Cardiac

What prenatal and family factors increase risk for congenital heart defects?

Maternal exposure to alcohol, drugs, or illnesses such as diabetes or lupus, and family history of heart defects.

What infant symptom suggests cardiac dysfunction during feeding?

Sweating while feeding.

What growth sign indicates possible cardiac dysfunction in infants?

Poor weight gain.

What respiratory finding is common in infants with cardiac problems?

Rapid breathing.

What overall appearance may indicate cardiac fatigue in infants?

General fatigue during activity or feeding.

What skin sign may indicate cardiac involvement?

Cyanosis.

What heart sound finding may indicate a structural defect?

Murmur.

What cardiovascular sign suggests abnormal circulation?

Unequal blood pressures between extremities.

What urinary sign may accompany heart failure?

Low urine output.

What lung sound may indicate fluid overload from heart failure?

Crackles.

What infection pattern is common in children with cardiac dysfunction?

Recurrent respiratory infections.

What nutritional issue occurs due to poor cardiac output?

Feeding intolerance or failure to thrive.

What are the key pre-procedure nursing responsibilities for a cardiac catheterization?

Keep NPO, assess for allergies, provide sedation if needed, and educate the family.

What are the main post-procedure nursing priorities after a cardiac catheterization?

Monitor vital signs, distal pulses, bleeding, fluid balance, and signs of infection.

What are common complications after a cardiac catheterization?

Bleeding, infection, arrhythmia, stroke, or air embolism.

What is the main home care instruction following cardiac catheterization?

Monitor site for bleeding or infection, keep it covered, and use acetaminophen for pain.

What cardiac medication increases contractility of the heart?

Digoxin.

When should digoxin be held in a child?

If the heart rate is below 70 beats per minute.

When should digoxin be held in an infant?

If the heart rate is below 100 beats per minute.

What are signs of digoxin toxicity?

Nausea, vomiting, bradycardia, and visual halos.

What is the antidote for digoxin toxicity?

Digibind.

What lab value must be monitored closely with digoxin use?

Potassium level.

What cardiac drug class reduces afterload and blood pressure?

ACE inhibitors.

What are examples of ACE inhibitors?

Captopril, Enalapril, and Lisinopril.

What are potential side effects of ACE inhibitors?

Hypotension, cough, hyperkalemia, and renal impairment.

What drug class is used to reduce fluid overload in heart failure?

Diuretics.

What should be monitored when giving diuretics?

Electrolytes, intake and output, weight, and renal function.

What drug class slows heart rate and reduces blood pressure?

Beta blockers.

What are examples of beta blockers used in children?

Carvedilol and Propranolol.

What should nurses monitor when administering beta blockers?

Hypotension, bradycardia, and signs of fluid overload.

What type of shunting occurs in acyanotic heart defects?

Left-to-right shunting of oxygenated blood.

What type of shunting occurs in cyanotic heart defects?

Right-to-left shunting of deoxygenated blood into systemic circulation.

What are examples of acyanotic heart defects?

Atrial septal defect, ventricular septal defect, patent ductus arteriosus, and coarctation of the aorta.

What are examples of cyanotic heart defects?

Tetralogy of Fallot, transposition of great arteries, hypoplastic left heart syndrome, and tricuspid atresia.

What defect involves an opening between the atria?

Atrial septal defect.

What shunting occurs in an atrial septal defect?

Left-to-right shunt.

What are typical signs of atrial septal defect?

May be asymptomatic or have a murmur.

What is the treatment for atrial septal defect?

Patch or device closure.

What defect involves a hole between the ventricles?

Ventricular septal defect.

What is a common complication of ventricular septal defect?

Heart failure.

What sound is often heard with ventricular septal defect?

Murmur.

What is the treatment for ventricular septal defect?

Patch or surgical banding.

What defect involves failure of a fetal vessel to close?

Patent ductus arteriosus.

What are characteristic findings of patent ductus arteriosus?

Bounding pulses and a continuous murmur.

What is the treatment for patent ductus arteriosus?

Indomethacin, surgical ligation, or device occlusion.

What defect involves narrowing of the aorta?

Coarctation of the aorta.

What is the key finding in coarctation of the aorta?

High blood pressure in upper extremities and low in lower extremities.

What is the treatment for coarctation of the aorta?

Patch repair or balloon angioplasty.

What are the four defects present in tetralogy of Fallot?

Ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta.

What symptom is characteristic of tetralogy of Fallot?

Cyanosis and "tet spells."

What is the treatment for tetralogy of Fallot?

Staged surgical repair (shunt then complete correction).

What congenital defect involves switching of the aorta and pulmonary artery?

Transposition of the great arteries.

What is the primary sign of transposition of the great arteries?

Cyanosis.

What medication keeps the ductus arteriosus open in transposition of the great arteries?

Prostaglandin infusion.

What is the definitive treatment for transposition of the great arteries?

Surgical repair.

What defect involves severe underdevelopment of the left heart?

Hypoplastic left heart syndrome.

What medication is required to maintain circulation in hypoplastic left heart syndrome?

Prostaglandin to keep ductus arteriosus open.

What is the long-term treatment for hypoplastic left heart syndrome?

Staged surgeries (Norwood, Glenn, Fontan).

What is the prognosis for heart transplant in hypoplastic left heart syndrome?

Poor transplant option due to complexity.

What are signs of congestive heart failure in children?

Tachycardia, tachypnea, enlarged liver, edema, and diaphoresis with feeding.

What medications are used to treat heart failure?

Diuretics, ACE inhibitors, digoxin, and oxygen.

What nonpharmacologic management supports heart failure care?

Fluid and nutrition management.

What is the last resort treatment for severe heart failure?

Heart transplant.

What are signs of hypoxemia in children?

Cyanosis, clubbing, increased red blood cells, poor feeding, and fatigue.

What serious complication can result from chronic hypoxemia?

Stroke.

What are main treatments for hypoxemia?

Oxygen therapy, hydration, infection prevention, and treating "tet spells."

What heart condition results from infection of the endocardium?

Bacterial endocarditis.

Which patients are at greatest risk for bacterial endocarditis?

Those with congenital heart disease, prosthetic valves, or prior heart surgery.

What are classic signs of bacterial endocarditis?

Fever, fatigue, weight loss, cough, murmur, Janeway lesions, Osler nodes, and splinter hemorrhages.

What is the primary treatment for bacterial endocarditis?

Intravenous antibiotics.

How can bacterial endocarditis be prevented?

Prophylactic antibiotics before surgery or dental work.

What disease results from untreated Group A strep infection?

Rheumatic fever.

What are clinical signs of rheumatic fever?

Carditis, joint pain, rash, nodules, and involuntary movements.

What medications are used to treat rheumatic fever?

Antibiotics and anti-inflammatory drugs.

What supportive care is important during rheumatic fever recovery?

Bed rest to reduce cardiac workload.

How can rheumatic fever be prevented?

Early treatment of strep throat.

What condition involves inflammation of blood vessels and can lead to coronary aneurysm?

Kawasaki disease.

What age group is most commonly affected by Kawasaki disease?

Children under five years old.

What are hallmark signs of Kawasaki disease?

High fever, conjunctivitis, strawberry tongue, rash, peeling of hands and feet, and swollen lymph nodes.

What medications are used to treat Kawasaki disease?

IV immunoglobulin and aspirin.

What are key nursing priorities in Kawasaki disease?

Monitor for fluid overload, manage symptoms, and educate family on follow-up.

What vaccine consideration is important after IVIG therapy for Kawasaki disease?

Delay live vaccines for several months.

What arrhythmia presents with an abrupt heart rate over 200 beats per minute?

Supraventricular tachycardia.

What are signs of supraventricular tachycardia in infants?

Poor feeding and irritability.

What treatments are used for supraventricular tachycardia?

Vagal maneuvers, adenosine, or ablation.

What syndrome involves an extra electrical pathway causing rapid heart rate?

Wolff-Parkinson-White syndrome.

How is Wolff-Parkinson-White syndrome managed?

Similar to supraventricular tachycardia treatment.

What conduction disorder increases the risk of sudden cardiac death during stress?

Long QT syndrome.

What treatments are used for long QT syndrome?

Beta blockers, pacemaker, or defibrillator.

What activity restriction is necessary for children with long QT syndrome?

Avoid competitive sports.