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Pediatric Cardio

peds/cardio/anomolies/disease

QuestionAnswer
What are the 3 shunts in fetal circulation Ductus Arteriosus Ductus Venosus Foramen Ovale
Give the functions of the Ductus Arteriosus protects lungs from circ. overload Allows (R) vent to strenghten increase pulmo vascular resist decrease pulmon blood flow carries mostly medium leve o2 saturated blood
Give the functions of the Ductus Venosus Connects umbilical vein to inferior vena cava regulates blood flow via sphincter carries mostly HI oxygenated blood
Give the functions of the Foramen Ovale Shunts highly oxygenated blood from (R)atrium to (L)atrium
What are the clinical manifestations of Coarctation of aorta Weaker pulses and B/p in LE's Congenital narrowing of the Aorta 80% have aortic valve anomalies
What diagnostic test will show defect Echocardiogram and CXR (enlarged heart and dialated PA)
What happens in Coarctation of aorta if PDA closes higher resistence develops and hear failure can occure
Give treatments for Coarctation of Aorta Prostaglandins may be given to keep PDA open to reducce pressure changes. most common would be resection of narrowed area and re-anastomosis. antibiotic prophylaxis d/t possible aortic valve abnormalities.
What are some complications of Coarctation surgery. Kidney damage d/t clamping off of blood flow increased b/p post surgery may need antihypertensive.
most common benign defect of the heart PDA patent ductus arteriosis
When should a PDA close and what makes the PDA close within hours after birth. when PO2 level in arterial blood increases the PDA closes
Pulmonary artery flows at what pressure Low
Aorta flows at what pressure High
Blood flows from high pressure to low pressure since this is the case in a PDA what direction is blood flowing (aorta vs pulmonary artery) With a PDA blood would flow from the aorta into the pulmonary artery circulation at the PDA which would increase the vol of blood going to the lungs.
With a PDA what type of shunting occurs Left-to-Right shunt
What are the affects of left-to-right shunting increased workload on the left side of heart increased pulmon vascular congestion potentially right vent pressure and hypertrophy.
Increased pulmonary blood flow usu exhibits what clinical manifestations signs and symptoms of CHF: Fatigue Tachycardia; sweating; heavy breathing;Restlessness;decreased urine output;decreased b/p
what medical management is used to close a PDA Indomethacin (prostaglandid inhibitor)
Name 4 goals of treatment for PDA 1)improve cardiac function 2)remove accumulated fluid 3) decrease cardiac demands 4)improve tissue oxygenation and decrease oxygen consumption
What primary medication is used in children to improve cardiac function Digitalis glycosides
What are the benefits of digitalis increased cardiac output (increased contractility), decreased heart size, decreased venous pressure and relief of edema
What is the therapeutic serum digoxin level range 0.8 to 2.0
What treatment is used to remove accumulated fluid Diuretics
What are the most common diurectics used Lasix and thiazides (potassium -losing) and aldactone
What effect does Lasix have Blocks reabsorption of sodium and water in proximal tubule and interfers with the reabsorption of sodium
common signs of digoxin toxicity in children N/V,anorexia,bradycardia,dysrhythmias
ventricular septal defect causes shunting from left-to-right
ventricular septal defect leads to (R) ventricular hypertrophy deficient systemic blood flow
ventricular septal defect does not usu cause cyanosis
If pulmonary arterial pressure = systemic pressure what will happen reversal of the (L) to (R) shunting and resulting in cyanosis
What happens in (R) to (L) shunting blood bypasses the lungs for re-oxygenation resulting in cyanosis,breathlessness,poor feeding,FTT
VSD can be diagnosed by hearing a heart murmur (the smaller the hole the louder it is)
long term exposure to increased blood vol. in pulmonary artery leads to thickened vessel walls = pulmonary vascular disease
What is the pathophysiology of an atrial septal defect there is a hole inbetween the right and left atrium and blood flows from left atrium into the left atrium
what are the clinical manifestations of ASD Pulmonary HTN,decreased blood vol. in systemic circulation.
How to diagnose ASD heart murmur @ the pulmonary valve d/t heart forcing lg. amt of blood thru normal sized valve
what is the treatment for ASD surgical closure
What is the pathophysiology of Tetralogy of Fallot (4) stenosis/narrowing of pulmon valve hypertrophy of (R) ventricle displacement of aorta over VSD VSD
abnormalities of tetrology of fallot leads to insuff. oxygenated blood pumped to body
tetrology of fallot is responsible for cyanosis in child over the age of 1
with increasing cyanosis there may be clubbing of the fingers
in tetrology of fallot what does not help the cyanosis oxygen
what treatments are available for tetrology of fallot Prostaglandins to keep PDA open (if O2 levels are extremely low) complete repair when infant is 6 mo
what information can be obtained from a cardiac cath visualization of heart/vessels measure of O2 of chambers measure intra-cardiac pressures determine muscle function and pumping action
What are red flags for cardiac cath procedure toxicity to dye shellfish allergy
what are signs/symptoms of toxicity during cardiac cath proced increased temp uticaria wheezing edema SOB HA
name pre-cardiac cath proced. all VS Labs for @ risk blood loss (Hgb and Hct) pedal pulses NPO hold digoxin IV if polycythemia(dilute to decrease thrombis)
name post-cardiac cath proced VS q 15 X 1 hr apical count X 1 min assess pulses below cath site assess temp and color of affected extremity monitor for bleeding and formation of hematoma acetaminophen for pain
what manifestations indicate a (R)to(L) shunting VSD obstructive lesion
pathophysiology of (R) to (L) shunting increased pressure on right than on left increased resistance of lungs pulmonary artery restricted
if (R) to (L) shunting occurs what happens to deoxygenated blood from right side it gets shunted to the left side and out to systemic circulation (body)= cyanosis because it bypasses lungs to pick up O2
what are affects of (R) to (L) shunting hypoxemia=decreased tissue oxygen polycythemia=dodys attempt to compensate for hypoxemia
what are complications of (R) to (L) shunting thrombus formation d/t sluggish circulation brain abcess or stroke
signs and symptoms of L side HF (systemic venous congestion) weight gain hepatomegaly edema JVD
signs and symptoms of R side HF (pulmonary venous congestion) tachypnea dyspnea cough wheezes
what are some compensatory responses to heart failure tachycardia cardiomegaly diaphoretic fatigue FTT
When giving digoxin what electrolyte should be closely monitored potassium levels
name apical pulse parameters to hold digoxin infant/toddler <100 older child <80 adult <60
What is Kawasaki Disease acute,self limiting generalized vasculitis(inflammation of all vessels) esp. coronary arteries.
manifestations of kawasaki disease enlarged lymph nodes patchy rash peeling skin oral mucosal changes pink eye stawberry tongue high fever edema hands and feet red palms of hands and soles
what labortory values do you expect to see in kawasaki disease increase WBC, ESR and platelets
What are some interventions for kawasaki disease IV gamma glubulin high dose of ASA in hospital, low dose at home baseline echo to assess CA
What anomoly happens in aortic stenosis there is 2 rather than 3 leaflets leaflets are thickened or fused there is obstruction of blood flow from left vent.
symptoms of aortic stenosis dizziness syncope angina fatigue
what are signs/symptoms in an infant who has aortic stenosis FTT poor feeding exertion breathlessness
left vent hypertrophy equals Cardiomegaly
Created by: Booschick