CHD QUESTIONS AND ANSWERS 100% CORRECT

CHD QUESTIONS AND ANSWERS 100% CORRECT Lesion or defect of the heart, most common congenital defect. Correct Answer: Congenital heart disease Children with certain genetic defects have an extremely high incidence of cardiac disorders, including children with chromosome aberrations, most specifically trisomy 21 known as________ __________. Correct Answer: Down syndrome True or False: Some children with non-hereditary conditions, such as fetal alcohol syndrome (FAS) are at an increased risk for CHD. Correct Answer: True True or False: A family hx of CHD increases the risk for giving birth to a child with CHD. Correct Answer: True Shunting, or blood flow through an abnormal opening in the heart or great vessels, occurs when: 1) There is an abnormal opening or connection between the cardiac chambers or great arteries 2) The pressure is ______ on one side of the heart 3)The O2 saturation is ________ or ________ Correct Answer: higher increased or decreased Normally the _____ side of the heart is a low-pressure, desaturated system Correct Answer: right Normally the _____ side of the heart is a high-pressure, fully saturated system Correct Answer: left Health history Correct Answer: Inquire about a family hx of CHD, sudden death or fetal/infant death Ask about prenatal care, maternal illnesses, infections, meds taken during pregnancy Discuss feeding difficulties Inspection (color) Correct Answer: Assess skin color in natural light oral mucous membranes, neal beds and conjunctiva Assess hands, feet, and face Assess body for differential cyanosis or color differences Inspection (activity level) Correct Answer: Assess the child sitting and laying Observe level of activity and position of comfort Observe color changes with activity, feeding, crying, exercise tolerance Inspection (chest) Correct Answer: Assess precordial activity, chest movement (including symmetry), and chest shape (including convex or concave) Assess for sternotomy or thoracotomy incisions. Inspection (R. pattern) Correct Answer: Observe WOB at rest and with activity Look for signs of R. alteration or distress (tachypnea, retractions, nasal flaring, crackles, grunting, and head bobbing are late signs of distress and may indicate impending R. failure) Auscultation Correct Answer: Heart sounds: Identify 1st and 2nd heart sounds Identify additional heart sounds (S3, S4) Identify presence of murmurs, clicks, precordial friction rubs Palpation Correct Answer: Temperature: Compare trunk and extremities Pulses: Compare central and distal pulses BP: Assess in all 4 extremities during initial assessment Cap refill: Chest: With fingertips locate the PMI Assess for presence of vibatory thrills, heaves or lifts, or friction rubs Abdomen: There may be an increased incidence of CHD, cardiomyopathies, arrhythmias, or hypercholesterolmia in some families. Chronic maternal illness such as diabetes, perinatal infections such as _______, and certain medications such as _______ have been linked to CHD. Correct Answer: rubella lithium ________, ___________, or restlessness may indicate poor cardiac function. Correct Answer: lethargy, irritablity S1 is best heard Correct Answer: at the apex of the heart S2 is best heard Correct Answer: at the base S__ can be heart at the at the apex and can be a normal finding or reflect CHD Correct Answer: 3 S4 can be heard at the apex and reflects ______ disease. Correct Answer: cardiac A ______ is an extra heart sound (S3 or S4), common in CHF. Correct Answer: gallop Murmurs are caused by ______ blood flow. Correct Answer: turbulent Murmurs are described according to _______, _______ within the cardiac cycle, intensity, pitch, quality, and duration. Correct Answer: location, timing Clicks reflect? Correct Answer: abnormal valve motion Precordial friction rubs can reflect pericardial _________. Correct Answer: inflammation Weak or absent pulses in the lower extremities may indicate? Correct Answer: COA Normal capillary refill Correct Answer: 2seconds L-R shunting lesions increase _______ blood flow. Some examples include: Correct Answer: pulmonary ASD, VSD, PDA, AVSD, endocardial cushion defect Obstructive or stenotic lesions decrease cardiac _______. Some examples include: Correct Answer: outflow Pulmonary stenosis Aortic stenosis COA Cyanotic lesions with decreased pulmonary blood flow examples: Correct Answer: TOF Tricuspid valve abnormalities Pulmonary atresia with intact ventricular septum Cyanotic lesions with increased pulmonary blood flow examples: Correct Answer: Truncus arteriosus Hypoplastic left heart syndrome Transposition of the great arteries Left-sided heart pressures, which normally exceed right-sided pressures, cause saturated blood to shunt through any abnormal opening in the heart, aorta or pulmonary artery. Results in a volume overload in the R side of the heart and in the _______ artery. This describes L-R shunting Correct Answer: pulmonary Assessment: Tachycardia- To compensate for _______ state Decreased peripheral perfusion-Resulting in ______extremities, ______ cap refill, ______pulses Heart murmurs Cyanosis (some acyanotic) Dysrhytmias Active precordium (feel or see) Pulmonary congestion (_____, coarseness)-d/t fluid in the heart, this makes the heart an ________ pump.