Classifications & Mechanisms
Congenital heart defects are primarily classified by what two main types of blood flow alterations?
Acyanotic (left-to-right shunts) and Cyanotic (right-to-left shunts).
In left-to-right shunting lesions, what hemodynamic effect occurs in the lungs?
Increased pulmonary blood flow.
What medication is used to maintain ductal patency in cyanotic CHDs before surgery?
Prostaglandin E1 (alprostadil).
What is a key developmental nursing intervention for infants with CHD?
Promote rest and conserve energy while supporting attachment.
What are early signs of CHF in infants?
Tachycardia, poor feeding, sweating during feeds.
What causes left-to-right shunting in acyanotic CHDs?
Higher left-sided pressure forces oxygenated blood into the right side.
What is the major hemodynamic problem in right-to-left shunting lesions?
Decreased pulmonary blood flow and hypoxemia.
What is the goal of palliative surgery for cyanotic lesions?
To increase pulmonary blood flow and improve oxygenation.
For school-age children with CHD, what psychosocial support is most important?
Encourage participation in school and peer activities as tolerated.
What clinical finding indicates worsening CHF?
Weight gain and peripheral edema.
Which heart defect is caused by failure of the ductus arteriosus to close after birth?
Patent Ductus Arteriosus (PDA).
In CHF, what compensatory mechanism initially maintains cardiac output?
Increased heart rate and sympathetic nervous system activation.
Name one priority nursing intervention for an infant with Tetralogy of Fallot during a “tet spell.”
Place infant in knee-chest position.
How should nurses educate parents about feeding infants with CHF?
Provide small, frequent, high-calorie feedings; allow rest.
What lab test helps monitor CHF treatment effectiveness?
Serum potassium.
Which CHD results in obstruction of blood flow from the left ventricle into systemic circulation?
Aortic stenosis.
Which defect often leads to bounding pulses and widened pulse pressure?
Patent Ductus Arteriosus (PDA).
Which diuretic is commonly used to manage CHF in infants?
Furosemide (Lasix).
What nursing role supports families during CHD diagnosis?
Provide emotional support, clear education, and connect to resources.
What nursing diagnosis is priority for CHF?
Impaired Gas Exchange r/t pulmonary congestion.
Which congenital heart disorder is characterized by four defects: VSD, pulmonary stenosis, right ventricular hypertrophy, and overriding aorta?
Tetralogy of Fallot.
What is the hallmark sign of coarctation of the aorta in older children?
Higher BP and bounding pulses in upper extremities; weak pulses and lower BP in legs.
Why is digoxin used in pediatric CHF, and what is a key nursing consideration before administration?
It increases contractility; check apical HR for 1 minute (hold if <90–110 in infants).
What key discharge teaching should be reinforced after cardiac surgery?
Monitor incision for infection; avoid crowds; follow up as directed.
What is the goal of nursing care for a child with CHF?
Improve cardiac function, remove excess fluid, and decrease cardiac workload.