Peds - CardioVascular_Defects

Peds - CardioVascular_Defects - Pediatrics Child Health...

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Unformatted text preview: Pediatrics Child Health Nursing Cardiovascular Study Guide Foramen Ovale Opening between the atria in the fetal heart (blood flow from R to L atrium) should close at birth after 1 st breath (not the case in ASD) Ductus Arteriosus Fetal vascular channel between pulmonary artery and descending aorta should close within 48 hrs. of life (not the case in PDA) Diagnostic Tests for CHD CXR size and characteristics ECG electrical activity Echo structures, pattern of movement, presence of defects Heart cath - O2 sats, pressure, and anatomic alterations Labs H/H, RBC, ABG, Plts, PT, clotting factors Normal Heart 1 Patent Ductus Arteriosus Fails to close after birth (blood flow from high-pressure aorta low pressure pulmonary artery); machinery-like murmur More common in premies Asymptomatic or s/s CHF; bounding pulses; tachypnea (> 70)/ tachycardia (>170) FTT note: q heart defect can result in FTT Risk for endocarditis and pulmonary vascular obstructive disease q heart defect Increased R ventricular pressure hypertrophy IV indomethacin (Indocin) up to 3x/ prostaglandin E1 inhibitor to stimulate closure if unsuccessful: surgical ligation (now through scope) Note: ductus reopens in 30% of cases treated with Indocin Lasix is given to decrease cardiac workload Transcath closure by obstructive device attempted in children > 18 months 2 Atrial Septal Defect Abnormal opening between atria L to R shunting of blood (soft systolic murmur) Small: foramen oval fails to close/ Large: absence of septum Often asymptomatic until later in life/ may develop s/s of CHF Decrease in growth Risk for arrhythmias, pulmonary vascular obstructive disease, embolus Sx to close ASD/ may be performed via transcath device during heart cath 3 Ventricular Septal Defect Abnormal opening between ventricles (murmur & thrill along L sternal border #1 CHD (membranous = 80% or muscular = 20%) Pressure in LV increases oxygenated blood to RV increased blood volume to lungs overload lungs become congested with blood (CHF is common) Risk for endocarditis (prophylaxis ABX)/ pulmonary vascular obstructive disease Most small VSDs close spontaneously baby is sent home initially Treatment is conservative if no s/s of CHF or poor growth Closure of VSD may be peformed via transcath device during heart cath May require positive inotropic agents (dopamine/ Isuprel) to increase CO Highest risk associated with VSD repair within 1 st few months of life Children usually catch up after Sx Complication in > 30% of patients: complete R bundle branch block 4 Hypoplastic Left Heart Syndrome Aortic and mitral valve atresia & small non-functional LV Potential complications: delayed growth/ devt, CHF, chronic infections, rejection of organ (transplant), death S/S: CHF in 1st week of life, dyspnea, hepatomegaly, low CO, weak/ absent peripheral...
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This note was uploaded on 05/04/2008 for the course NURS 220 taught by Professor Dewitt during the Spring '08 term at Lady of the Lake.

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Peds - CardioVascular_Defects - Pediatrics Child Health...

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