Cardiovascular Pediatrics NURS 413

Question-and-Answer flashcards covering pediatric fetal circulation, congenital heart defects, heart failure management, hypertension, Kawasaki disease, and rheumatic fever.

What are the three fetal circulation structures that bypass the lungs and liver?

Ductus venosus (bypasses liver), Foramen ovale (right atrium → left atrium), Ductus arteriosus (pulmonary artery → aorta)

What circulatory changes occur after birth?

Closure of the foramen ovale, ductus arteriosus, and ductus venosus

What abnormal findings suggest persistence of fetal circulation post-natally?

Murmurs, cyanosis, tachypnea, failure to thrive, hypoxemia, signs of heart failure

Which assessment findings indicate an Atrial Septal Defect (ASD)?

Soft murmur and a fixed split S2, possible arrhythmias if untreated

Which assessment findings indicate a Ventricular Septal Defect (VSD)?

Harsh murmur, congestive heart failure (CHF), and failure to thrive (FTT)

Which assessment findings indicate a Patent Ductus Arteriosus (PDA)?

Machinery-like murmur, bounding pulses, and wide pulse pressure

Which assessment findings indicate an Atrioventricular Canal (AVC) defect?

Systolic murmur, CHF, respiratory problems, commonly associated with Down syndrome

Which assessment findings indicate Coarctation of the Aorta?

High blood pressure in upper extremities with weak or absent femoral pulses

Which assessment findings indicate Aortic or Pulmonic Stenosis?

Systolic murmur, ventricular hypertrophy, poor perfusion

Which assessment findings indicate Tetralogy of Fallot (TOF)?

Cyanosis, clubbing, tet spells, and a murmur

Which assessment findings indicate Tricuspid Atresia?

Severe cyanosis, CHF, and dependence on a PDA to remain open

Which assessment findings indicate Transposition of the Great Arteries (TGA)?

Severe cyanosis, CHF, and cardiomegaly

Which assessment findings indicate Total Anomalous Pulmonary Venous Return (TAPVR)?

Cyanosis, recurrent respiratory infections, and CHF

Which assessment findings indicate Truncus Arteriosus?

Cyanosis, CHF, and polycythemia

Which assessment findings indicate Hypoplastic Left Heart Syndrome (HLHS)?

Cyanosis, respiratory distress, poor perfusion—often fatal without treatment

How is cardiac function improved in pediatric heart failure?

Administer digoxin and ACE inhibitors (e.g., captopril)

How can cardiac demand be reduced in children with heart failure?

Cluster care, provide small frequent feedings, and allow uninterrupted rest

How is fluid loss promoted in pediatric heart failure?

Monitor intake and output, obtain daily weights, administer diuretics

How is respiratory distress reduced in heart failure?

Elevate the head of the bed and provide oxygen therapy

How is nutrition optimized for children with heart failure?

Provide high-calorie formulas and feeding support

How are families supported when caring for a child with heart failure?

Educate on medications, teach signs of worsening condition, and offer emotional support

What are general manifestations of congenital heart disease (CHD)?

Murmurs, cyanosis or acrocyanosis, failure to thrive, clubbing, and frequent infections

What nursing care is needed for CHD?

Monitor vitals and oxygenation, support feeding, prepare for catheterization/surgery, educate family, and prevent infections

What is essential post-operative nursing care after CHD repair?

Monitor vitals and perfusion, manage pain, prevent infection, support nutrition/hydration, and educate on medications, wound care, and activity limits

At what age should routine blood pressure screening begin in children?

At age 3 (earlier if at risk)

What are common signs of pediatric hypertension?

Headache, vision changes, and irritability

What are the adolescent blood pressure categories?

Normal: <120/<80; Elevated: 120–129/<80; Stage 1: 130–139/80–89; Stage 2: ≥140/90

How is pediatric hypertension managed?

Lifestyle changes (diet and exercise), medications if necessary, and monitoring for organ damage

What are the three phases of Kawasaki Disease?

Phase 1: Fever >5 days, conjunctivitis, rash, cracked lips; Phase 2: Skin peeling, irritability, joint pain; Phase 3: Inflammation gradually subsides but may persist

How is Kawasaki Disease treated?

IV immunoglobulin (IVIG) and high-dose aspirin

What nursing care is provided for Kawasaki Disease?

Monitor fever, prevent aneurysms, provide oral care, control pain, and watch for aspirin side effects

What are key signs of Rheumatic Fever?

Joint pain/swelling, fever, new murmur, and Sydenham’s chorea (involuntary movements)

How is Rheumatic Fever managed?

Penicillin antibiotics, aspirin for anti-inflammatory effect, bed rest during acute phase, and long-term prophylaxis