congenital heart defects

acyanotic pulmonary flow

increased pulmonary flow leading to respiratory s/s

acyanotic shunting

left to right shunting, CHF risk

acyanotic defects

ASD, VSD, PDA

cyanotic pulmonary flow

decreased pulmonary flow

cyanotic shunting

right to left shunting

cyanotic defects

TOF, cyanosis

cyanosis is unresponsive to what

o2

atrial septal defect pathophys

small to large hole in septum at atrium level

ASD findings

asymptomatic; fatigue, poor growth, murmur

ASD key finding

fixed split S2

diagnostic test recommended for all defects

echocardiogram

nursing intervention recommended for all defects

cluster care, small frequent meals with increased calories

ASD surgical treatment

cardiac cath

ASD nursing care

monitor growth, 4 point blood pressure, cap refill, signs of CHF

ventricular septal defect pathophys

small or large hole through septum at ventricle level

VSD findings

tachypnea, tachycardia, sweating with feedings, FTT

VSD key finding

holosystolic murmur

VSD nursing care

monitor respiratory distress, provide rest, monitor feeding tolerance

patent ductus arteriosus pathophys

blood flows from aorta to pulmonary artery because the patent ductus arteriosus did not close at birth

PDA findings

tachypnea, dyspnea, bounding pulses

PDA key findings

continuous machine like murmur

PDA medication

indomethacin (NSAID)

indomethacin function

prostaglandins to close PDA

PDA surgical treatment

cardiac Cath, surgery to close PDA

tetralogy of fallot pathophys

4 defects = VSD, pulmonary stenosis, overriding aorta, right ventricle hypertrophy

what happens in TOF pathophys

deoxygenated blood mixes with oxygenated blood on left side, the blood is low and o2 and is pumped thoughtout the body

TOF findings

cyanosis, clubbing, murmur

TOF key finding

tet spells

TOF nursing care

manage tet spells, monitor hypoxemia

tet spells management

knee to chest, o2, morphine, must respond quickly

coarctation of the aorta pathophys

narrowing of aorta obstructing blood flow

CoA findings

HTN, bonding pulses in arms, weak/absent femoral pulses, headaches, dizziness

CoA findings in older kids

frequent nosebleeds

CoA surgical treatment

some surgery

CoA nursing care

monitor BP in all extremities and note discrpiencies in upper vs lower, temperature of skin in upper vs lower

alprostadil

keep PDA open

diuretics

manage CHF symptoms

teach families to report

cyanosis, edema, poor feedings

other teaching points

daily weights, medication adherence, support growth, infection prophylaxis

ECG and CXR are considered

supportive data

MRI/CT scan used for

complex defects

cardiac Cath is

diagnostic and interventional