ATI Ch. 20 Cardiovascular Disorders Questions

Low BP causes angiotensin and kidneys to

retain fluid and increase vascular resistance

Pulmonary congestion or systemic edema leads to

right or left sided HF

Decreased Oxygen causes organs to produce metabolites which

stimulates vasodilation and lowers BP

Clinical manifestations of pulmonary stenosis

systolic ejection murmur cyanosis cardiomegaly heart failure

Clinical manifestations of patent ductus arteriosus (PDA)

murmur wide pulse pressure bounding pulse heart failure

coarctation of the aorta

narrowing of the lumen of the aorta that results in obstruction of blood flow from the ventricle

pulmonary stenosis

narrowing of the pulmonary valve or artery that results in obstruction of blood from the ventricles

CHD that causes decreased pulmonary blood flow

pulmonary stenosis Tetralogy of Fallot

Mgt for PDA

** Indomethacin or ibuprofen to stimulate closure insertion of coils to occlude PDA

Clinical manifestations of Kawasaki disease in the acute phase

-Fever > 102F for 5days to 2wks unresponsive to antipyretic -Red eyes -Bright red chapped lips -Strawberry tongue!!! -Red oral mucus membranes -Swelling of hands and feet -Nonblistering rash -Bilaterally joint pain -Coronary abnormalities

Clinical manifestations of Kawasaki disease in the subacute phase

-Fever gradually subsiding -Irritability -Peeling skin around nails, hands, feet -Temporary arthritis

A nurse is caring for an infant. Which of the following are clinical manifestations of coarctation of the aorta? (Select all that apply.) A. Weak femoral pulses B. Cool skin of lower extremities C. Severe cyanosis D. Clubbing of the fingers E. Heart failure

A. CORRECT: Narrowing of the lumen of the aorta results in obstruction of blood flow from the ventricle, resulting in weak or absent femoral pulses. B. CORRECT: Narrowing of the lumen of the aorta results in obstruction of blood flow from the ventricle, resulting in cool skin of the lower extremities. E. CORRECT: Heart failure occurs when the heart is unable to meet the body's demands, and is a manifestation of coarctation of the aorta.

Clinical manifestations of atrial septal defect (ASD)

loud harsh murmur Heart failure

A nurse is caring for a child who is suspected of having rheumatic fever. Which of the following manifestations support this diagnosis? (Select all that apply.) A. Erythema marginatum (rash) B. Continous joint pain of the digits C. Tender, subcutaneous nodules D. Decreased erythrocyte sedimentation rate E. Elevated C-reactive protein

A. CORRECT: Rheumatic fever is caused by Group A beta‑hemolytic streptococcus. An erythema marginatum (rash) is a manifestation. E. CORRECT: Rheumatic fever is caused by Group A beta‑hemolytic streptococcus. An increase in C‑reactive protein is a manifestation.

CHD that causes increased pulmonary blood flow

ASD VSD PDA

Transposition of the great arteries

Aorta is connected to the RV instead of the Left. Pulmonary arter is connected to the LV instead of the Right OK if there is septal defect or PDA

A nurse is assessing an infant. Which of the following should the nurse recognize as clinical manifestations of heart failure? (Select all that apply.) A. Bradycardia B. Cool extremities C. Peripheral edema D. Increased urinary output E. Nasal flaring

B. CORRECT: A client who has heart failure will exhibit cool extremities as the heart is unable to adequately circulate oxygenated blood. C. CORRECT: A client who has heart failure will exhibit peripheral edema as the heart is unable to adequately circulate blood through the body and back to the heart. E. CORRECT: A client who has heart failure will exhibit nasal flaring due to inadequate oxygenation of blood.

A nurse is caring for a 2-year-old child who is cyanotic and is in the hospital for a cardiac catheterization to repair cardiac defects. The child will be transferred to the pediatric ICU following the procedure. Which of the following is an appropriate nursing action when providing care to this child? A. Place on NPO status for 12 hours prior to the procedure. B. Check for iodine for shellfish allergies prior to the procedure. C. Elevate the affected extremity following the procedure. D. Limit fluid intake following the procedure.

B. CORRECT: Iodine‑based dyes can be used in this procedure, so the child is assessed for allergies to iodine or shellfish which could lead to anaphylaxis.

A nurse is providing teaching to the mother of an infant who is to start taking digoxin (Lanoxin). Which of the following instructions should the nurse include? A. "Do not offer your baby fluids after giving the medication." B. "Digoxin increases your baby's heart rate." C. "Give the correct dose of medication at regularly scheduled times." D. "If your baby vomits a dose, you should repeat the dose to ensure that he gets the correct amount."

C. CORRECT: The correct amount of digoxin should be administered at regularly scheduled times to maintain therapeutic blood levels.

Nursing mgt for Kawasaki disease

Educate pt: arthitic pain can last for several weeks, do ROM exercises in the bathtub

Clinical manifestations of Bacterial endocarditis

Fever Malaise New Murmur Myalgias or Arthralgias Neonates: feeding problems, respiratory distress, septicemia

Medication for Kawasaki disease

Gamma globulin IV infusion Aspirin

Clinical manifestations of ventricular septal defect (VSD)

loud harsh murmur at left sternal border heart failure

Hypoplastic left heart syndrome

Left side of the heart is underdeveloped OK if there is an ASD or foramen ovale

Clinical manifestations of Hypoplastic left heart syndrome

Mild cyanosis HF lethargy cold extremeties

Mgt for Transposition of the great arteries

Prostaglandin E until balloon atrial septostomy

Kawasaki disease

acute systemic vasculitis

Bacterial endocarditis is

an infection of the inner lining of the heart and valves - Staphylococcus aureus - Streptococcus viridans

Clinical manifestations of coarctation of the aorta

bounding pulse in upper extremities elevated BP in arms decreased BP in legs cool skin in legs weak or absent femoral pulses Infants: HF Children: h/a, dizziness, nosebleeds

CHD that causes obstruction to blood flow in the heart

coarctation of the aorta hypoplastic left heart syndrome

Clinical manifestations of Tetralogy of fallot

cyanosis at birth and progressive systolic murmur episodes of acute cyanosis and hypoxia

Nursing considerations for Bacterial endocarditis

high-risk clients should receive prophylactic antibiotic therapy

atrial septal defect (ASD)

hole in the septum btwn the R and L atria increased pulmonary blood flow (L to R shunt)

ventricular septal defect (VSD)

hole in the septum btwn the R and L ventricle increased pulmonary blood flow (L to R shunt)

Tetralogy of fallot

includes: pulmonary stenosis, VSD, overriding aorta, right ventricular hypertrophy causes mixed blood flow

Hypertrophy of the heart is caused by

obstructive defects that restrict blood flow

Clinical manifestations of Transposition of the great arteries

possible murmur varying cyanosis cardiomegaly HF

patent ductus arteriosus (PDA)

pulmonary artery and aorta fails to close and results in increased pulmonary blood flow (L to R shunt)

Catecholamines causes

tachycardia improved heart muscle contraction ventricular hypertrophy

CHD that causes mixed blood flow in the heart

transposition of the great arteries