NURS 306 Exam 2 – Questions With Step By Step
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Terms in this set (232)
3 differences in fetal circulation - foramen ovale: opening in atria
- ductus arteriosus: pulmonary artery and aorta
- ductus venosus: present in liver
normal blood flow through the heart superior/inferior vena cava > r atrium > tricuspid valve
> r ventricle > pulmonic valve > pulmonic artery >
lungs > pulmonary vein > l atrium > mitral valve > l
ventricle > aortic valve > aorta > body
congenital heart disease - anatomic abnormalities present at birth
- acyanotic: increased pulmonary blood flow,
obstruction of blood flow
- cyanotic: decreased pulmonary blood flow, mixed
blood flow
how does blood flow? high pressure systems to low pressure systems
nursing interventions for the child with - maintain adequate oxygenation
CHD - maintain adequate cardiac output and tissue
perfusion
- maintain adequate hydration and nutrition
- promote pain relief, comfort, and rest
- administer medications
- monitor for and prevent complications
- promote growth and development
- provide emotional and psychosocial support to
child and family
,increased pulmonary blood flow - ASD (atrial septal defect)
defects - VSD (ventricular septal defect)
- PDA (patent ductus arteriosus)
- AV canal (atrioventricular canal)
ASD hole between atria
VSD hole between ventricles
PDA hole didn't close (should close within two weeks)
AV canal hole between atria and ventricles
increased pulmonary blood flow left to right shunting: blood is moving back into
defects: key thing to know pulmonary circulation
increased pulmonary blood flow - pulmonary side effects
defects: s/s - audible murmur
- poor feeding/weight gain
- diaphoresis
- tachycardia
- frequent respiratory infections
increased pulmonary blood flow - PDA --> administer indomethacin to closes PDA:
defects: interventions inhibits prostaglandins (allows smooth muscle
contraction)
- cardiac cath/surgery to close
- supportive care for other symptoms prior to
correction of defect: diuretics, optimize nutrition,
NGT placement
obstruction of systemic blood flow - coarctation of the aorta
defects - aortic stenosis/interrupted aortic arch
- mitral stenosis
- hypoplastic left heart syndrome
coarctation of the aorta - 4 extremity blood pressures
- upper BP > lower BP = positive test
,hypoplastic left heart syndrome - underdeveloped left side of heart (ineffective)
- multiple stages of surgical correction
- first surgery shortly after birth (within hours)
- nordwood, glenn, fontan
- long term management is surgery, may need
heart/lung transplant
obstruction of systemic blood flow: - decreased cardiac output
key things to know - increase pressure before defect
- issue with blood flow in outflow tract
obstruction of systemic blood flow: - diminished pulses (after defect)
s/s - delayed cap refill
- changes in color/perfusion
- heart failure
- pulmonary edema
- assessment of 4-extremity BPs (coarc)
obstruction of systemic blood flow: - prostaglandins: opens ductus arteriosus --> helps
interventions overall blood flow
- surgical repair
decreased pulmonary blood flow - tetralogy of fallot
defects - tricuspid atresia
- pulmonary atresia
- pulmonary stenosis
tetralogy of fallot 4 components:
- VSD
- overriding aorta
- pulmonary stenosis
- thickened muscle
decreased pulmonary blood flow: key - deoxygenated blood enters systemic circulation
things to know - right to left shunting: less blood flow to lungs,
deoxygenated blood into oxygenated blood
, decreased pulmonary blood flow: s/s - cyanosis
- poor weight gain
- hypercyanotic episodes
- polycythemia
- hypoxemia
- murmur (TOF)
decreased pulmonary blood flow: - decrease systemic venous flow during
interventions hypercyanotic spells: cry, stress --> more sedation,
give them what they need, knee to chest maneuver
- surgical repair
- administration of prostaglandins IV (increases
blood flow)
mixed blood flow defects - transposition of the great arteries
- truncus arteriosus
- double outlet right ventricle
- hypoplastic left heart syndrome
transposition of the great arteries aorta and pulmonary valves switched
truncus arteriosus aorta and pulmonary arteries are one vessel
double outlet right ventricle leads to aorta and pulmonary artery
mixed blood flow: keys things to know - rely on other defects to maintain oxygenation -->
very complex
- surgical intervention = early (done within 1 month)
mixed blood flow: s/s - cyanosis
- poor weight gain
- pulmonary congestion
- heart failure
mixed blood flow: interventions prostaglandins
Solutions
Save
Terms in this set (232)
3 differences in fetal circulation - foramen ovale: opening in atria
- ductus arteriosus: pulmonary artery and aorta
- ductus venosus: present in liver
normal blood flow through the heart superior/inferior vena cava > r atrium > tricuspid valve
> r ventricle > pulmonic valve > pulmonic artery >
lungs > pulmonary vein > l atrium > mitral valve > l
ventricle > aortic valve > aorta > body
congenital heart disease - anatomic abnormalities present at birth
- acyanotic: increased pulmonary blood flow,
obstruction of blood flow
- cyanotic: decreased pulmonary blood flow, mixed
blood flow
how does blood flow? high pressure systems to low pressure systems
nursing interventions for the child with - maintain adequate oxygenation
CHD - maintain adequate cardiac output and tissue
perfusion
- maintain adequate hydration and nutrition
- promote pain relief, comfort, and rest
- administer medications
- monitor for and prevent complications
- promote growth and development
- provide emotional and psychosocial support to
child and family
,increased pulmonary blood flow - ASD (atrial septal defect)
defects - VSD (ventricular septal defect)
- PDA (patent ductus arteriosus)
- AV canal (atrioventricular canal)
ASD hole between atria
VSD hole between ventricles
PDA hole didn't close (should close within two weeks)
AV canal hole between atria and ventricles
increased pulmonary blood flow left to right shunting: blood is moving back into
defects: key thing to know pulmonary circulation
increased pulmonary blood flow - pulmonary side effects
defects: s/s - audible murmur
- poor feeding/weight gain
- diaphoresis
- tachycardia
- frequent respiratory infections
increased pulmonary blood flow - PDA --> administer indomethacin to closes PDA:
defects: interventions inhibits prostaglandins (allows smooth muscle
contraction)
- cardiac cath/surgery to close
- supportive care for other symptoms prior to
correction of defect: diuretics, optimize nutrition,
NGT placement
obstruction of systemic blood flow - coarctation of the aorta
defects - aortic stenosis/interrupted aortic arch
- mitral stenosis
- hypoplastic left heart syndrome
coarctation of the aorta - 4 extremity blood pressures
- upper BP > lower BP = positive test
,hypoplastic left heart syndrome - underdeveloped left side of heart (ineffective)
- multiple stages of surgical correction
- first surgery shortly after birth (within hours)
- nordwood, glenn, fontan
- long term management is surgery, may need
heart/lung transplant
obstruction of systemic blood flow: - decreased cardiac output
key things to know - increase pressure before defect
- issue with blood flow in outflow tract
obstruction of systemic blood flow: - diminished pulses (after defect)
s/s - delayed cap refill
- changes in color/perfusion
- heart failure
- pulmonary edema
- assessment of 4-extremity BPs (coarc)
obstruction of systemic blood flow: - prostaglandins: opens ductus arteriosus --> helps
interventions overall blood flow
- surgical repair
decreased pulmonary blood flow - tetralogy of fallot
defects - tricuspid atresia
- pulmonary atresia
- pulmonary stenosis
tetralogy of fallot 4 components:
- VSD
- overriding aorta
- pulmonary stenosis
- thickened muscle
decreased pulmonary blood flow: key - deoxygenated blood enters systemic circulation
things to know - right to left shunting: less blood flow to lungs,
deoxygenated blood into oxygenated blood
, decreased pulmonary blood flow: s/s - cyanosis
- poor weight gain
- hypercyanotic episodes
- polycythemia
- hypoxemia
- murmur (TOF)
decreased pulmonary blood flow: - decrease systemic venous flow during
interventions hypercyanotic spells: cry, stress --> more sedation,
give them what they need, knee to chest maneuver
- surgical repair
- administration of prostaglandins IV (increases
blood flow)
mixed blood flow defects - transposition of the great arteries
- truncus arteriosus
- double outlet right ventricle
- hypoplastic left heart syndrome
transposition of the great arteries aorta and pulmonary valves switched
truncus arteriosus aorta and pulmonary arteries are one vessel
double outlet right ventricle leads to aorta and pulmonary artery
mixed blood flow: keys things to know - rely on other defects to maintain oxygenation -->
very complex
- surgical intervention = early (done within 1 month)
mixed blood flow: s/s - cyanosis
- poor weight gain
- pulmonary congestion
- heart failure
mixed blood flow: interventions prostaglandins
