Term
| What body part is comparable to the size of your heart? |
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Definition
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|
Term
| What is the purpose of the ductus arteriosus in utero? |
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Definition
| divert blood from lungs to aorta (mom breathes for them so blood doesn't need to go to their lungs) |
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Term
| Describe the two types of peds heart defects |
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Definition
| congenital (at birth) and acquired (after birth; infection, autoimmune, environment, genetic) |
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Term
| ductus arteriosus can be kept open by what? |
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Definition
| fetal prostaglandin E (PGE) and decreased O2 |
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Term
| What are 4 first breath hemodynamic changes? |
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Definition
| alveoli expand, placenta removed, ductus arteriosus closes, foramen ovale closes |
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Term
| The best way to describe congenital heart disease is in relation to ___ |
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Definition
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Term
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Definition
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Term
| What two critical events differentiate fetal circulation from postnatal circulation? |
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Definition
| interruption of the umbilical cord and spontaneous respirations |
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Term
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Definition
| abnormal opening between atria; asymptomatic with spontaneous closure by 2 yrs; RV volume overload and RV dilation |
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Term
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Definition
| ventricular septal defect, increased PBF and PH, murmur soft or late; L atrial dilation |
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Term
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Definition
| peripheral vascular resistance |
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Term
| What are the clinical manifestations of a large VSD? |
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Definition
| tachypnea, sweating with feeding, frequent URI, FTT |
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Term
| Describe PDA (patent ductus arteriosus) after birth |
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Definition
| failure to close within first wks of life; machinery like murmur, FTT, exercise intolerance, wide pulse pressure, increases pulmonary blood flow |
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Term
| What are the complications of PDA? |
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Definition
| CHF, bacterial endocarditis, PH |
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Term
| Describe Coarctation of the aorta |
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Definition
| CoA or Coarc, discrete narrowing segment of aorta just beyond LSCA, distal blood flow decreases with high BP and strong pulse in upper extremities |
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Term
| What are the clinical manifestations of Coarctation of the aorta in a newborn? |
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Definition
| Asymptomatic till PDA closes; severe CHF, poor perfusion, tachypnea, acidosis, absent femoral pulses |
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Term
| What are the clinical manifestations in an older child with CoA? |
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Definition
| Asymptomatic; HTN upper extremities, weak femoral BP, nosebleeds, leg cramps |
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Term
| What are the complications of CoA? |
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Definition
| Hypertension, CHF, cerebral hemorrhage, endocarditis |
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Term
| Describe tetralogy of fallot |
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Definition
| most common CHD; Tetrad: VSD, Pulmonary Stenosis, Overriding Aorta, RVH; cyanosis SOB fainting |
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Term
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Definition
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Term
| What are the 4 abnormalities of TET? (patho) |
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Definition
| large, nonrestrictive VD, aortic override, RV outflow obstruction, RV hypertrophy |
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Term
| What are the clinial manifestations of TET? |
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Definition
| Cyanosis, polycythemia, squatting, TET spell |
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Term
| Describe a blalock taussig shunt |
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Definition
| shunts blood from R or L subclavial artery to PA |
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Term
| What is another name for TET spells? |
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Definition
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Term
| What is the goal of TET treatment? Example? |
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Definition
| increase pulmonary blood flow; squatting, sedation |
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Term
| Those with polycythemia are at an increased risk for what? |
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Definition
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Term
| What are the 4 main issues with congestive heart failure? |
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Definition
| volume overload, pressure overload, decreased contractility, high output demands |
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Term
| What are the important clinical manifestations of CHF? |
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Definition
| wheezing, grunting, accessory muscles |
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Term
| What are the clinical manifestations of CHF related to systemic venous congestion? |
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Definition
| weight gain, hepatomegaly, peripheral edema, ascites |
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Term
| What're the 3 physiological factors for circulation? |
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Definition
| pressure gradients, flow and resistance; blood flows from high to low pressure and takes path of least resistance |
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Term
| What are the 4 med interventions for CHF? |
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Definition
| Digoxin, diuretics, ACE inhibitors, O2 |
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Term
| What is the most common response to hypoxemia? |
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Definition
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Term
| Which side of the heart has the lowest pressure/resistance? |
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Definition
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Term
| What do you suspect if you assess an infant with CHF who has rales, ronchi, nasal flaring, restlessness and decreased O2 sat? |
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Definition
| increased fluid in lungs or congenital heart defect |
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|
Term
| Which side of the heart has higher systemic pressure from lungs? |
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Definition
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|
Term
| What 4 things contribute to the airflow limitation and obstruction in asthma? |
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Definition
| edema, increased mucous production, bronchoconstriction, and air trapping |
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Term
| The use of singulair as a leukotrine modifier is ____ therapy |
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Definition
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Term
|
Definition
| increased viscosity of mucous gland secretion (throughout body), autosomal recessive, abnormal Cl movement |
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Term
| Describe RSV bronchiolitis |
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Definition
| acute viral infection of lower airways; bronchila mucosa swells and lumina fills with mucus and exudate that cause obstruction of bronchioles; those <2 at highest risk |
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Term
| How is RSV bronchiolitis transmitted? |
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Definition
| Direct contact with respiratory secretions |
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Term
| Describe the symptoms of RSV bronchiolitis |
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Definition
| mild usually begins as URI, moderate progresses to lower airway, severe is all of the above |
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Term
| What're 3 types of GI issues experienced by those with CF? |
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Definition
| Nutrition (need high calorie/protein diet), Intestinal obstruction (lower fat diet), rectal prolapse |
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|
Term
| What are the symptoms of depression? |
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Definition
| sadness, despair, pessimism, loss of interest in usual activities, altered sleep patterns |
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Term
| Depression rates are high among patients with ____ |
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Definition
|
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Term
| What are 3 categories of contributing factors of depression? |
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Definition
| biological, psychosocial and stressful life event |
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Term
| Depression alters the 4 spheres of human functioning which are.... |
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Definition
| affective (sadness), behavioral (tearful), cognitive (poor concentration) and physiological (insomnia) |
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|
Term
ID behavior associated with depression:
preoccupied with thoughts of loss, self blame, anger and denial |
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Definition
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|
Term
ID behavior associated with depression:
helplessness, lack of eye contact, negative, sensitive to criticism |
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Definition
|
|
Term
ID behavior associated with depression:
confusion, difficulty concentrating, inaccurate interpretation of environment |
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Definition
| disturbed thought process |
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Term
| What are 2 important markers of postpartum or peripartum depression? |
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Definition
| ineffective childbearing process (not acting like you're pregnant) and not demonstrating attachment to baby |
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Term
| Depression during periods and post partum depression can be a red flag for? |
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Definition
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Term
| What are 3 major risk factors for PPD? |
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Definition
| sleep deprivation, hx of depression, and isolation |
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Term
| Baby blues should last no longer than ___ days |
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Definition
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|
Term
|
Definition
| causes significant maternal distress characterized by scary thoughts, negative intrusive images |
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Term
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Definition
| associated with abnormal behaviors not usually seen with certain attitudes |
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Term
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Definition
| normal acceptable behaviors for a set of circumstances |
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Term
| What is the most sensitive period in pregnancy for inducing birth defects? |
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Definition
| 3-8 wks; period of embryogenesis |
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Term
| In what class do 66% of pregnancy meds fall? |
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Definition
| C;; animal studies show no risk or animal studies show risk but not human studies |
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Term
| What is the most common preventable risk for children with mental retardation? |
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Definition
|
|
Term
| What 3 supplements can improve depression? |
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Definition
| Vitamin D, B12 and omega 3 fatty acids |
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|
Term
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Definition
| traumatic, accidental,acquired and elective |
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Term
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Definition
| wound that fails to proceed through orderly process of repait |
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|
Term
| Describe the 4 phases of wound healing |
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Definition
| hemostasis (clotting), inflammation, proliferation (collagen formation), remodeling (maturation phase) |
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|
Term
| What can cause chronic wounds? |
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Definition
| repeated trauma, ischemia, necrotic tissue, tissue breakdown |
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Term
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Definition
|
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Term
| What are some factors that contribute to impaired healing? |
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Definition
| age, infection, sensory perception, smoking, tissue integrity, immobility, continence |
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|
Term
| What are the mechanical stressors of wounds? |
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Definition
| friction, sheer, pressure |
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Term
| Describe the effect of temperature on wound healing |
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Definition
| low temps slow healing; it can take 4 hrs post dressing change for the temp to return to normal |
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Term
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Definition
| black hard substance that covers a wound; must be removed for healing |
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Term
|
Definition
| thick, fibrous, and yellow material on or coming from a wound |
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|
Term
|
Definition
| skin filled excessively with fluid; skin loss but not a pressure ulcer; breast and abdominal folds |
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|
Term
|
Definition
| drugs a hospital will give for categories of wounds |
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Term
|
Definition
| drugs for wounds patient can special order and the hospital will administer it |
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|
Term
| Describe wound assessment |
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Definition
| length (head to toe), width (hip to hip), depth, location, tunneling/undermining |
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|
Term
|
Definition
| space between surrounding skin and wound bed; SQ fat necrosis |
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|
Term
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Definition
| abnormal connection between 2 parts of the body lined with epithelial cells; congenital, surgical or disease producing |
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|
Term
| What 4 things do you look for in a wound bed? |
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Definition
| granulation, bruising, slough, eschar |
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|
Term
| pain in a wound is a high indicator of what? |
|
Definition
| high bioburden, arterial insufficiency, major infection |
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|
Term
| What causes arterial ulcers? |
|
Definition
| insufficient arterial flow to tissues causes ischemia and necrosis; atherosclerosis is most common cause |
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|
Term
| What is the primary goal in wound care? |
|
Definition
| increase circulation to the effected area |
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|
Term
| Describe the appearance of arterial ulcers |
|
Definition
| punctated, shiny, hairless skin, base of wound resembles slough, line of demarcation |
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|
Term
|
Definition
|
|
Term
| What causes venous stasis ulcers |
|
Definition
| chronic venous insufficiency-> venous HTN; lower limb blood pooling/edema cause incompetent valves |
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|
Term
| Describe hydrocolloid wound care products |
|
Definition
| an occlusive and adhesive wafer dressing for moderate amounts of exudate |
|
|
Term
|
Definition
| protects wound bed from dessication and promotes epithelialization and grannulation |
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|
Term
| Describe calcium alginate |
|
Definition
| highly absorbent dressing that maintains moist environment that promotes healing |
|
|
Term
| What are the risk factors for cellulitis? |
|
Definition
| age, weak immune system, diabetes, IV drug use |
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|
Term
| What are 3 types of debridement |
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Definition
| surgical, autolytic, enzymatic |
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|
Term
| In the eye, veins are ____ than arteries |
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Definition
|
|
Term
| Where are rods and cones located in the eye? |
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Definition
|
|
Term
|
Definition
|
|
Term
| Describe red eye problems |
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Definition
| sudden tearing, puffiness, redness and blurred vision; check visual acuity; physical eye exam |
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|
Term
| Red eye problems are most commonly seen with who? |
|
Definition
|
|
Term
| ID the opthalmic red flags |
|
Definition
| sudden and painless decreased vision, trauma, foreign body, corneal abrasion, pain |
|
|
Term
|
Definition
| lens opacity>>decreased visual acuity>> blindness; dull red reflex and opaque pupil; need stronger glasses or surgery |
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|
Term
| Describe age related macular degeneration |
|
Definition
| diminished central vision due to aging macule; leading cause of irreversible vision loss; prevented with high dose antioxidants and zinc |
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|
Term
|
Definition
| damage to optic nerve from high intraocular pressure; loss of visual field>>blindness; open angle and angle closure are urgent |
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|
Term
| What're the symptoms of open angle glaucoma? |
|
Definition
| asymptomatic elevation of IOP; "silent blinder" |
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|
Term
| What are the syptoms of angle closure glaucoma? |
|
Definition
| painful red eye, decreased visual acuity, n/v; treated with beta blockers |
|
|
Term
| What is the leading cause of blindness in ppl<65? |
|
Definition
| diabetic retinopathy; associated with DM, HTN, smoking |
|
|
Term
| What are the symptoms of diabetic retinopathy? |
|
Definition
|
|
Term
| What is the most common complaint in the hospital? |
|
Definition
| Dry eyes; decreased tear production or increased evaporation; avoid irritants, give hot compress or artificial tears |
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|
Term
| What are the 4 types of conjunctivitis? |
|
Definition
| Bacterial (staph most common), viral, inclusion, allergy (non-contagious) |
|
|
Term
| Describe bacterial conjunctivitis |
|
Definition
| mucopurulent discharge (oozing), unilateral initially |
|
|
Term
| Describe viral conjunctivitis |
|
Definition
| mucoid discharge sometimes seen with URI symptoms; photophobic; limit eye rubbing |
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|
Term
| Describe allergic conjunctivitis |
|
Definition
| itchy, watery bilateral; mild redness and swelling of lids and conjunctiva; use cool compress |
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|
Term
|
Definition
| blurred vision, pain and photophobia with small fixed pupil; emergency |
|
|
Term
|
Definition
| abrasion, foreign body, erosion or ulcer |
|
|
Term
|
Definition
| emergent accumulation of blood in anterior chamber from trauma |
|
|
Term
|
Definition
| itching, discomfort, drainage, decreased hearing; remove debris and acidify canal with vinegar and alcohol |
|
|
Term
|
Definition
| fusion of stapes, they no longer vibrate to detect sound; chronic, progressive |
|
|
Term
| Describe meniere's disease |
|
Definition
| immediate onset of extreme vertigo with n/v, hearing loss and tinnitus |
|
|
Term
|
Definition
| chronic ringing, buzzing, roaring in ears; can be caused by persistent loud music, excessive earwax or antibiotics (IV drip) |
|
|
Term
| Describe the treatment of tinnitus |
|
Definition
| control external noise (ear plugs), hearing aids (to hear above ringing) |
|
|
Term
| What are the rights of the sick person? |
|
Definition
| Forgiveness (exempt from normal social roles); responsible for seeking out care to get well |
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