CV Disorders MCN Notes

What are the objectives for understanding pediatric cardiovascular disorders?

Contrast differences in cardiovascular systems between infants and adults, discuss assessments, medications, diagnostic tests, and interventions.

What are congenital heart diseases?

Structural anomalies present at birth affecting the cardiovascular system.

What are the three fetal structures involved in fetal circulation?

Ductus arteriosus, foramen ovale, and ductus venosus.

What is the function of the ductus arteriosus?

Shunts blood from the pulmonary artery to the aorta.

Define 'patent ductus arteriosus' (PDA).

A condition where the ductus arteriosus remains open, shunting blood from the pulmonary artery to the aorta.

What are the characteristics of heart size in children under 7?

The heart is more horizontally positioned, apex at the 4th intercostal space.

List common symptoms of cardiac patients in health history assessments.

Activity intolerance, failure to thrive, tachypnea, color changes, delayed growth.

What is the importance of family history in cardiac assessments?

It can indicate a genetic predisposition to congenital heart disease.

What is one typical finding during auscultation of a cardiac exam in children?

Murmurs are the most common finding.

What are some lab tests used for diagnosing cardiovascular disorders?

CBC, blood gas, ECG, chest x-ray, echocardiography.

What is the purpose of cardiac catheterization in children?

It is a definitive diagnostic study for cardiac disease.

List one complication of cardiac catheterization.

Bleeding.

What disorders fall under 'increased pulmonary blood flow / acyanotic' heart defects?

Atrial septal defect (ASD), ventricular septal defect (VSD), and patent ductus arteriosus (PDA).

What are the symptoms of a ventricular septal defect (VSD)?

Heart murmur, tachypnea, poor growth, respiratory infections.

What are the four defects associated with Tetralogy of Fallot (TOF)?

Pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, overriding aorta.

What is a classic sign of Tetralogy of Fallot during a hypercyanotic spell?

Cyanosis due to desaturated blood entering the peripheral circulation.

What is the management for a hypercyanotic spell in children with TOF?

Calm approach, knee-chest position, provide supplemental O2, administer morphine sulfate.

What is coarctation of the aorta and how does it present in older children?

It involves stenosis in a vessel leading to increased blood pressure and symptoms like headaches and leg pain.

What is transposition of the great vessels?

A mixed defect where major arteries are switched, affecting oxygenation.

What signifies increased pulmonary blood flow in acyanotic defects?

Symptoms of congestive heart failure and a heart murmur.

Describe Kawasaki disease in terms of peak age and demographic.

It typically occurs in young children, peak age 1-2 years, more common in males and Asian descent.

What are the diagnostic criteria for Kawasaki disease?

Fever for at least 5 days and at least 4 of 5 specific conditions.

What is the initial treatment for Kawasaki disease?

Intravenous immunoglobulin (IVIG) and high-dose aspirin during fever.

What are signs of heart failure in children?

Sweating, blue color around mouth and eyes, breathing problems, swelling.

What medications are commonly used for managing heart failure in children?

Digoxin and furosemide.

What should be monitored in children taking digoxin?

Electrolytes, heart rate, signs of toxicity.

What is the primary goal of nursing management in heart failure?

Support cardiac function and promote adequate nutrition.

What lifestyle changes are recommended for managing hypertension in children?

Healthy diet, increase physical activity, weight reduction.

What is a significant factor in screening for hyperlipidemia in children?

Family history.

Define 'innocent systolic murmur'.

A common finding in over 50% of newborns typically observed without underlying disease.

What is the role of education in managing congenital heart diseases?

To inform families about symptoms, care needs, and medication adherence.

What factor complicates the prognosis in congenital heart disease patient care?

Associated syndromes and chromosomal defects.

What is the outcome of untreated acute rheumatic fever?

Cardiac complications such as aortic stenosis and leaking mitral valve.

What is the management approach for children with hyperlipidemia?

Dietary management and potential medication based on risk assessment.

What key aspect of care should be performed prior to tooth or minor procedures in at-risk children?

Administer prophylactic antibiotics to prevent infective endocarditis.

How is blood pressure categorized in children aged 1-13 years?

Based on percentiles related to age, gender, and height.

What complication may arise from Kawasaki disease?

Coronary artery aneurysms.

What essential nursing intervention for children with ineffective tissue perfusion?

Positioning to maximize chest expansion.

What is the typical age for diagnosis of pediatric heart conditions?

Most heart conditions are diagnosed within the first year of life.

What is the significance of 'Acidosis' in pediatric patients?

Acidosis indicates a state of increased acidity in the blood and can affect heart function.

Define 'Left-to-right shunt'.

An abnormal flow of blood from the left side of the heart to the right side, often due to defects like ASD or VSD.

What are the clinical manifestations of heart failure in infants?

Poor feeding, lethargy, tachypnea, and sweating during feeding.

What is the function of the pulmonary artery?

Carries deoxygenated blood from the right ventricle to the lungs for oxygenation.

What is the purpose of a chest x-ray in cardiac evaluation?

To assess heart size, shape and the presence of fluid in the lungs.

What lifestyle modification is recommended to reduce the risk of hypertension in children?

Encouraging regular physical activity.

What are common diagnostic imaging techniques used for pediatric cardiac conditions?

Echocardiography, MRI, and CT scans.

What does 'cyanosis' indicate in a pediatric patient?

A lack of oxygen in the blood, leading to a bluish discoloration of the skin.

What laboratory finding is commonly seen in rheumatic fever?

Elevated antistreptolysin O (ASO) titers.

Define 'right-to-left shunt'.

An abnormal flow of blood from the right side of the heart to the left side, resulting in cyanosis.

What role does the Foramina Ovale play in fetal circulation?

Allows blood to bypass the non-functioning fetal lungs by connecting the right and left atria.

What is the management for atrial septal defect (ASD)?

Observation, surgical repair, or catheter-based closure depending on symptoms.

What is the primary cause of congestive heart failure in infants?

Congenital heart defects and cardiomyopathy.

What is 'pulsus paradoxus'?

A decrease in blood pressure during inspiration, often seen in cardiac tamponade.

What type of murmur is often associated with innocent murmurs in children?

A systolic ejection murmur.

What are common side effects of digoxin in children?

Nausea, vomiting, diarrhea, and visual disturbances.

What is the effect of temperature on the heart rate in children?

Elevated temperatures can lead to increased heart rates.

What condition involves abnormal narrowing of the aorta?

Coarctation of the aorta.

What is the significance of measuring blood pressure in both arms in children?

To detect coarctation of the aorta.

What lifestyle change can help in managing hyperlipidemia in children?

A diet low in saturated fats and cholesterol.

What are the signs of infection in children with heart disease?

Fever, increased heart rate, and lethargy.

What is the importance of early intervention in congenital heart disease?

It improves outcomes and reduces the risk of complications.

Define 'cardiac output'.

The amount of blood the heart pumps in one minute.

What is the role of the left ventricle?

Pumps oxygenated blood to the body through the aorta.

What is the typical INR target range for children on anticoagulants?

Therapeutic range is usually between 2.0 and 3.0, but depends on the condition.

What are the potential complications of untreated congenital heart disease?

Heart failure, arrhythmias, and pulmonary hypertension.

What role does oxygen saturation play in pediatric cardiac assessments?

It helps assess the effectiveness of the heart and lungs in oxygenating blood.

What are the potential effects of maternal diabetes on fetal heart development?

Increased risk for congenital heart defects.

What is 'cardiomyopathy'?

A disease of the heart muscle that affects its size, shape, and function.

What are the management strategies for children with rheumatic heart disease?

Antibiotic prophylaxis, symptomatic treatment, and possible surgical interventions.

What is the typical treatment for patent ductus arteriosus (PDA)?

Indomethacin for closure in premature infants, surgical or catheter-based closure in older children.

What is the management strategy for atrial septal defect (ASD)?

Surgical repair or catheter-based closure depending on size and symptoms.

What are common treatments for ventricular septal defect (VSD)?

Observation for small defects, surgical repair for larger or symptomatic defects.

What is the surgical treatment for Tetralogy of Fallot (TOF)?

Corrective surgery to address all four defects typically performed in infancy or early childhood.

What is the management approach for coarctation of the aorta?

Surgical repair or balloon angioplasty to relieve the narrowing.

What is the treatment for transposition of the great vessels?

Surgical arterial switch operation is required to correct the defect.

What is the role of prostaglandins in managing congenital heart defects like PDA?

Prostaglandins are used to maintain ductal patency until surgical closure can be performed.

How can the symptoms of ASD be managed in children?

Regular monitoring, sometimes with medication to manage symptoms, and planning for surgical intervention when needed.

What are the long-term outcomes for children with untreated VSD?

Heart failure, pulmonary hypertension, and increased risk of infections.

What is the clinical significance of early surgical intervention for coarctation of the aorta?

Reduces the risk of hypertension, heart failure, and associated complications later in life.