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PEDs Final Heart
Heart Questions from Test map
Question | Answer |
---|---|
Afterload | The Resistance against which ventricles must pump when ejecting blood (Certain BP [Ace-inhibitors] effect this) AFFECTS LEFT VENTRICLE |
Preload | The volume of blood returning to the heart or the circulating blood volume (referes to myocardial fiber length [diuretics effects this]). DIURETICS AFFECT THIS |
Cardiac Output | Heart Rate *Stroke Volume (preload, afterload, and contractility) the volume of blood ejected by the heart in 1 minute. |
What lesions are related to decreased pulmonary blood flow? | TETRALOGY OF FALLOT (TOF) and Tricuspid Atresia |
What lesions are related to increased pulmonary blood flow? | Atrial septal defect (ASD) and Ventricular septal defect (VSD) |
What lesions are related to the obstruction of pulmonary blood flow? | Coarctation of the aorta; pulmonic and aortic stenosis |
Acyanotic lesions | ASD, VSD, and PDA |
Cyanotic lesions | TOF and Tricuspid atresia |
What are manifestations of chronic hypoxemia? | Blue discoloration of the skin and nail beds (cyanosis), cool to touch, clubbing (thickening and flattening of tips of nails), polycythemia, squatting, decreased pulse, metabolic acidosis |
What is a TET or hypercyanosis spell? | The child becomes acutely cyanotic and hyperpneic because sudden influndibular spasms decrease pulmonary blood flow and increase right to left shunting. Child turns blue during crying and feeding from low O2. |
Treatment for TET or hypercyanosis spell | Place child in a knee to chest position, give O2, and administer morphine. |
What is bacterial endocarditis? | An infection of the heart valves and inner lining of the heart (endocardium) or cardiac prosthesis. |
What is the relationshp between bacterial endocarditis and CHD? | Those with CHD are at a higher risk of acquiring bacterial endocarditis. |
How would you prevent and treat bacterial endocarditis? | Antibiotc prophylaxis in high risk patients only to prevent. Treatment: high dose of antibiotics given IV for 2-8 weeks. |
What is a Janeway Spot? | **Also known as Janeway Lesion** Purplish macules on the palms or soles. Associated with Endocarditis |
What are the signs of digoxin toxicity? | FATIGUE, NVD, Decreased output, CHANGE IN HR AND BP, Whole body swelling, Visual disturbances (nightmares), and hypersalviation, Bradycardia, Anorexia |
When would you want to open the ductus arteriosus? | For a patient that is not getting enough O2 |
What medicine helps open the ductus arteriosus? | Prostaglandin |
When do you close the PDA? | When it's open, close it to hear a murmur and to decrease chances of mixing blood from the right and left sides of the heart. PREMATURE BABIES |
What medicine is used to close the PDA | Indomethacin |
What is the first symptom in an acyanotic lesion? | Heart Murmur |
In what lesion is there an increase in blood pressure in upper extremities and decreased blood pressure in lower extremitites? | Coarctation (Cortex) of the aorta |
What may happen if the child with cyanotic lesion becomes dehydrated? | Hypoxic; due to this causing decreased pulmonary blood flow. Bluebaby |
What is Kawasaki disease? | Inflammation of the small and medium blood vessels, left untreated it will cause damage to the heart muscles and arteries, Erythema of the oral cavity, lips, tongue "strawberry tongue," Desquamation of the palms, Irritability, Age 3-5 year old |
Role of ASA and heart monitor with Kawasaki disease | ASA is given as an ANTI-INFLAMMATORY; antihimbolytic therapy. DECREASES INFLAMMATION |
Treatment of Kawasaki | High dose IV gamma globulin and salicylate therapy, heart monitor is for monitoring cardiac status for signs of heart failure |
Rheumatic fever | An inflammatory disease that occurs after pharyngitis caused by A B-hemolytic strep |
Jones Criteria (Rheumatic fever)Major risk factors: | Major risk factors: Carditis, chorea, erythema marginatum, sub-q nodules |
Jones Criteria (Rheumatic fever) Minor risk factors: | Minor risk factors: Arthralgia, prolonged pr interval, fever, elevated acute phase reactants. |
Polyarthritis | Inflammation of more than one joint. Swollen, hot painful joints. |
Aschoff bodies | Inflammatory hemorrhagic bullous lesions. A tiny lump that will damage the mitrals and aortas of the heart in rheumatic fever and polyarthritis. |
Signs of CHF in a child | Impaired mycardial function, Pulmonary congestion, Systemic venous congestion |
The four defects in Tetralogy of Fallot | VSD, Pulmonary Stenosis, Overriding aorta, Right ventricle hypertrophy |
Acyanotic | Related to increase pulmonary blood flow and there will be a murmur |