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104 Cards in this Set
- Front
- Back
Fetal Circulation: Ductus Venosus -
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Shunts blood past portal circulation
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Fetal Circulation: Ductus Arteriosus -
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Shunts blood past the lungs
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Fetal Circulation: Foramen Ovale -
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Shunts blood past lungs
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Right Side of Heart:
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SVC/IVC
RA Tricuspid Valve RV Pulmonic Valve Pulmonic Artery Lungs |
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Left Side of Heart:
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Pulmonary Veins
LA Mitral Valve LV Aortic Valve Aorta/Lg. Arteries/Capillaries/VC |
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Cardiac Output:
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Volume of blood ejected from heart in 1 min.
CO = HR x SV |
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Stroke Volume:
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Amount of blood ejected by heart in any 1 contraction
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3 Factors that Influence Stroke Volume:
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Preload
Afterload Contractability |
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Preload:
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Volume of blood returning to heart
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Afterload:
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Resistance against which ventricles must pump when ejecting blood
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Contractility:
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Efficiency of the myocardial fiber to act as a pump
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Subtle Symptoms of CV Dysfunction:
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Duskiness w/ feeding & exertion
Dyspnea w/ physical effort Fatigue Sweating w/ feeding Excessive sweating Expiratory grunt Squatting Clubbing (LT) Failure to Thrive |
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Diagnosing CV Dysfunction:
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Radiography
ECG Echocardiography Cardiac Catheterization |
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Radiography:
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Permanent record of heart size and configuration, it's chambers and great vessels
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ECG:
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Detects arrhythmias, muscular damage, hypertrophy, effects of electrolyte imbalance
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Echocardiography:
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Uses high frequency sound waves obtained by a transducer to produce an image of cardiac structure
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Cardiac Catheterization:
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Uses radiopaque catheters placed in peripheral blood vessel and advanced into heart to measure pressures and oxygen levels in heart chambers & visualize heart structures & blood flow patterns.
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Defects of Increased Pulmonary Flow:
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Patent Ductus Arteriosus (PDA)
Atrial Septal Defect (ASD) Ventrical Septal Defect (VSD) Artioventricular Canal Defect (AVC) |
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Defects of Increased Pulmonary Flow: Patent Ductus Arteriosus (PDA)
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Failure of the fetal ductus arteriosus (artery connecting the aorta and pulmonary artery) to close w/in the 1st weeks of life.
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Patent Ductus Arteriosus (PDA): Symptoms -
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May Be Asymptomatic
CHF Full Bounding Pulses Machine Like Murmur |
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Patent Ductus Arteriosus (PDA): Treatment -
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Prostaglandin Inhibitors
Surgical Ligation |
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Patent Ductus Arteriosus (PDA): Risks -
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Bacterial Endocarditis
Pulmonary Vascular Obstructive Disease later in life |
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Defects w/ Increased Pulmonary Flow: Atrial Septal Defect (ASD) -
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Abnormal opening RA and LA that allows blood from the higher pressure LA to the lower pressure RA. Larger the hole larger the problem.
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Atrial Septal Defect (ASD): Symptoms -
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May be Asymptomatic
CHF Murmur |
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Atrial Septal Defect (ASD): Treatment -
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Surgical Patch Closure
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Atrial Septal Defect (ASD): Risks -
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Bacterial Endocarditis
Atrial Dysrhythmias |
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Defects w/ Increased Pulmonary Flow: Ventrical Septal Defect (VSD) -
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Abnormal opening between the RV and LV. Blood goes from higher pressure LV to lower pressure RV.
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Ventrical Septal Defect (VSD): Symptoms -
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CHF
Murmur Frequently assoc. w/ other defects |
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Ventrical Septal Defect (VSD): Treatment -
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Pulmonary Artery Banding
Suture or Patching |
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Ventrical Septal Defect (VSD): Risks -
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Bacterial Endocarditis
Pulmonary Vascular Obstructive Disease |
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Defects w/ Increased Pulmonary Blood Flow: Artioventricular Canal Defect (AVC) -
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Incomplete fusion of the endcardial cushions.Large opening in the center of the heart which allows blood to flow between all four chambers. Common in DS children.
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Artioventricular Canal Defect (AVC): Symptoms -
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Mod - Sev. CHF
Murmur Mild cyanosis w/ crying |
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Artioventricular Canal Defect (AVC): Treatment -
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Banding
Patch Closure |
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Artioventricular Canal Defect (AVC): Risks -
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Bacterial Endocarditis
Pulmonary Obstructive Vascular Disease |
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Defects w/ Decreased Pulmonary Flow:
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Tetralogy of Fallot
Tricuspid Atresia |
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Defects w/ Decreased Pulmonary Flow: Tetralogy of Fallot -
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4 Classic Defects:
VSD Aorta laying over VSD Pulmonary Stenosis Right Ventricular Hypertrophy |
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Tetralogy of Fallot: Symptoms -
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Cyanosis
Murmur Tet Spells |
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Tetralogy of Fallot: Tet Spells -
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Acute spells of cyanosis w/ hyperpnea (deeper more rapid respirations). May occur during crying, defecating of feeding.
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Tetralogy of Fallot: Treatment of Tet Spells -
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Calm infant
Place in knee to chest position Give blow by O2 Call for assistance IV Morphine Fluid Replacement |
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Tetralogy of Fallot: Treatment -
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Surgical Repair
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Defects w/ Decreased Pulmonary Blood Flow: Tricuspid Atresia -
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Failure of tricuspid valve to develop resulting in lack of communication between RA and RV. PDA allows child to remain alive.
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Tricuspid Atresia: Symptoms -
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Cyanosis
Tachycardia Dypnea Hypoxemia Clubbing (LT) |
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Tricuspid Atresia: Treatment -
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Prostaglandin to maintain patency of PDA
Surgical Repair |
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Tricuspid Atresia: Risk -
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Bacterial Endocarditis
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Obstructive Defects:
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Aortic Stenosis
Pulmonic Stenosis Coarctation of the Aorta |
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Obstructive Defects: Aortic Stenosis -
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Narrow aortic valve d/t thickened or deformed valve cusps.
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Aortic Stenosis: Symptoms -
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Murmur
Decreased CO2 Faint Pulses Hypotension Tachycardia Poor Feeding Exercise Intolerance |
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Aortic Stenosis: Risks -
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Bacterial Endocarditis
Coronary Insufficiency Ventricular Dysfunction |
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Aortic Stenosis: Treatment -
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Balloon Angioplasty
Aortic Valvotomy *Rarely results in "normal" valve* |
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Obstructive Defects: Pulmonic Stenosis -
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Narrowing at the entrance to the pulmonary artery.
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Pulmonic Stenosis: Symptoms -
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May be asymptomatic
Murmur CHF Cyanosis (severe) |
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Pulmonic Stenosis: Risks -
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Bacterial Endocarditis
Ventricular Hypertrophy |
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Pulmonic Stenosis: Treatment -
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Balloon Angioplasty
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Obstructive Defects: Coarctation of the Aorta -
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Localized narrowing of the aorta near the ductus arterosis
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Coarctation of the Aorta: Symptoms -
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Increased pressure in head & upper extremities
Decreased pressure in body and lower extremities *BP and Pulse vary between upper and lower extremities |
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Coarctation of the Aorta: Treatment -
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Balloon Angioplasty
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Mixed Blood Flow Defects:
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Transposition of the Great Vessels
Truncus Arteriosus Hypoplastic Left Heart Syndrome |
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Mixed Blood Flow Defects: Transposition of the Great Vessels -
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No communication between systemic and pulmonary circulation. PDA keeps patient alive.
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Transposition of the Great Vessels: Symptoms -
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Dependant on severity and PDA:
Cyanosis CHF Depressed Functioning |
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Transposition of the Great Vessels: Treatment -
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Surgery - arterial switch
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Mixed Blood Flow Defects: Truncus Arteriosis -
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One artery arises from the heart and forms both aorta and pulmonary artery
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Truncus Arteriosis: Symptoms -
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May be asymptomatic
Variable cyanosis Poor growth Activity intolerance |
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Truncus Arteriosis: Risks -
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Bacterial Endocarditis
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Truncus Arteriosis: Treatment -
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Surgical Repair
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Mixed Blood Flow Defects: Hypoplastic Left Heart Syndrome -
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Underdevelopment of the left side of the heart.
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Hypoplastic Left Heart Syndrome: 4 Common Defects -
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Hypoplastic left heart & ascending aorta
Coarctation of the aorta Aortic and mitral valve defects Progressive deterioration and cardiovascular collapse if PDA closes |
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Hypoplastic Left Heart Syndrome: Symptoms -
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Mild Cyanosis
CHF until PDA closes |
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Hypoplastic Left Heart Syndrome: Treatment -
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Multi-stage surgical repair
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Congestive Heart Failure:
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Inability of the heart to pump an adequate amount of blood to systemic circulation to meet body demands.
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CHF: Causes -
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Volume Overload
Pressure Overload Decreased Contractility High Cardia Output Demands |
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CHF: Manifestation Classifications -
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Impaired Myocardial Function
Pulmonary Congestion Systemic Venous Congestions |
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CHF: Symptoms of Impaired Myocardial Function -
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Tachycardia
Inappropriate Sweating Oliguria Fatigue/Weakness Restlessness Anorexia Weak Peripheral Pulses/Pale Cool Extremities Hypotension Gallop Rhythm Cardiomegaly |
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CHF: Symptoms of Pulmonary Congestion -
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Tachypnea
Dyspnea Retractions (infants) Flaring Nares Exercise Intolerance Feeding Difficulties Cyanosis Irritability Wheezing/Crackles/Grunting/Cough |
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CHF: Symptoms of Systemic Venous Congestions -
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*Weight Gain
Hepatomegaly Peripheral Edema Ascites Neck Vein Distension |
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CHF: Signs of Impending Heart Failure -
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Increase in:
Weight Pulse Cyanosis |
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CHF: Goals of Treatment -
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Improve Cardiac Function
Remove Accumulated Fluid and Sodium Decrease Cardiac Demands |
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CHF: Medications to Improve Cardiac Function -
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Digoxin
ACE Inhibitors |
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CHF: Digoxin -
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Increases contractility
Slows conduction through AV node Enhances diuresis |
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CHF: Digoxin Toxicity -
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Bradycardia
Nausea Vomiting Visual Disturbances |
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CHF: Digoxin Administration -
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2 RN's check dosage
1 min. apical pulse Hold if pulse below 100 Monitor I&O Between 0.8-2ug/L |
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CHF: ACE Inhibitors -
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Blocks conversion of angiotension I to angiotension II.
EX: Catopril Enalapril lisinopril |
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CHF: Treatment of Fluid Accumulation -
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Diuretics
Fluid Restriction |
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CHF: Treatment to Decrease Cardiac Demands -
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Minimize metabolic needs (avoid cold stress)
Treat infection Reduce breathing effort (semi-fowlers) Sedation Rest Frequent small meals Administer ordered O2 |
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Hypoxemia:
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Arterial oxygen tension (or pressure) that is lower then normal. Identified by measuring arterial oxygen saturation (SaO2) or PaO2.
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Hypoxemia: 2 Physiological Changes -
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Polthycemia
Clubbing |
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Hypoxemia: Polthycemia -
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Increased number of RBC's
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Hypoxemia: Clubbing -
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A thickening and flattening of the tips of the fingers and toes.
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Acquired Cardiovascular Disorders:
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Bacterial Endocarditis
Rheumatic Fever Kawasaki Disease |
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Bacterial Endocarditis:
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Infection of the valves and inner lining of the heart. Most commonly caused by Strepococcus viridians but many also be caused by Staphlococcus aureus or Candida albicans
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Bacterial Endocarditis: Symptoms -
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Low grade fever
Anorexia Malaise Headache Weight loss New/different murmur Osler Nodes Janeway Spots |
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Bacterial Endocarditis: Diagnosis -
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Echocardiogram
ECG Blood Cultures |
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Rheumatic Fever:
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An autoimmune illness resulting from a systemic inflammatory collagen disease that follows a group A beta hemolytic streptococcal infection.
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Rheumatic Fever: Compilications -
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Rheumatic Heart Disease
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Rheumatic Fever: Aschoff Bodies -
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Inflammatory hemorrhagic bullous lesions in connective tissue, blood vessels, brain, joints, pleura
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Rheumatic Fever: Prevention -
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Screen all sore throats
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Rheumatic Fever: Treatment -
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Antibiotic
Aspirin Bed rest Long term antibiotic prophylaxis |
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Kawasaki Disease:
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Mucocutaneous Lymph Node Syndrome. Acute systemic vasculitis of unknown cause.
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Kawasaki Disease: Diagnostic Criteria -
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Fever lasts 5+ days
5 of 6 of the following: Bacterial conjunctivitis w/out exudate Changes in oral mucosa (erythema, dryness, lip fissures, strawberry tongue) Changes in extremities (peripheral edema, erythema of palms/soles, peeling of hands/feet) Cervical lymphadenopathy Polymorphous rash |
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Kawasaki Disease: Risks -
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Damage to CV system
Leading cause of acquired HD in US (scarring) |
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Systemic Hypertension:
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Consistent elevation of B/P
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Systemic Hypertension: Causes -
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Renal dysfunction
CV dysfunction Endocrine dysfunction Neurologic dysfunction Drugs |
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Systemic Hypertension: Symptoms -
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Frequent headaches
Dizziness Vision changes Infants: Irritability Head banging/rubbing Night screaming |
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Hyperlipidemia:
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Increased amount of lipids. Play and important role in producing atherosclerosis leading to coronary artery disease
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Hyperlipidemia: Plaque Detection -
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May be seen as early as 2yrs old.
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