Congenital Heart Defects-Nursing III/Exam 1

What sides of the body do the left and right sides of the heart pump to?

The left side pumps oxygenated blood to the body and the right side pumps deoxygenated blood to the lungs so it can be oxygenated

-this makes the left side of the heart stronger

Systolic pressure results from what?

contraction of ventricles

Diastolic pressure results from…

ventricles at REST

What is different about pediatric cardiac function?

If oxygenation fails, we will have heart failure

T/F: Women are at a greater risk of developing heart disease after menopause

True

T/F: those who have parents or siblings with heart disease are at a greater risk of developing heart disease

True

congenital heart defects can occur because…

1. an change occurred in fetal development

2. a fetal structure doesn’t convert to extrauterine anatomy following birth

3. can be caused by heredity, maternal medication use during pregnancy, no known cause

When do most congenital heart defects develop? What are they caused by?

In the first 8 weeks of gestation; can be the result of combined: fetal exposure to drugs, maternal viral infections, maternal metabolic disorders, maternal complications of pregnancy, chromosomal abnormalities

What is usually the first indication that a baby has a congenital heart defect?

Heart murmur

Defects that increase pulmonary blood flow

-PDA, ASD, VSD, AV canal

-Will not see anything in baby that is of concern when performing pulmonary assessment

-miscommunication between left and right sides of heart

-this type of defect allows blood to flow between the left and right sides of the heart, increasing the amount of oxygenated blood that is pumped into the lungs (extra blood flow to lungs causes oxygenation issues and pulmonary HTN)

What creates pulmonary hypertension?

Increased BP in vessels of lungs causes heart to work harder to get blood there and causes heart failure in the long term

What are the clinical manifestations of defects that increase pulmonary blood flow?

Increased HR, RR, metabolic rate

sweating while feeding

poor weight gain

frequent respiratory infections

signs of CHF

Defects that decrease pulmonary blood flow

-baby will be blue

-this type of defect obstructs pulmonary blood flow so little to no blood reaches the lungs

-platelet survival is reduced and clotting factors are impaired

-pulmonary stenosis

tetralogy of fallot

-pulmonary or tricuspid atresia

What are the clinical manifestations of defects that decrease pulmonary blood flow?

-cyanosis shortly after birth

dyspnea

loud murmur

diaphoresis

signs and symptoms of chronic hypoxia

increased work of feeding

skin may be ruddy or mottled

Clinical manifestations of mixed defects

-varying degrees of cyanosis

varying degrees of chronic heart failure

pulmonary congestion

poor weight gain

What are mixed defects?

Mixing of oxygen saturated and desaturated blood, resulting in systemic blood flow consisting of desaturated blood

-transposition of great arteries

truncus arteriosus

total anomalous venous return

Defects that obstruct systemic blood flow

Medical Emergency

-AORTIC STENOSIS

-coarctation of aorta

-hypoplastic left heart syndrome

Clinical manifestations of defects that obstruct systemic blood flow

diminished pulses

poor color

delayed capillary refill time

decreased urinary output

congestive heart failure (all the blood is staying in the upper body)

pulmonary edema