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Pediatric Cardiovascular System

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Children who undergo cardiac procedures often have a chest tube inserted to manage drainage. What amount of drainage is a cause for concern and warrants a call to the physician?
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Drainage of > 3ml/kg/hr for 3 consecutive hours warrants contacting MD- may indicate hemorrhage
_________ is a condition that results from defects causing left to right shunting (too much flow that the right side is not used to handling).
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Heart failure
___________ results from defects that cause decreased pulmonary blood flow (not enough O2 being oxygenated).
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Hypoxemia
What are the signs and symptoms of bacterial endocarditis?
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Flu-like, weight loss, cough, joint pain, fever, malaise, Splinter hemorrhages, new or changed heart murmur, Janeway’s lesions on palms and soles—red spots, painless, Osler’s nodes in pads of finger, toes—painful, pea sized, red or purple.Petechiae in conjunctiva, mucous membranes
_________ is characterized by vegetation on the walls of the heart comprised of fibrin, organisms and platelets that can embolize to circulation and damage heart valves.
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Bacterial endocarditis.
What conditions create an increased risk of getting bacterial endocarditis?
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Heart defects (VSD, PDA, TOF), heart surgury, Prosthetic valves, CM, valve disease
What is the best way to prevent bacterial endocarditis in a child with a preexisting heart condition?
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Antibiotic prophylaxis in those at high risk w/ invasive procedures, prophylatic antibiotic counseling and early s/s recognition- this is key to preventing long term problems
Where does peripheral edema typically begin to develop in infants?
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First in the face, then the presacral region, and then the extremities.
What respiratory condition may be a sign of congenital heart disease?
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Frequent bouts of pneumonia can be a significant sign of pediatric heart disease
Diaphoresis is a sign often reported by parents of infants who are experiencing ___________ .
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early heart failure
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Why does clubbing not typically appear in children until they are at least a year old?
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The child must experience chronic hypoxia in order for clubbing to develop and it is a process which takes time.
A child has undergone a Blalock-Taussig shunt to connect the subclavian artery to the pulmonary artery in order to treat tetrology of fallot. What are some nursing measures for the post-operative period?
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Don't take BP measurements or perform venipuncture in the affected arm. Pulses may not be palpable in that arm. Monitor for ventricular arrythmias.
________ is a congenital heart defect where the valves between the right atrium and right ventricle fail to develop.
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Tricuspid atresia
To treat ______, a temporary Blalock shunt or pulmonary artery banding is done to help the child until they are 3-6 months old. At that point, the SVC is detached from the heart and reconnected to the pulmonary artery.
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Tricuspid atresia (the ultimate goal is to get blood flow via the pulmonary artery to the lungs)
In children with congenital defects resulting in increased pulmonary blood flow, _______ is not a recommended intervention because it is a potent vasodilator and can start a cascade which results pulmonary hypertension.
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Oxygen
Signs and symptoms of what cardiac defect? Fixed split S2, systolic ejection murmur (best heard in the pulmonic valve area), right ventricular heave, shortness of breath, fatigue, poor growth.
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Atrial Septal Defect
What condition is Eisenmenger syndrome (cyanosis and pulmonary hypertension) associated with?
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Ventricular Septal Defect (VSD)
What cardiac condition occurs 30 times more in children born in high altitudes than those born at sea level?
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Patent Ductus Arteriosus (PDA)
What complications can develop in children with coarctation of the aorta?
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Stroke, aortic rupture, or aortic aneurysm
Signs and symptoms of what cardiac condition? Epistaxis, headaches, leg pain with activity, bounding pulses, widened pulses, notching of the ribs, murmur.
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Coarctation of the aorta
Which heart defect doesn't result in abnormal growth of the child?
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Pulmonary Stenosis
  
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