Peds Test - 5.txt

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Peds Test - 5.txt
2012-04-15 20:02:55
Cardiac Alterations

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  1. What does Cyanosis mean?
    • Low oxygenation
    • Blue
  2. What does Pallor mean?
    • Low Perfusion
    • White
  3. Normal capillary refill in children?
    < 2 seconds
  4. What is seen in toddlers and older children as an unconscious attempt to relieve hypoxia, especially during activity?
  5. What is clubbing related to?
  6. After a cardiac cath, what is the nursing care that should be provided?
    Affected Leg kept straight for 4-6 hours

    HOB 20 or less

    VS every 5-15 min - check distal pulses
  7. When should you notify doctor after a cardiac cath?
    • Absent pulse
    • Increased mottling
    • Increasing pain
  8. If bleeding occurs from insertion site of catheter what should you do?
    Hold pressure for 10-15 min
  9. Discharge instructions for someone go just have a cardiac cath?
    No soaking in tub for first few days

    No strenuous activity for 1 week
  10. When should you not give digoxin to an infant?
    • If pulse rate below <100
    • (count apical pulse)
  11. What are signs of digoxin toxicity in children?
    • Nausea/vomiting
    • Bradycardia
    • Dysrthymias
  12. What should you teach parents about digoxin?
    How to take pulse (hold if less than 100)

    Give at same time each day

    Call Doctor if child vomiting or lethargic

    Keep locked in cabinet
  13. Interventions for excess fluid volume r/t Fluid Overload?
    Give diuretics (Lasix or Spironolactone)

    Asses edema, especially Periorbital

    (fluid and sodium restriction usually not needed because children have a decreased appetite anyways)
  14. Interventions for Ineffective breathing pattern r/t pulmonary congestion?
    • Monitor rate and rhythm
    • HOB 30-45 degrees
    • O2 as ordered
    • Rest periods
    • Prevent exposure to illness
  15. Interventions of imbalances nutrition?
    • Small frequent meals
    • Feed every 3 hrs
    • Assess for dehydration
    • Weigh daily
  16. What does the Foramen Ovale do?
    Allows blood to flow from the right atrium to the left atrium
  17. What does the Ductus Arteriosis do?
    Allows blood to flow from the pulmonary artery to the descending aorta
  18. What is Patent Ductus Arteriosis?
    What do u hear to diagnose this?
    Opening persists between the aorta and pulmonary artery

    • Hear a continuous
    • Machine like murmur
  19. Treatment for Patent Ductus Arteriosis?
    Indocin or NSAID

    Cardiac cath & surgery
  20. What is an abnormal opening between atria, (patent foramen ovale)?
    Atrial Septal Defect - sometimes infants are asymptomatic but over time can develop fatigue & dyspnea and itwill be notived around middle age or later

    may close on its own or need surgery
  21. What is the most common congenital cardiac lesion?
    Ventricular Septal Defect
  22. Ventricular Septal Defect?
    Abnormal openin between ventricles
  23. I
  24. If your patient measures with different BPs and pulses in the upper and lower extremities what should you expect?
    Coarction of the Aorta
  25. What are the 4 defects of Tetralogy of Fallot?
    • VSD
    • Pulmonic Stenosis
    • Overriding Aorta
    • Right Ventricular Hypertrophy
  26. Tet spells are common with Tetraology of Fallot and considered to be an emergency, what interventions should you do?
    • Place infant in the KNEE-CHEST position
    • Calm infant
    • 100% oxygen
    • Morphine
  27. What are common causes or Infective Carditis?
    Stap or Strep

    Dental work may increase your risk! UTI or Cardiac surgery as well
  28. What should children do before any invasive procedure that have a history of endocarditis?
    Prophylactic Amoxicillin orally 1 hr prior
  29. What is the drug of choice for Rheumatic Fever?
  30. What are the major clinical manifestations of Rheumatic Fever?
    • Carditis
    • Polyarthritis
    • Chorea
    • Sub-Q nodules
    • Rash
  31. What are the minor clinical mnifestations of Rheumatic Fever?
    • Fever
    • Arthalgia
    • Prolonged P-R interval
    • Elevated ESR or + CRP
  32. Qualifications of being diagnosed with Rheumatic Fever?
    Must have 2 major or 1 major/2 minor manifestations and evidence of a recent strep throat infection
  33. Treatment for Kawasaki Disease?
    IV gamma globulin & Aspirin within 10 days of fever onset
  34. Treatment for secondary hypertension?
    treat underlying disease
  35. Treatment for primary hypertension?
    Weight reduction, physical conditioning, dietary modification, relaxation techniques, meds, no tobacco