fetal circulation
Why are there shunts for the fetus
Bypass the underdeveloped lungs and liver- straight to the placenta
What happens when the umbilical cord and placenta are removed
the heart takes over and the SVR rises
-Blood moves from high to low pressure
After birth, the left side has higher pressure to push blood to the body (systolic pressure)
heart sounds that reflect the flow of blood within the heart
what can CHD result in
Left-to-right shunting of blood (CHF)
Decreased pulmonary blood flow (cyanosis)
What is PVR (pulmonary vascular resistance)
the resistance to blood flow within of the lungs that the right side of the heart must overcome to pump blood
What are the three shunts
1. Ductus Venosus
2. Foramen Ovale
3. Ductus Arteriousus
What happens when the SVR rises
The LV becomes thicker, and the pressure of the left rises
When do murmurs occur
periods of stress, anemia, fever, or rapid growth (80% of kids have it)
What does increased pulmonary blood flow mean
abnormal connection between the sides of the heart, increased blood volume on the right which increases BF, decreased systemic BF)
What is SVR (systemic vasular restistance)
esistance that the heart must overcome to pump blood through the body's circulatory system
What is the Ductus Venosus
from the umbilical vein to the vena cava
What happens when the lung expands
Decreases PVR, takes over oxygenation, vasodilation
What is the Pre Catheter care
prep, explanation at a developmental level, assessment (pedal pulses), sedation, NPO
What does obstructive defects mean
blood exiting the heart meets area of narrowing causing obstruction flow, increases pressure before obstruction and decreased after
Why is PVR higher before birth
the fetus does not use their lungs to breath and go to the shunts
What is the Foramen Ovale
hole in the wall between the atrium to allow oxygenated blood to bypass the lungs to the rest of the body
RV pumps to low-pressure pulmonary bed (6-8 weeks)
What is the post catheter care
cardiac/pulse monitoring, VS q 15min, monitor pulses (temp, color), dressing for bleeding/hematoma*****, I/O, hypoglycemia, positioning
What does decreased pulmonary blood flow mean
obstruction of pulmonary blood flow and an anatomic defect between the sides of the heart, pressure on the right side increases, and desaturatred blood from right to left (cyantoic and hypoxemia)
Why is SVR higher after birth
the systemic circuit must pump blood through the entire body
What is the Ductus Arteriosus
connects the aorta and pulmonary trunk to go straight to the body
When does the DA close and what influences it to close
2-3 weeks and influenced by O2 levels, prostaglandin levels, and maturity
What are the classificatiions for CHD
Increased Pulmonary Blood Flow
Obstructive Defects
Decreased Pulmonary Blood Flow
Mixed
What can mixed defects mean
-complete mixing of blood
-relative desaturation
-pulmonary congestion
-decreased cardiac output
What side of the heart is higher in pressure AFTER birth
left