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Peds Test 3
Chapters 30, 33, 34, 35
Term | Definition |
---|---|
Ventricular Septal Defect (VSD): A hole in the septum between the right and left ventricle that results in INCREASED pulmonary blood flow (left-to-right shunt) | Manifestations: loud, harsh murmur that is not usually audible until pulmonary pressures drop at about 4-8 weeks of age -HF -Failure to thrive -small, possibly asymptomatic defects |
Ventricular Septal Defect (VSD): A hole in the septum between the right and left ventricle that results in INCREASED pulmonary blood flow (left-to-right shunt) | Manifestations: loud, harsh murmur that is not usually audible until pulmonary pressures drop at about 4-8 weeks of age -HF -Failure to thrive -small, possibly asymptomatic defects |
Atrial Septal Defect (ASD)- a hole in the septum b/t the right and left atria that results in INCREASED pulmonary blood flow (left-to-right shunt) | Manifestations: loud harsh murmur -mild HF -possible enlarged RA -increased O2 Sats in RA -asymptomatic (possibly) |
Patent Ductus Arteriosus (PDA)- a condition in which the normal fetal circulation conduit b/t the pulmonary artery and the aorta fails to close and results in INCREASED pulmonary blood flow (left-to-right shunt) | Manifestations: murmur (machine hum) -wide pulse pressure -bounding pulses -asymptomatic (possibly) |
Pulmonary Stenosis- a narrowing of the pulmonary valve or pulmonary artery that results in obstruction of blood flow from the ventricles | Manifestions: systolic ejection murmur -RV enlargement -exercise intolerance -cyanosis w/severe narrowing |
Aortic Stenosis- a narrowing at, above, or below the aortic valve | Manifestions: murmur -LV enlargement -Chest pain; exercise intolerance; weak, thready pulses; hypotension; dizziness, and syncope |
Coarction of the Aorta- a narrowing of the lumen of the aorta, usually at or near the ductus arteriosus, that results in obstruction of blood flow from the ventricles | Manifestations: increased blood pressure and O2 sat in the upper extremities compared to the lower extremities -nosebleeds -H/A, vertigo, leg pain, weak or absent lower extremity pulses (indicate decreased CO) |
Transposition of the great arteries- a condition in which the aorta is connected to the right ventricle instead of the left, and the pulmonary artery is connected to the left ventricle instead of the right | Manifestations: murmur -severe cyanosis appearing hours to days after birth (as the PDA closes) -cardiomegaly -HF |
Tricuspid Atresia- a complete closure of the tricuspid valve that results in mixed blood flow | Manifestations: no bloodflow from the RA to the RV -severe cyanosis w/in hours of birth (increased as PDA closes) -HF -chronic hypoxemia -failure to thrive and growth retardation |
Tetralogy of Fallot- Four defects that result in MIXED blood flow -pulmonary stenosis -ventricular septal defect -overriding aorta -RV hypertrophy | Manifestations: murmur -cyanosis, severe dyspnea, clubbing of the fingers, hypercyanotic spells, and acidosis -polycythemia, clot formation -child frequently assuming squatting position (decrease venous return) -failure to thrive and growth retardatio |
Right sided HF | Right side usually unable to pump blood and increased pressure in RA increasing systemic venous circulation (s&sx= edema, hepatosplenomegaly) |
Left sided HF | Left side is unable to pump causing increased pressure in Left atrium and pulmonary vein and lungs become edematous and congested increasing pressure |
what is the number 1 earliest sign of CHF in children? | Tachycardia |
when do you hold Digoxin for babies and kids? | pulse <90 on babies pulse <70 on kids |
What are the 4 classifications of hemodynamic characteristics of CHD? | -increased pulmonary blood flow -decreased pulmonary blood flow -obstruction of blood flow from heart -mixed blood flow |
All defects with INCREASED pulmonary blood flow? | -atrial septal -ventricular septal -atrioventricular canal -patent ductus arteriosus (PDA) |
All defects with OBSTRUCTION of blood flow from heart? | -coarction of the aorta -aortic stenosis -Pulmonic stenosis |
All defects with DECREASED pulmonary blood flow? | -tetralogy of fallout - tricuspid atresia |
All defects with MIXED blood flow? | -transposition of great vessels -total anomalous pulmonary venous connection -Hypoplastic heart syndrome (left, right) |