Flashcards in Care of the child with a cardiovascular disorder - Part 2 - Unit 4 Deck (25)
What is an atrial septal defect?
Failure of the SEPTUM between the atriums to completely form - can also occur from a patent foramen ovale. Some blood shifts back.
What is a VSD?
Ventricular septal defect - most common!
Failure of the septum between the ventricles to completely form, so it floods the lungs! Possibly closed with cath or sternotomy.
AV canal - what is it? two types? what type of lung flooding?
Openings between atria and ventricles -- also cause valve abnormalities. AKA endocardial cushion defect.
Incomplete - separate AV valves.
Complete - common AV valve
EXCESSIVE lung flooding.
what is a PDA? When does it usually close?
Patent ductus arteriosis - allows blood to flow to the aorta while being diverted from the lungs. Usually closes during first 12-24 hours (by rise in PO2 and decrease in PGE) - causes a left to right shunt when not closed, so increased blood flow to lungs.
what is indomethacin?
NSAID - inhibits the synthesis of porstaglandins - 3 IV doses given at 12 to 24 hour intervals, with careful attention to urinary output.
What are the obstructive defects?
Coarctation of the aorta, aortic stenosis, and pulmonary stenosis
what is coarctation of the aorta?
Narrowing of the aorta - BP increased in upper extremities/decreased in lower extremities. Management with PGE, balloon angioplasty, surgical repair. risk of aneurysm present, etc.
What is aortic stenosis? Management?
narrowing of aortic valve, chest pain with activity/intolerance, increased afterload, syncope present, sudden death, etc.
Managed with balloon valvuloplasty/surgical repair.
What is pulmonary stenosis? Management? symptoms?
Narrowing of the pulmonary artery, right ventricular hypertrophy due to increased workload of right ventricle. DECREASED pulmonary blood flow. Manifested as loud murmur, dyspnea, syncope, angina. etc. Managed by balloon valvuloplasty & surgical repair.
what are the defects that cause decreased pulmonary blood flow?
Tetrology of fallot/tricuspid atresia.
what is tetrology of fallot? which side is stronger?
Pulmonary stenosis, hypertrophy of the right ventricle, overriding aorta, VSD
Increased right side pressure.
what's the #1 intervention for tetrology of fallot?
bring knees to chest! then do O2..but not o2 right away.
What is the blalock taussig shunt?
Bides time with t of f - branch of artery to pulmonary artery - increases blood flow to lungs.
what is tricuspid atresia?
lack of tricuspid valve between right atrium and ventricle. Underdeveloped right ventricle! ASD or PFO present, VSD present, mixing of blood occurs, increasing cyanosis, etc.
Tricuspid atresia - they need a VSD. T/F?
what's a fontan?
Systemic venous return is directed to pulmonary artery - baffle inside right atrium to direct blood from the IVC to the pulmonary artery.
What are the mixed defects?
Transposition of the great vessels, total anomalous pulmonary venous connection, hypoplastic left heart
what is transposition of the great vessels ?
Aorta is connected to R ventricle - pulmonary artery is connected to L ventricle - MUST have ASD/VSD, or PDA., cyanosis usually noted in 1st hour....
What is the atrial switch?
Aorta and the pulmonary artery are transected above the valves, moved to the correct position! Coronary arteries have to be moved as well...
Once moved, ASD/VSD/PDA are closed.
What is total anomalous pulmonary venous connection?
The 4 pulmonary veins are connected ELSEWHERE! need other defects to deliver oxygenated blood to the body. Surgical correction!
what is hypoplastic left heart? symptoms? management?
underdevelopment of the left ventricle, aortic atresia, manifested with extreme cyanosis/decreased CO, management = transplant, norwood, glenn, fontan
hypoplastic left heart - 100% mortality until surgically corrected - so they remove what?
Remove septum and just let it flow!
what are some complications of CHD?
failure to thrive, cardiogenic shock, thromboembolism, infection, respiratory compromise, cardiac dysrhythmia
What are some therapeutic nursing things for CHD?
avoid situations that increase cardiac demand (exercise, feeding, running, playing), monitor weight, small frequent feed, O2, medication, I&O, protect from infection..so DO NOT let kids cry - even though they'll be brats, DO NOT LET THEM CRY - too much energy!