Patho
A newborn has a defect that causes increased pulmonary blood flow. What direction is the shunt?
Left-to-right
Left-to-right shunts typically cause what type of cyanosis?
Acyanotic
A child tires easily and has poor feeding. Which type of defect is most likely?
Increased pulmonary blood flow defect
What position should a child be placed in during a hypercyanotic spell?
Knee-chest position
A 2-month-old presents with:
What condition is most likely?
Ventricular Septal Defect (VSD)
A defect causes obstruction to pulmonary blood flow and results in systemic circulation receiving deoxygenated blood. What type of defect is this?
Decreased pulmonary blood flow defect
Right-to-left shunts result in what key clinical finding?
Cyanosis
A nurse notes a murmur and thrill in a child. Which defect is most likely?
Ventricular Septal Defect (VSD)
A child with TOF becomes cyanotic and irritable. What is the FIRST action?
Place in knee-chest position
A 2-month-old presents with:
Which findings support heart failure? (Select all that apply)
A. Tachypnea
B. Weight gain
C. Diaphoresis
D. Poor feeding
E. Bradycardia
A.Tachypnea
C. Diaphoresis
D. Poor feeding
A nurse is reviewing a chart of a child with Tetralogy of Fallot. Which pathophysiologic finding explains cyanosis?
Right-to-left shunting causing deoxygenated blood to enter systemic circulation
A child with a VSD develops pulmonary hypertension. What happened to the shunt?
It reversed from left-to-right to right-to-left
Which finding is most concerning in Tetralogy of Fallot?
Cyanosis / hypercyanotic (tet) spells
Which intervention is priority during a hypercyanotic spell?
Provide oxygen
A 2-month-old presents with:
What is the priority nursing diagnosis?
Decreased cardiac output
A patient develops Eisenmenger syndrome. What caused this progression?
Long-term left-to-right shunt leading to pulmonary hypertension → reversal to right-to-left
Which defect increases blood flow to the lungs and can lead to heart failure?
ASD or VSD
A child presents with bounding upper extremity pulses and weak lower extremity pulses. What is the likely diagnosis?
Coarctation of the aorta
A nurse suspects coarctation of the aorta. What assessment is priority?
Compare BP and pulses in upper vs lower extremities
Case:
A 2-month-old presents with:
Which intervention is most appropriate?
A.Increase activity
B. Provide small frequent feeds
C. Restrict oxygen
D. Delay treatment
B. Provide small frequent feeds
Which condition results from narrowing of a major vessel leading to increased cardiac workload?
Obstructive defect (Coarctation of the aorta)
Which congenital heart defect includes VSD, pulmonary stenosis, overriding aorta, and RV hypertrophy?
Tetralogy of Fallot
Which finding indicates worsening heart failure in a child with ASD/VSD?
Tachypnea, poor growth, diaphoresis with feeding
A newborn fails pulse oximetry screening. What is the nurse’s priority?
Notify provider for further cardiac evaluation
Which complication is MOST concerning if untreated?
Pulmonary hypertension → Eisenmenger syndrome