Increased Blood Flow
What type of shunt is created for increased pulmonary blood flow defects?
Left to right shunt
High pressure to low pressure
What type of shunt is created for decreased pulmonary blood flow defects?
Right to left shunt
Obstructive blocks the blood flow= not enough 02 to the body (tissues)
What can low oxygenated systemic blood flow cause?
Pulmonary congestion
An infant is sweating w/feeding and has a murmur. What category of defect do they most likely have?
Increased Pulmonary Blood Flow
What are the 3 defects w/increased pulmonary blood flow?
1) Atrial Septal Defect
2) Ventricular Septal Defect
3) Patent Ductus Arteriosus
What are the 3 defects w/decreased pulmonary blood flow?
1) Tetralogy of Fallot
2) Pulmonary Stenosis
3) Pulmonary Atresia
What are the 3 defects associated w/ obstructive blood flow?
1) Coarctation of the Aorta
2) Aortic Stenosis
3) Hypoplastic Left Heart Syndrome
What are the 2 defects associated w/mixed blood?
-Transposition of the Great Arteries
-Total Anomalous Pulmonary Venous Return
What medication is used to keep the PDA open?
Prostaglandins
PROPS it open
What medication will be used to close the Patent Ductus Arteriosus?
IV Indomethacin (NSAID)
Indo=ENDS the opening
What are the 4 defects related to Tetralogy of Fallot?
Pulmonary Stenosis
Right Ventricular Hypertrophy
Overriding Aorta
VSD (Ventricular Septal Defect)
What are the significant clinical manifestations associated to Coarctation of the Aorta?
Higher BP in UE
Lower BP in LE
Swelling of feet/legs
What needs to happen for survival in Transposition of the Great Arteries?
The PDA needs to stay OPEN!
Need surgery to live!
What is the top nursing intervention for a fussy infant with a Congenital Heart Defect?
No matter what, calm that bby down.
Where is the blood sent with this category of defects? What diagnosis can it result in?
1) The lungs
2) Fluid Volume Excess
What is a hypercyanotic spell?
What is the nursing intervention?
1) "Tet" spell where a toddler will squat
2) Put child in knees to chest position
Why is the BP altered in Coarctation of Aorta?
There is a "kink" at the bifurcation of the aorta causing higher blood pressure ABOVE the kink and lower pressure BELOW
Where is oxygenated blood going to in TGA?
Where is deoxygenated blood going?
1) Oxygenated to the lungs
2) Deoxygenated to the body
What are common diagnostic tests used to determine defects?
CXR
EKG
Echo
Cardiac Cath
Name s/s associated with all increased pulmonary flow defects (Think Heart Failure)
-Fatigue
-Murmur
-High risk of endocarditis
-CHF
-Growth restriction
Name s/s associated with decreased pulmonary blood flow defects.
(Think Cyanosis)
-Poor growth
-Systolic murmur
-Decreased 02%
What is significant about Hypoplastic Left Heart Syndrome?
The left side of the heart doesn't form properly during fetal growth and it's teeny tiny
Name s/s associated with Mixed blood defects
-Cyanosis
-Hypoxia
-Fatigue
-Failure to thrive
What infection do most patients have to be on prophylaxis to prevent from occurring d/t defects?
Infective Endocarditis