Congenital Heart Defects Lecture Review

Flashcards testing knowledge on classifications, clinical manifestations, procedures, and nursing interventions for congenital heart defects based on the lecture transcript.

What are congenital heart defects (CHDs)?

Structural anomalies that are present at birth, accounting for the largest percentage of all birth defects.

Which heart defects are classified as left-to-right shunting defects with increased pulmonary blood flow?

Patent ductus arteriosus (PDA), atrial septal defect (ASD), and ventricular septal defect (VSD).

Which congenital heart defects are classified as causing decreased pulmonary blood flow?

Tetralogy of Fallot and tricuspid atresia.

Which conditions are categorized as obstructive or stenotic defects causing decreased cardiac outflow?

Coarctation of the aorta, aortic stenosis, and pulmonary stenosis.

Which congenital heart defects are classified as mixed or cyanotic defects with increased pulmonary blood flow?

Transposition of the great vessels (TGV), total anomalous pulmonary venous return (TAPVR), truncus arteriosus, and hypoplastic left heart syndrome (HLHS).

What are the key clinical manifestations of Patent Ductus Arteriosus (PDA)?

A machine-like murmur, widening pulse pressure, bounding pulses, an enlarged heart, and signs/symptoms of heart failure depending on the size of the defect.

What murmur and heart sound characteristics are associated with an Atrial Septal Defect (ASD)?

A split S1 sound, a soft systolic ejection murmur in the pulmonic area with a fixed wide splitting of S2, and a mid-systolic murmur at the lower left sternal border (LSB).

What clinical manifestations are typical of a Ventricular Septal Defect (VSD) in infants?

Excessive sweating during feedings, fatigue during feedings due to increased cardiac output, lack of adequate growth, frequent respiratory infections, tachypnea with exercise, and CHF with moderate to large defects.

What four structural abnormalities comprise Tetralogy of Fallot?

Overriding aorta, pulmonic stenosis, ventricular septal defect, and right ventricular hypertrophy.

What clinical manifestations develop in an infant with Tetralogy of Fallot?

Hypoxia, cyanosis, systolic murmur (and thrill) in the pulmonic area, polycythemia, hypoxic episodes, metabolic acidosis, poor growth, clubbing of the fingers, and exercise intolerance.

What actions should a nurse take to manage hypercyanotic episodes in a child with Tetralogy of Fallot?

Place the infant in the knee-chest position, calm the child, supply oxygen, and administer IV morphine and propranolol.

What critical conditions must be monitored during hypercyanotic episodes in Tetralogy of Fallot?

Metabolic acidosis or prolonged unconsciousness.

What clinical signs regarding pulses and blood pressure are characteristic of Coarctation of the Aorta?

Higher blood pressure and pulse in the upper extremities, along with absent or decreased femoral pulses and a difference between femoral and carotid pulses.

What clinical manifestations of Coarctation of the Aorta occur in adults?

Cyanosis, shortness of breath, headache, lower limb claudication, and increased complications such as dysrhythmias, stroke, heart failure, pulmonary hypertension, and heart valve issues.

Which genetic disorders are associated with an increased risk for Hypoplastic Left Heart Syndrome?

Turner Syndrome, Trisomy 13, Trisomy 18, Trisomy 21, and Noonan Syndrome.

What proportion of live-born newborns with Hypoplastic Left Heart Syndrome die before surgical intervention?

Approximately one-third of live born newborns.

Why do one-third of Hypoplastic Left Heart Syndrome patients die by age 25?

Right ventricle failure.

What medication is administered pre-procedure for Hypoplastic Left Heart Syndrome, and what is its purpose?

Alprostadil; it helps dilate the vessels in the body and keep the heart open, especially the ductus arteriosus.

Why is supplemental oxygen avoided prior to surgery in infants with Hypoplastic Left Heart Syndrome?

Oxygen promotes blood flow to the lungs, which decreases blood flow to the body and places excessive demands on the already stressed right ventricle.

What is the purpose of an atrial septostomy before surgical correction of Hypoplastic Left Heart Syndrome?

It creates one big atria to allow more blood flow.

What occurs during the Norwood procedure for Hypoplastic Left Heart Syndrome, and when is it done?

Done in the first 2 weeks of life as the 1st procedure; it creates a new aorta to the right ventricle and places a tube from either the aorta or right ventricle to the pulmonary arteries.

What is the Bi-directional Glenn procedure, and when is it performed?

Performed 4 to 6 months after birth; it creates a direct connection between the pulmonary artery and superior vena cava to return oxygen-poor blood from the upper body and reduce right ventricle work.

What occurs during the Fontan procedure, and what is its clinical outcome?

Performed between 18 months and 4 years; it connects the inferior vena cava to the pulmonary arteries, allowing oxygen-poor blood from the lower body to be oxygenated, resulting in no more blood mixing and returning skin color to normal.

How are Grade I, Grade III, and Grade VI heart murmur intensities defined in the lecture notes?

Grade I is soft and hard to hear; Grade III is loud without thrill; Grade VI is very loud, audible with a stethoscope or with the naked ear.

What are the main focus areas of nursing care for a child with a cardiac disorder?

Improving oxygenation, promoting adequate nutrition, assisting the child and family with coping, providing postoperative nursing care, preventing infection, and providing child and family education.