RNSG 1412 (Ob/Pedi) - Exam 2, PPT & Learning Guide: PEDI
Cardiac|Pediatric Cardiology, Congenital Heart Defects, Acquired
Heart Disease, Tetralogy of Fallot, Hypoplastic Left Heart Syndrome,
Patent Ductus Arteriosus, Ventricular Septal Defect, Aortic Stenosis,
Valvular Disease, Endocarditis, Bacterial Endocarditis Risk Factors,
Rheumatic Fever, Jones Criteria, Kawasaki Disease, Phases of
Kawasaki, IVIG Therapy, Aspirin Therapy, Coronary Artery Monitoring,
Polycythemia, Thromboembolism Prevention, Cardiac
Catheterization, Supraventricular Tachycardia, Heart Failure
Management, Congestive Heart Failure, Digoxin and Furosemide
Therapy, Exercise Intolerance, Nutritional Support in CHF, Cyanosis,
Knee-Chest Position, Oxygenation Strategies, Prostanoid Therapy,
Patient/Family Education, Long-Term Cardiac Follow-Up, Symptom
Recognition, Infection Prevention Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
Review of the Heart
•Normal cardiac anatomy and physiology
•Muscular pump divided into four chambers
•Upper chambers are atria.
•Lower chambers are ventricles.
•Atria are the filling chambers.
•Ventricles are the pumping chambers.
•Two atrioventricular (AV) valves, two semilunar valves
•Mechanical contraction of the heart begins with electrical
stimulation.
Fetal Circulation
,What are the routes of blood flow through the fetal heart?
Why does the blood flow in that route?
ductus arteriosis, foramen ovale, ductus venosus
it needs to bypass the lungs & liver
What is the stimulus for the change in circulation?
baby's 1st breath
What happens after the umbilical cord is clamped?
prostaglandin lvl drops and ductus arteriosus begins to close
What changes occur in intrauterine vs. extrauterine circulation?
foramen ovale closes w/i min.
ductus arteriosis closes hrs to a few days
ductus venosus thickens and closes over days as well
Intrauterine to Extrauterine
Infant takes first breath, and the lungs inflate which leads to...
decreased pulmonary vascular resistance.
,The change in pulmonary vascular resistance leads to...
Increased pulmonary blood flow.
Increased pressure in the left atrium & decreased pressure in the right atrium leads to...
closure of the foramen ovale.
The ductus arteriosus and ductus venosus close related to pressure changes & increased levels of
oxygen.
Heart Failure
What is wrong with the heart?
Why does the heart fail?
In heart failure, the heart is unable to pump enough blood and oxygen to the body's organs and tissues.
This can happen when the heart is too weak or stiff to pump properly, or when it can't fill up with
enough blood
Heart failure can affect the left side of the heart, the right side, or both sides. The most common type of
heart failure is left-sided, which occurs when the left ventricle can't pump enough blood. This can
happen in two ways:
Systolic heart failure
The heart muscle is weak and enlarged, and can't contract with enough force to pump blood.
Diastolic heart failure
, The heart muscle becomes stiff and can't relax enough to fill with blood between heartbeats
Heart Failure Etiology and Pathophysiology
Congenital Heart Defects
•Left to Right shunts - volume overload
•Left side heart obstructions - pressure overload
Acquired Heart Defects
•Infective endocarditis
•Rheumatic Heart Disease
•Kawasaki Disease
Heart Failure Compensation
-Cardiac output decreases stimulating sympathetic nervous system
-Sympathetic nervous system increases HR, contractility, and SV
-Changes result in increased afterload and peripheral vasoconstriction
-Increased HR leads to increased oxygen consumption by heart, decreased time for the heart to fill and
reset, and decreased coronary artery perfusion
-Blood flow to kidneys decreases leading to simulation of renin, angiotensin, and aldosterone
-The body then retains water and sodium
-Then preload increases and myocardium is stretched
-Compensatory mechanisms become exhausted leading to heart failure
What is the effect on:
Cardiac|Pediatric Cardiology, Congenital Heart Defects, Acquired
Heart Disease, Tetralogy of Fallot, Hypoplastic Left Heart Syndrome,
Patent Ductus Arteriosus, Ventricular Septal Defect, Aortic Stenosis,
Valvular Disease, Endocarditis, Bacterial Endocarditis Risk Factors,
Rheumatic Fever, Jones Criteria, Kawasaki Disease, Phases of
Kawasaki, IVIG Therapy, Aspirin Therapy, Coronary Artery Monitoring,
Polycythemia, Thromboembolism Prevention, Cardiac
Catheterization, Supraventricular Tachycardia, Heart Failure
Management, Congestive Heart Failure, Digoxin and Furosemide
Therapy, Exercise Intolerance, Nutritional Support in CHF, Cyanosis,
Knee-Chest Position, Oxygenation Strategies, Prostanoid Therapy,
Patient/Family Education, Long-Term Cardiac Follow-Up, Symptom
Recognition, Infection Prevention Exam Questions Verified and
Provided with Complete A+ Graded Rationales Latest Updated 2026
Review of the Heart
•Normal cardiac anatomy and physiology
•Muscular pump divided into four chambers
•Upper chambers are atria.
•Lower chambers are ventricles.
•Atria are the filling chambers.
•Ventricles are the pumping chambers.
•Two atrioventricular (AV) valves, two semilunar valves
•Mechanical contraction of the heart begins with electrical
stimulation.
Fetal Circulation
,What are the routes of blood flow through the fetal heart?
Why does the blood flow in that route?
ductus arteriosis, foramen ovale, ductus venosus
it needs to bypass the lungs & liver
What is the stimulus for the change in circulation?
baby's 1st breath
What happens after the umbilical cord is clamped?
prostaglandin lvl drops and ductus arteriosus begins to close
What changes occur in intrauterine vs. extrauterine circulation?
foramen ovale closes w/i min.
ductus arteriosis closes hrs to a few days
ductus venosus thickens and closes over days as well
Intrauterine to Extrauterine
Infant takes first breath, and the lungs inflate which leads to...
decreased pulmonary vascular resistance.
,The change in pulmonary vascular resistance leads to...
Increased pulmonary blood flow.
Increased pressure in the left atrium & decreased pressure in the right atrium leads to...
closure of the foramen ovale.
The ductus arteriosus and ductus venosus close related to pressure changes & increased levels of
oxygen.
Heart Failure
What is wrong with the heart?
Why does the heart fail?
In heart failure, the heart is unable to pump enough blood and oxygen to the body's organs and tissues.
This can happen when the heart is too weak or stiff to pump properly, or when it can't fill up with
enough blood
Heart failure can affect the left side of the heart, the right side, or both sides. The most common type of
heart failure is left-sided, which occurs when the left ventricle can't pump enough blood. This can
happen in two ways:
Systolic heart failure
The heart muscle is weak and enlarged, and can't contract with enough force to pump blood.
Diastolic heart failure
, The heart muscle becomes stiff and can't relax enough to fill with blood between heartbeats
Heart Failure Etiology and Pathophysiology
Congenital Heart Defects
•Left to Right shunts - volume overload
•Left side heart obstructions - pressure overload
Acquired Heart Defects
•Infective endocarditis
•Rheumatic Heart Disease
•Kawasaki Disease
Heart Failure Compensation
-Cardiac output decreases stimulating sympathetic nervous system
-Sympathetic nervous system increases HR, contractility, and SV
-Changes result in increased afterload and peripheral vasoconstriction
-Increased HR leads to increased oxygen consumption by heart, decreased time for the heart to fill and
reset, and decreased coronary artery perfusion
-Blood flow to kidneys decreases leading to simulation of renin, angiotensin, and aldosterone
-The body then retains water and sodium
-Then preload increases and myocardium is stretched
-Compensatory mechanisms become exhausted leading to heart failure
What is the effect on:
