12. Cardiac & NTD Review

what is coarctation of the aorta?

narrowing of the aorta

what blood pressure and pulse findings suggest coarctation of the aorta?

arms: increased blood pressure, bounding pulses;legs: decreased blood pressure, weak or absent pulses

what is transposition of the great vessels?

aorta arises from the right ventricle;pulmonary artery arises from the left ventricle

what is hypoplastic left heart syndrome?

severely underdeveloped left heart with a nonfunctional left ventricle

what four defects make up tetralogy of Fallot? *

pulmonary stenosis;right ventricular hypertrophy;overriding aorta;ventricular septal defect

what is a tet spell?

sudden increase in cyanosis, often during feeding, crying, or activity

what is the first intervention for an infant having a tet spell? *

knee-to-chest position

what is tricuspid atresia?

failure of the valve between the right atrium and right ventricle to develop

what is truncus arteriosus?

one major artery supplies both pulmonary and systemic circulation

why is prostaglandin given for certain congenital heart defects? *

keep the ductus arteriosus open

what major adverse effect should the nurse monitor for during a prostaglandin infusion? *

apnea

when should an indomethacin order be questioned in a newborn with a heart defect? *

when the newborn needs the ductus arteriosus to remain open

what daily supplement helps prevent neural tube defects? *

folic acid 0.4 mg;begin before pregnancy

what is encephalocele?

brain and meninges protrude through a skull defect

what is spina bifida occulta?

vertebral defect without protruding spinal cord or meninges;may have a dimple, hair patch, or skin discoloration

what is meningocele?

meninges protrude through a vertebral defect;spinal cord usually normal

what is myelomeningocele?

spinal defect with a protruding sac containing meninges, spinal fluid, and neural tissue

how should a newborn with myelomeningocele be positioned before repair? *

prone with hips flexed

how should an exposed spinal sac be covered? *

sterile, nonadherent dressing soaked in warm normal saline

how is warmth maintained before myelomeningocele repair?

radiant warmer without restrictive swaddling

what precautions are needed when caring for myelomeningocele?

• no pressure on the sac

• no diaper over the sac

• latex-free supplies

what should the nurse do if a spinal sac leaks or ruptures?

notify the provider immediately and prepare for emergency surgery

when is repair of an open neural tube defect usually planned?

within 24–48 hours after birth