Term
| CV Observation/Inspection Assessment Areas |
|
Definition
1. Color
2. Mucous Membranes
3. Precordium
4. Edema |
|
|
Term
| What happens to fetal circulation after birth? |
|
Definition
1. Systemic vascular resistance increases
2. Foramen ovale closes
3. Ductus arterious constricts-closes within 10 to 15 hours of birth
4. Left ventricle enlarges due to increased pressure |
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|
Term
| Why is an newborn heart rate so high? |
|
Definition
|
|
Term
| Does blood pressure increase or decrease as the heart develops from birth? |
|
Definition
|
|
Term
| What does pulse oximetry measure? |
|
Definition
| The amount of oxygen available for tissue delivery |
|
|
Term
|
Definition
| An abnormally increased concentration of hemoglobin in the blood, through either reduction of plasma volume or increase in red cell numbers. |
|
|
Term
| What is the body's response to chronic hypoxia? |
|
Definition
|
|
Term
| What is a major risk of polycythemia? |
|
Definition
| Dehydration turns the blood thick, like mud. This puts the patient at risk for a stroke |
|
|
Term
| How do you calculate cardiac output? |
|
Definition
| Heart Rate x Stroke Volume |
|
|
Term
| What are 5 situations that can lead to CHF in children? |
|
Definition
1. Cardiac output cannot keep up with circulatory or metabolic demands
2. Congenital heart defects
3. Decreased heart contractility
4. Disease processes that require high cardiac output
5. Acquired diseases |
|
|
Term
| What are disease processes that require high cardiac output? |
|
Definition
1. Severe anemia
2. Acidosis
3. Respiratory disease |
|
|
Term
| What are several risk factors for cardiac dysfunction in a child? |
|
Definition
1. Alcohol/drugs
2. diabetes
3. infection early in pregnancy
4. Toxins
5. Family history
6. Trisomy 21, 13, 18 |
|
|
Term
| What are examples of acquired diseases that result in child CHF? |
|
Definition
1. Cardiomyopathy
2. Kawasaki disease |
|
|
Term
| What happens when there is a volume overload on the heart due to increased pulmonary circulation? |
|
Definition
The is back flow from the right ventricle to the right atrium that results in peripheral edema
Right sided CHF |
|
|
Term
| What happens and obstruction defect, such as a dysfunctional right valve? |
|
Definition
| Left sided CHF that results in pulmonary edema |
|
|
Term
| What are early signs of CHF in infants? |
|
Definition
1. Tiring during feeding
2. Weight loss (or lack of weight gain) |
|
|
Term
| What are early signs of CHF in children? |
|
Definition
1. Exercise intolerance
2. Dyspnea
3. abdominal pain
4. Periorbital & sacral edema before any other edema
5. peripheral edema |
|
|
Term
| What are late signs of CHF in children? |
|
Definition
1. Respiratory symptoms: tachypnea, nasal flaring, retractions, cough, crackles
2. Tachycardia
3. Generalized fluid overload
4. Cardiomegaly |
|
|
Term
| What are 4 diagnostic tests that measure cardiac function? |
|
Definition
1. Radiography
2. EKG
3. Echocardiography
4. Cardiac catheterzation |
|
|
Term
| What is cardiac catheterization? |
|
Definition
| It is a catheter guided with fluoroscopy dye injected for visualization and blood pressures measured |
|
|
Term
| How can you determine cyanosis is cardiac related? |
|
Definition
| If you give the patient oxygen at he remains blue it is of cardiac in origin |
|
|
Term
| What can cardiac catheterization be used for? |
|
Definition
1. Diagnosis
2. Intervention
3. Electrophysiology |
|
|
Term
| What is one risk associated to cardiac catheterization? |
|
Definition
| Hemorrhage from a blood clot |
|
|
Term
| What are reasons for cancellation of a cardiac catheterization? |
|
Definition
| Infection with a fever, rashes, arrhythmias |
|
|
Term
| What are possible nursing care tasks for a patient receiving a cardiac catheterization? |
|
Definition
| NPO, mark site with an X , keep the leg straight, keep a clean pressure dressing on the site, check pulses, vitals every 15 minutes for the first 4 hours following the procedure |
|
|
Term
| What education should be given by the nurse to a patient receiving a cardiac catheterization? |
|
Definition
1. Normal activity within 24 hours
2. Call the physician if there is any drainage
3. Call the physician if there is a color change in the leg
4. Call the physician if there |
|
|
Term
| What are 4 heart defects that increase pulmonary blood flow? |
|
Definition
| Patent ductus arteriosus (PDA), atrial septal defect (ASD), Ventricular septal defect (VSD), atrioventricular can defect (AV canal) |
|
|
Term
| If left untreated what can pulmonary over circulation lead to? |
|
Definition
1. CHF
2. Pulmonary HTN
3. Death |
|
|
Term
| How can you describe PDA circulation? |
|
Definition
| Persistent fetal circulation |
|
|
Term
| What infant characteristic is common with PDA? |
|
Definition
|
|
Term
|
Definition
Closed with:
1. medication
2. Devices ie coil embolization
3. Surgery |
|
|
Term
| How can you describe ASD? |
|
Definition
| A very common heart defect (15% of child heart defects) that has an opening (large or small) in the atrial septum that permits left to right shunting of blood |
|
|
Term
| How can a closure be attained for an ASD? |
|
Definition
1. It can close spontaneously
2. Devices that open like an umbrella can be inserted via cardiac catheter, and cause clotting
3.Surgery uses the pericardium to patch the opening |
|
|
Term
| What are the three types of ASDs? |
|
Definition
1. Ostium secudum: an opening in the center which is easily fixed
2. Ostium primum and opening by the AV node or valves which is a more serious defect
3. Sinus Vinosous an opening near the superior vena cava |
|
|
Term
| How can you describe a VSD? |
|
Definition
| The most common child heart defect (25% of all child heart defects) is an opening in the ventricular septum that permits left-to-right shunting of blood. |
|
|
Term
| How can a closure be attained for a VSD? |
|
Definition
1. Spontaneously
2. Surgery |
|
|
Term
| What is a major risk from VSD? |
|
Definition
|
|
Term
| What is the prognosis of a child with a VSD? |
|
Definition
| High risk if repair is needed in first few weeks of life |
|
|
Term
| What is a sign of an VSD that can be found during assessment? |
|
Definition
|
|
Term
|
Definition
| ASD + VSD + tricuspid & mitral valve defects |
|
|
Term
| What group of children is at risk for an AV canal? |
|
Definition
|
|
Term
| How is an AV canal repaired? |
|
Definition
Surgery:
1. Close the ventricle wall first
2. Cannot use artificial valves because the child is growing |
|
|
Term
| What is the prognosis for a child with AV canal? |
|
Definition
| Mitral valve insufficiency and arrhythmias are common |
|
|
Term
|
Definition
| Four defects: PS, Ventricular hypertrophy, VSD, Overriding aorta that increases in pressure on the right side of the heart and causes right to left shunting |
|
|
Term
|
Definition
1. During the play the child suddenly stops and squats to promote blood flow back to the heart
2. Cyanotic (Tet) spells |
|
|
Term
|
Definition
| Shunt is created from subclavian artery to the lungs. Then VSD is treated patched. As the child grows the other defects are treated. |
|
|
Term
| What is the prognosis of a child with TOF? |
|
Definition
| Mortality is less than 3%. The child may have right ventricular dysfunction. |
|
|
Term
| How can you treat TOF immediately? |
|
Definition
| Give oxygen and have the patient bend there knees |
|
|
Term
| What are 3 mixed heart defects in children? |
|
Definition
1. Transposition of the great arteries (TGA)
2. Truncus Arterious
3. Total anomalous pulmonary venous return (TAPVR) |
|
|
Term
| What is an infant with mixed heart defects dependent on? |
|
Definition
| The mixing of systemic and pulmonary blood |
|
|
Term
|
Definition
| Parallel circulation of the heart that is life threatening |
|
|
Term
| How does mixing of blood occur in a patient with PGA? |
|
Definition
| Via PDA, patent foramen ovale (PFO), ASD, or VSD |
|
|
Term
| What diagnostic tool is used to identify TGA? |
|
Definition
|
|
Term
|
Definition
1. Prostaglandins E1 are given to maintain PDA
2. Balloon arterial septostomy is used to enlarge PFO (create ASD)
3. Surgical repair, usually within the first week (Jeteen switch |
|
|
Term
| What is the prognosis for TGA patients? |
|
Definition
| Less than 2% mortality; the 5 year survival rate is 82%. Pulmonary & aortic stenosis, coronary artery obstruction may occur |
|
|
Term
| What is Truncus Aterious? |
|
Definition
| An uncommon heart defect where a single large vessel empties into both vesicles instead of the normal two vessels (pulmonary trunk & aorta) |
|
|
Term
|
Definition
| Four defects: PS, Ventricular hypertrophy, VSD, Overriding aorta that increases in pressure on the right side of the heart and causes right to left shunting |
|
|
Term
|
Definition
1. During the play the child suddenly stops and squats to promote blood flow back to the heart
2. Cyanotic (Tet) spells |
|
|
Term
|
Definition
| Shunt is created from subclavian artery to the lungs. Then VSD is treated patched. As the child grows the other defects are treated. |
|
|
Term
| What is the prognosis of a child with TOF? |
|
Definition
| Mortality is less than 3%. The child may have right ventricular dysfunction. |
|
|
Term
| How can you treat TOF immediately? |
|
Definition
| Give oxygen and have the patient bend there knees |
|
|
Term
| What are 3 mixed heart defects in children? |
|
Definition
1. Transposition of the great arteries (TGA)
2. Truncus Arterious
3. Total anomalous pulmonary venous return (TAPVR) |
|
|
Term
| What is an infant with mixed heart defects dependent on? |
|
Definition
| The mixing of systemic and pulmonary blood |
|
|
Term
|
Definition
| Parallel circulation of the heart that is life threatening |
|
|
Term
| How does mixing of blood occur in a patient with PGA? |
|
Definition
| Via PDA, patent foramen ovale (PFO), ASD, or VSD |
|
|
Term
| What diagnostic tool is used to identify TGA? |
|
Definition
|
|
Term
|
Definition
1. Prostaglandins E1 are given to maintain PDA
2. Balloon arterial septostomy is used to enlarge PFO (create ASD)
3. Surgical repair, usually within the first week (Jeteen switch |
|
|
Term
| What is the prognosis for TGA patients? |
|
Definition
| Less than 2% mortality; the 5 year survival rate is 82%. Pulmonary & aortic stenosis, coronary artery obstruction may occur |
|
|
Term
| What is Truncus Aterious? |
|
Definition
| An uncommon heart defect where a single large vessel empties into both vesicles instead of the normal two vessels (pulmonary trunk & aorta) |
|
|
Term
| What may result from truncus arteriosus? |
|
Definition
1. Cardiomegaly
2. Right sided CHF |
|
|
Term
|
Definition
| A rare heart condition where pulmonary veins empty into the right atrium instead of the left atrium |
|
|
Term
|
Definition
|
|
Term
| How is truncus arterious treated? |
|
Definition
|
|
Term
| What is the prognosis for truncus arteriosus? |
|
Definition
| Improving but long term is unknown |
|
|
Term
| How is blood mixed in a patient with TAPVR? |
|
Definition
| The foramen ovale allows oxygenated blood to move from the right atrium to the left atrium |
|
|
Term
|
Definition
1. Prostaglandin E1 is used to to maintain PDA to allow more mixed blood
2. Balloon atrial sepstomy is use to enlarge PFO into and ASD
3. If pulmonary veins have an adequate diameter they can be surgically attached to the left atrium |
|
|
Term
|
Definition
| The most common where pulmonary veins go into the superior vena cava |
|
|
Term
|
Definition
| Pulmonary veins go directly to the right atrium |
|
|
Term
|
Definition
| Pulmonary veins form a common pulmonary vein that descends below the diaphragm that goes into the ductus venosus or the portal vein so blood goes to the liver before is returns to the right atrium |
|
|
Term
|
Definition
| Some of the pulmonary veins join the system at one place and the other pulmonary veins at a second place randomly |
|
|
Term
| What is a complication with pulmonary veins that can occur in TAPVR patients? |
|
Definition
| The diameter size can be small and cause pulmonary hypertension |
|
|
Term
| Prognosis of patients with TAPVR? |
|
Definition
| Generally good as long as they have adequate diameter pulmonary veins. |
|
|
Term
|
Definition
Crying and exercise causes increase in cyanosis
1/2 are cyanotic during the first month of life.
2/3 develop CHF by 3 months
90% have CHF by 1 year |
|
|
Term
| What are 3 heart defects that obstruct systemic blood flow? |
|
Definition
1. Aortic stenosis
2. Coarction of the aorota
3. hypoplastic left heart syndrome |
|
|
Term
| What are the effects of defects that obstruct systemic blood flow? |
|
Definition
| Increase workload on one or both ventricles of the heart, leading to CHF if untreated |
|
|
Term
|
Definition
| A narrowed aortic valve that obstructs blood flow. AS is very deadly |
|
|
Term
|
Definition
1. The valve is dilated with a balloon
2. The valve is replaced or a surgical valvuloplasty is performed |
|
|
Term
| What is the prognosis for patients with AS? |
|
Definition
| The child may need repeated valve replacements or dilations as they grow. Sudden death may occur. |
|
|
Term
| What is a coarctation of the aorta? |
|
Definition
| A common defect where the aorta narrows, usually near the ductus, obstructing blood flow |
|
|
Term
|
Definition
| a condition in which an orifice or passage in the body is abnormally closed or absent. |
|
|
Term
|
Definition
1. Blood pressure is higher in arms than legs
2. Weak femoral pulses
3. HTN IV treatment does not bring down the blood pressure |
|
|
Term
|
Definition
1. Balloon dilation
2. Surgical repair |
|
|
Term
| What is the prognosis for COA? |
|
Definition
Persistent Hypertension is common aorta is common
Aorta can stenosis at the surgical site |
|
|
Term
|
Definition
| A very severe heart defect where the mitral and aortic are abnormally small because they fail to develop in utero. It is more common in males. 80% also have coarctation of the aorta. 95% die by week one. |
|
|
Term
|
Definition
1. The ductus arteriosus and foramen ovale are kept open with prostaglandin E1
2. Comfort care is given
3. 3 stage surgery
4. Heart transplant |
|
|
Term
|
Definition
|
|
Term
| What are the different stages/surgeries involved in treating HLHS? |
|
Definition
1. Norwood (immediately also highest mortality, 5 year survival rate is 50-70%)
2. Glen (3-8 mos)
3. Fontan (18 months) |
|
|
Term
| What are nursing considerations for HLHS patients? |
|
Definition
1. Keep patient on dry side
2. Keep patient polycythemic (HCT 45%) to ensure enough oxygen is distributed throughout the tissues. O2 saturations will be around 80-85%.
3. Be cautious not to overload the right side of the heart because it will give up |
|
|
Term
|
Definition
| Without surgery the patient is dead within days. |
|
|
Term
| What is the issue with heart transplants for infants? |
|
Definition
1. There are not many hearts available for that age.
2. Immunosuppressants must be used
3. Hearts last for 10-15 years
4. 63% of infants waiting for donor hearts die |
|
|
Term
| What is the prognosis for HLHS? |
|
Definition
| Long term survival rate is not known. |
|
|
