RNC-NIC STUDY LATEST
GUIDE
What is coarctation of the aorta? How often does it occur? -
ANSWERS-Narrowing of the aorta distal to where the major vessels
supply blood to the upper body & head, restricting blood flow to lower
body
6-8% of infants
When do symptoms of coarctation of the aorta occur? What are they? -
ANSWERS-When the DA closes
Tachypnea, tachycardia, increases WOB, poor or absent pulses in legs,
murmur
What is the ductus arteriosus? When does it close and why? -
ANSWERS-Connection between pulmonary artery and aorta that shunts
blood around non functioning lungs of fetus
Usually closes within first 24 hrs after birth due to pressure changes
What is the ductus venous? When does it close? - ANSWERS-
Connection between umbilical vein and inferior vena cava, carries
oxygenated blood from placenta past the fetal liver to the fetal brain
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GUIDE
Closes within first week of life
What is the foremen ovale? Why does it close? - ANSWERS-
Connection between right and left atrium that allows blood to flow from
the right atrium into the left atrium
Oxygenated blood is shunted away from non functioning fetal lungs
Elevated pressure in L atrium after birth causes flap to close
How does left heart failure present and why? - ANSWERS-When the
left ventricle doesn't pump efficiently, fluid accumulates in lungs —>
symptoms of RDS like tachypnea, refractions, grunting, & difficulty
feeding
How does right heart failure present and why? - ANSWERS-Enlarged
liver, spleen, ascites and edema because blood is backing up in systemic
circulation
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, RNC-NIC STUDY LATEST
GUIDE
How is heart failure treated? - ANSWERS-Digoxin is used to make
heart contract harder
Diuretics to reduce intravascular volume which decreases preload and
allows heart to pump more efficiently
What is shock and what are the three types? - ANSWERS-When the CV
system is unable to supply organs with adequate perfusion
Hypovolemic
Distributive
Cardiogenic
hypovolemic shock - ANSWERS-Inadequate intravascular blood
volume due to blood loss from placental abruption or excessive fluid
loss from gastro or omphalocele
So insufficient fluid is available to fill heart and perfume tissues
efficiently
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, RNC-NIC STUDY LATEST
GUIDE
Distributive shock - ANSWERS-Aka septic shock—type of
hypovolemic shock where capillaries are excessively permeable and
fluid moves from intravascular space to extracellular spaces
Accompanied by vasodilation which further exacerbated decreased
intravascular volume
Cardiogenic shock - ANSWERS-When cardiac muscle doesn't pump
with enough strength to maintain tissue perfusion
Caused by myocarditis, hypoxemia, hypoglycemia, acidosis, or
dysrhythmias
How does a neonate compensate for the inadequate perfusion that
accompanies shock? - ANSWERS-Vasoconstriction of vessels supply
skin, skeletal muscle and GI—cools skin and causes increased cap refill
Tachycardia
Decreased urine output
What does uncompensated shock look like? - ANSWERS-Decreased
consciousness
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4
GUIDE
What is coarctation of the aorta? How often does it occur? -
ANSWERS-Narrowing of the aorta distal to where the major vessels
supply blood to the upper body & head, restricting blood flow to lower
body
6-8% of infants
When do symptoms of coarctation of the aorta occur? What are they? -
ANSWERS-When the DA closes
Tachypnea, tachycardia, increases WOB, poor or absent pulses in legs,
murmur
What is the ductus arteriosus? When does it close and why? -
ANSWERS-Connection between pulmonary artery and aorta that shunts
blood around non functioning lungs of fetus
Usually closes within first 24 hrs after birth due to pressure changes
What is the ductus venous? When does it close? - ANSWERS-
Connection between umbilical vein and inferior vena cava, carries
oxygenated blood from placenta past the fetal liver to the fetal brain
END OF
PAGE
1
, RNC-NIC STUDY LATEST
GUIDE
Closes within first week of life
What is the foremen ovale? Why does it close? - ANSWERS-
Connection between right and left atrium that allows blood to flow from
the right atrium into the left atrium
Oxygenated blood is shunted away from non functioning fetal lungs
Elevated pressure in L atrium after birth causes flap to close
How does left heart failure present and why? - ANSWERS-When the
left ventricle doesn't pump efficiently, fluid accumulates in lungs —>
symptoms of RDS like tachypnea, refractions, grunting, & difficulty
feeding
How does right heart failure present and why? - ANSWERS-Enlarged
liver, spleen, ascites and edema because blood is backing up in systemic
circulation
END OF
PAGE
2
, RNC-NIC STUDY LATEST
GUIDE
How is heart failure treated? - ANSWERS-Digoxin is used to make
heart contract harder
Diuretics to reduce intravascular volume which decreases preload and
allows heart to pump more efficiently
What is shock and what are the three types? - ANSWERS-When the CV
system is unable to supply organs with adequate perfusion
Hypovolemic
Distributive
Cardiogenic
hypovolemic shock - ANSWERS-Inadequate intravascular blood
volume due to blood loss from placental abruption or excessive fluid
loss from gastro or omphalocele
So insufficient fluid is available to fill heart and perfume tissues
efficiently
END OF
PAGE
3
, RNC-NIC STUDY LATEST
GUIDE
Distributive shock - ANSWERS-Aka septic shock—type of
hypovolemic shock where capillaries are excessively permeable and
fluid moves from intravascular space to extracellular spaces
Accompanied by vasodilation which further exacerbated decreased
intravascular volume
Cardiogenic shock - ANSWERS-When cardiac muscle doesn't pump
with enough strength to maintain tissue perfusion
Caused by myocarditis, hypoxemia, hypoglycemia, acidosis, or
dysrhythmias
How does a neonate compensate for the inadequate perfusion that
accompanies shock? - ANSWERS-Vasoconstriction of vessels supply
skin, skeletal muscle and GI—cools skin and causes increased cap refill
Tachycardia
Decreased urine output
What does uncompensated shock look like? - ANSWERS-Decreased
consciousness
END OF
PAGE
4
