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Pediatric Cardiovascular System

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The __________ is located between the aorta and the pulmonary artery and connects the pulmonary artery to the aorta, allowing a bypass of the pulmonary circuit. It protects the lungs from circulatory overload by shunting blood (right to left) into the descending aorta. A small portion of blood flows through the pulmonary circuit for the purpose of providing oxygen and nutrients and for removal of waste products.
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The ductus arteriosus
Describe the events that trigger the closure of the foramen ovale.
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With the baby's first breath, air pushes into the lungs, triggering an increase in pulmonary blood flow and pulmonary venous return to the left side of the heart. Pressures in the left atrium become higher than in the right atrium. Systemic vascular resistance increases and blood return to the heart via the inferior vena cava decreases. This causes an increase in pulmonary blood flow and left atrium pressure which closes the foramen ovale.
In order for the foramen ovale to close, pulmonary blood flow and pulmonary venous return increases in the ________ side of the heart.
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Left
In order for the foramen ovale to close, pressures in the _____ atrium become higher than in the ______ atrium.
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Pressures in the left atrium become higher than in the right atrium
In order for the foramen ovale to close, systemic vascular resistance ______ and blood return to the heart via the inferior vena cava ______. This causes an increase in pulmonary blood flow and left atrium pressure
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Systemic vascular resistance increases and blood return to the heart via the inferior vena cava decreases.
The ductus arteriosus becomes functionally closed within a few hours of birth, with _______ being the most important factor in its closure.
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Oxygenation-Aeration of the lungs at birth from the first breath, causes a decrease in pulmonary vascular resistance and allows pulmonary blood flow to increase and for oxygen exchange to occur in the lungs
The first few minutes of life, the baby’s heart rate is ______ bpm. It then begins to decrease to an average of _______ bpm.
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The first few minutes of life, the baby’s heart rate is 120-180 bpm. It then begins to decrease to an average of 120-130 bpm.
Which side of the infant heart has the highest pressures, right or left?
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Left
Pulmonary artery pressures in the infant should be the same as the pressure in the __________.
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Right ventricle
What prenatal/maternal health history factors would be significant for the development of fetal cardiac problems? (4)
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Alcohol use, use of teratogenic drugs (like Dilantin), infections during pregnancy (like Rubella), and the presence of certain medical conditions (like Lupus/DM)
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What are common findings in infants with cardiac problems? (4)
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Fatigue, tachypnea, sweating when feeding, and poor weight gain.
What is the normal heart rate for a toddler/preschooler?
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80-105 beats per minute
What is the normal heart rate for a school aged child?
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70-80 beats per minute
What is the normal heart rate for an adolescent?
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60-68 bpm
Digoxin should be given at regular intervals, usually every _______ hours.
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12 hours, i.e. 8:00 AM & 8:00 PM
Digoxin should be given at least _______ hour before eating or _______ hours after
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1 hour before or two hours after
T/F If a child vomits after being given Digoxin, they should not be given another dose.
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True
Edema of __________ is characteristic of right ventricular heart failure in older children.
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the lower extremities
When measuring a child's blood pressure, you note that the blood pressure in the right side of the arm is significantly higher than the left arm. You know this is a common finding with what heart condition?
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Coarctation of the aorta. It is also possible to have a BP higher in the upper extremities than the lower extremities
What is the normal urine output expected for a child?
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1 ml/kg/hour until they weight 30 kg (66 lbs.), then it should be 30 ml/hr (the adult rate)
_______ output is a good indicator of cardiac output.
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Urine output
  
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