increased CVP; systemic venous engorgement
  27. Causes of left sided heart failure (4)
    LV end-diastolic pressure rises; increased pressure in LA; increased pressure in pulmonary veins; pulmonary congeston/edema
  28. Compensatory mechanisms for CHF (3)
    increase in heart size (hypertrophy), increase in heart muscle, increase in contractility of ventricles
  29. S/S of impaired myocardial function in children (9)
    tachycardia, fatigue, weakness, restless, pale, cool extremities, decreased BP, decreased urine output, altered LOC
  30. S/S of systemic venous congenstion in children (5)
    Edema, edema with weight gain, ascites, hepatomegaly, neck vein distention
  31. Goals for a child with CHF: (4)
    imrpove cardiac function; remove accumulated fluid/sodium; decrease cardiac demand; improve tissue oxygenation
  32. improves contractility, increases force of contraction, decreases rate of contractions, increases renal perfusion
    Digoxin
  33. inhibits normal function of renin-angiotensin system of the kidney; causes vasodilation
    ACE inhibitors
  34. used with chronic CHF; decreases HR and BP; causes vasodilation; side effects are dizziness, headache, hypotension
    Beta blocker (Carvedilol)
  35. Nursing considerations for giving digoxin
    Check apical pulse (infant 90 to 110); hold medication if below parameter; check drug levels (should be 0.8 to 2 mcg/l)
  36. S/S of toxicity of digoxin
    bradycardia, nausea/vomiting, anorexia
  37. Diuretics decrease:
    Preload
  38. What is the drug of choice for CHF?
    Lasix; causes exretion of CL and K
  39. Side effects of Lasix
    N/V; diarrhea, ototoxicity, hypokalemia (which causes cramps)
  40. at birth, the ductus arteriousus/foramen ovale usually closes when?
    within 24-48 hours
  41. 2 types of cardiac defects:
    anatomic and acquired
  42. If a mother drinks, had rebulla in first 7 weeks of pregnancy, had CMV, toxoplasmosis, or other viral illnessess, the fetus is at risk for:
    Congenital heart disease
  43. clincial manifestations of atrial septal defect (3)
    may be asymptomatic; murmur; at risk for atrial dysrhytmias
  44. Treatment for atrial septal defect
    Surgical patch closure before school age
  45. caused by an abnormal connection between 2 sides of the heart
    increased pulmonary blood flow defects
  46. left to right shutn; S/S include CHF, murmur, right ventricular hypertrophy, eisenmenger syndrome
    ventricular septal defect
  47. Clinical manifestations of patent ductus arteriosus (5)
    may be asymptomatic early; CHF; washing machine-like murmer; widened pulse pressure; bounding pulses
  48. most common cardiac defect assoicated with in Down's syndrome; S/S include CHF, murmur, cyanosis with crying
    Atrioventricular canal
  49. When blood exiting the heart is restricted by an anatomic narrowing (stenosis)
    Obstructive defects
  50. increased pressure proximal to defects and decreased pressure distal to defect; S/S include decreased circulation in lower extremities, CHF with rapid deterioration, occurs in older children, disparity of BP between upper/lower extremities
    Coarctation of aorta
  51. S/S of aortic stenosis includes: (5)
    exercise intolerance, chest pain when standing, faint pulses, tachycardia, hypotension, poor feeding
  52. narrowing of pulmonic valve or entrance to PA
    pulmonic stenosis
  53. S/S of pulmonic stenosis (4)
    May be asymptomatic, cyanosis, murmur, cardiomegaly
  54. obstruction of pulmonary blood flow and an anatomic defect b/w right and left sides of heart
    decreased pulmonary blood flow defects
  55. has 4 defects (VSD, pulmonic stenosis, overriding aorta, right ventricular hypertrophy)
    Tertralogy of Fallot
  56. S/S of Tertralogy of Fallot (4)
    cyanosis, murmur, hypercyanotic or "tet" spells, anoxic episodes
  57. no communication between right atrium/right ventricle; mixing of blood
    Tricuspid atresia
  58. Clincial manifestations of tricuspid artesia in the newborn (3)
    cyanosis, tachycardia, dyspnea
  59. Clinical manifestations of tricuspid artesia in the older child
    chronic hypoxemia with clubbing
  60. S/S of transposition of great vessels (3)
    severe cyanosis; CHF with mild cyanosis; cardiomegaly within few weeks of birth
  61. Pulmonary veins abnormally correct to the RA or veins draining to RA instead of LA
    TAPVC
  62. Single vessel that overrides both ventricles; S/S includes CHF, cyanosis, poor growth, activity intolerance, murmur
    Truncus arteriosus
  63. under development of left side of heart; S/S include mild cyanosis, CHF
    hypoplastic left heart
  64. arterial oxygen tension that is less than normal
    Hypoxemia
  65. decreased tissue oxygenation
    Hypoxia
  66. S/S of hypoxemia
    Polycythemia, clubbing, squatting (reduces venous return from the legs ind increases systemic vascular resistance), poor weight gain, dyspnea on exertion, poor exercise tolerance, increased risk for bacterial endocarditis
  67. if PaO2 is > 150, it is a ? disease; less than 100, it is a ? disease
    pulmonary; cardiac
  68. maintains patent ductus arteriousus; used to treat hypoxemia R/T CHD; causes vasodilation and smooth muscle relaxation
    Prostaglandin E
  69. What to do during hypercyanotic spells (4)
    knee-chest position, 100 percent FiO2, MSO4, IV fluid replacement
  70. Palliative surgical procedure to create communication b/w R or L subclavian and the pulmonary artery
    Modified Blalock-Taussig shunt
  71. compression of heart by blood and other effusions in the pericardial sac; S/S include increased/equalizing RA and LA filling pressures; narrowing pulse pressure, tachycardia, dyspnea, apprehension, suddenly no test tube drainage
    Cardiac tamponade
  72. S/S of pneumothorax (5)
    decreased breath sounds; sudden dyspnea; tachycardia; cyanosis; restlessness
  73. s/s of pleural effusion (5)
    increased RR, vomiting, decreased breath sounds, irritability, decreased oxygen sats
  74. Occurs in immediate postop period, can also occur day 7 to 21 post op; S/S include fever, pericardial friction rub, pericardial, pleural effusion
    Postperiocardiotomy syndrome
  75. Treat postpericardiotomy syndrome with: (4)
    rest, salicylate, NSAIDs, steroids
  76. Inflammatory disease occurs after streptococcal pharyngitis; affects joints, brain, serous surfaces, heart
    Rheumatic fever
  77. Most common complication of RF, damage to valves as result of RF
    Rheumatic heart disease
  78. S/S of rheumatic fever (6)
    mitral regurtiation, tachycardia out of proportion to fever; CHF; cardiomegaly; pericardial effusions (muffled heart sounds); progressive valvular damage
  79. causes edema, inflammation, effusions; reversible, favors large jionts; usually accompanies acute febrile period
    Polyarthritis
  80. transitory, nonpuritic rash found on trunk/proximal portion of extremities
    erythema marginatum
  81. small, nontender; persists indefinitely after onset of disease but no resulting damage; found in clusters over bony prominences
    Subcutaneous nodules
  82. Involves CNS symptoms including irregular movements of the extremities, involuntary facial grimaces, speech disturbance, muscle weakness; aggravated by anxiety/relieved by rest
    St. Vitus Dance or Sydenham Chorea
  83. Penicillin G Im X 1; penicillin V X 10 days; sulfa (oral) x 10 days; erythromycin if allergic to above (oral) X 10 days
    prevention of RHD and treatment
  84. acute systemic vasculities with coronary arteries being the most susceptible to damage/ most cases under 5
    Kawaski disease
  85. Leading cause of heart disease in children in US
    Kawaski disease
  86. Manifestations of Heart failure (7)
    Dyspnea, orthopnea, fatigue, weakness, confusion, fluid retention/edema, arrythmias
  87. Route of blood to the heart: Vena cava to ? to tricuspid valve to ? to pulmonic valve to ? to lungs to ? to LA to ? to LV to ? to aorta
    RA, RV, pulmonary arter, pulmonary veins, mitral valve, aortic valve
  88. period during which chambers of heart relax; electrical diastole is the resting phase of electrical cardiac cycle
    Diastole (filling phase)
  89. period during which chambers of heart contracts; begins as soon as ventricles fill with blood
    Systole
  90. Failure of right ventricle to move unoxygenated blood from venous system into pulmonary circulation; eventual back up into systemic venous circulation
    Right sided heart failure
  91. Failure of left ventricle to move oxygenated blood from pulmonary circulation into arterial circulation; eventual backup of blood into lungs
    Left sided heart failure
  92. What is the difference in right sided vs. left sided HF?
    Right sided backups into the systemic venous circulation; left sided by lungs

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