Holes of heart
What you hear, what you see
Intervention
Cath lab and nursing
Feeding, meds, & Home care
100

The direction blood shunts through both an ASD and a VSD

What is a left-to-right shunt? 

100

The classic second heart sound finding in atrial septal defect.

What is wide, fixed splitting of S2?

100

The four goals of medical management for a child with a septal defect.

What are improve cardiac function, remove fluid and sodium, decrease cardiac demands, and improve tissue oxygenation?

100

NPO time before cardiac catheterization — and why infants get IV fluids during it.

What is 6 to 8 hours with IV fluids to prevent dehydration and hypoglycemia?


100

The feeding interval that works best for an infant with significant heart disease.

What is every 3 hours?

200

The ASD type described as an abnormal opening at the center of the septum. 

What is Ostium secundum (ASD 2)? 

200

This feeding behavior in an infant is an early red flag for a septal defect.

What is exhaustion or tiredness while feeding?

200

These two medications bridge a child while awaiting defect closure.

What are digoxin and an ACE inhibitor?

200

You mark these before the procedure so you have something to compare against afterward.

What are baseline pedal pulses?

200

Daily fluid and caloric goals for an infant with significant heart disease.

What are 150 mL/kg/day and at least 120 kcal/kg/day?

300

Syndrome where the chronic pulmonary overcirculation remodels the pulmonary vessels until the shunt reverses. 

What is Eisenmenger syndrome? 

300

The murmur of a VSD and where on the chest you auscultate it.

What is a pansystolic murmur at the left lower sternal border?

300

Weight and age at which ASD device closure is typically scheduled, and the test done first.

What is over 15 kg, age 3 to 5, with an echocardiogram first?


300

After the procedure, coolness or blanching of the affected extremity signals this.

What is arterial obstruction?

300

This is the common misconception about feeding infants with congenital heart defects.

What makes breastfeeding not possible? 

400

Unlike ASD, a VSD can also be acquired after birth — through these two kinds of events.

What are ischemic episodes and inflammatory events? 

400

This syndrome can lead to cyanosis, clubbing, SOB, and chest pain. 

What is Eismenger Syndrome. 

400

Surgery is first line for most VSDs rather than device closure. This is the risk that drives that decision.

What is a conduction injury?

400

The catheterization site starts bleeding. This is exactly where you apply pressure.

What is 2.5 cm above the puncture site, direct and continuous?

400

Recommended for high-risk infants under 2 years, this protects against a virus that would be dangerous for an already-strained heart.

What is palivizumab (RSV prophylaxis)?

500

Which of the two is more common? ASD or VSD?

What is Ventricular Septal Defect. 

500

The primary diagnostic method for both ASD and VSD.

What is an echocardiogram?

500

What is the daily caloric goal for an infant with significant heart disease? 

What is 120 kcal/kg/day.

500

How long the affected extremity must stay straight after venous access, versus after arterial access.

What is 4 to 6 hours after venous, and 6 to 8 hours after arterial?

500

Apical pulse thresholds below which you hold a digoxin dose — for an infant or young child, and for an older child.

What is below 90 to 110 bpm for an infant or young child, and below 70 bpm for an older child?