Cardiac
Can you describe pulmonary stenosis? What are some manifestations?
*BONUS: what are some treatments? (think of nonsurgical and surgical)
Narrow entrance to the pulmonary artery or valve. Obstruction of blood flow to pulmonary artery leads to right ventricular hypertrophy. Severe cases cause regurgitation into right atrium resulting in patent foramen ovale leading to R to L shunting.
M: Many are asymptomatic, Systolic ejection murmur (possible palpable thrill), Cyanosis (varies with defect and narrowing), Cardiomegaly, Heart failure
*B:
Can you describe patent ductus arteriosus? What are some manifestations?
*BONUS: what are some treatments? (think of nonsurgical and surgical)
Failure of the fetal ductus arteriosus to close completely after birth. Blood shunts from aorta (left) to the pulmonary artery (right). Returns to the lungs causing increased left sided cardia workload and increased pulmonary blood flow
M: Sometimes asymptomatic, Systolic murmur (machinery like sound), Widened pulse pressure (increased difference between systolic and diastolic readings), Bounding pulses, Heart failure, Rales, Cardiac enlargement
*B:
Can you describe coarctation of aorta? What are some manifestations?
*BONUS: what are some treatments? (think of nonsurgical and surgical)
Narrowing of lumen of aorta near ductus arteriosus. Left ventricular output is obstructed leading to left ventricular hypertrophy. Decreased blood flow to lower body and abdominal organs.
M: Poor lower extremity peripheral perfusion, Elevated BP in arms, Bounding pulses in upper extremities, Decreased BP in lower extremities, Cool skin in lower extremities, Weak or absent femoral, Leg cramps/tingling, Heart failure in infants, Older children- dizziness, headaches, nose bleeds
*B: Nonsurgical Procedures/Therapies
Surgical Procedures
•Repair of defect (infants less than 6 months)
Can you describe Truncus arteriosus? What are some manifestations?
*BONUS: what are some treatments? (think of nonsurgical and surgical)
Failure of septum formation, resulting in a single vessel that comes off of the ventricles. VSD allows blood from both R and L ventricles to enter.
M: Heart Failure (greater HF symptoms if higher volume of pulmonary blood flow), Harsh systolic murmur, Bounding pulse, Widened pulse pressure, Variable Cyanosis, Delayed growth, Lethargy, Fatigue, Poor feeding habits
*B:
Can you describe Infective Endocarditis? What are some manifestations?
*BONUS: what are some diagnostic and treatments? (think of nonsurgical and surgical) What about some nursing care?
Infection of the inner lining of the heart and the valves that can enter the bloodstream. Caused by bacteria, fungi, or virus. Causative organisms include streptococcus viridans, candida albicans, and staphylococcus aureus. More common in children with congenital heart disease.
M: Fever, Anorexia, Nausea, Diaphoresis, Weight loss, Splinter hemorrhages under finger nails, Malaise, Chest pain, Heart failure, Arthralgias (joint pain), Petechiae. LATE SIGNS: Neuro impairment, New heart murmur
*B:
NC: •Maintain a high level of oral care, •Monitor vital signs, cardiac & neuro status, •Pain management, •Advise dentist of pt. history to ensure preventative treatment (prophylactic antibiotics), •Pt./Family Education- Observe for manifestations of endocarditis, regular prophylactic antibiotics for high-risk patients, schedule follow-up appts.