Peds test 2 CV

Rhonchi low-pitched, coarse sounds, often described as having a snoring or moaning quality.

Rhonchi indicate partial bronchial obstruction caused by mucus or other fluids in the airway, bronchial hyperreactivity, or the presence of a tumor

When right-to-left shunting of blood occurs in a congenital heart defect, nonoxygenated blood is being circulated to the extremities, resulting in tissue hypoxia.

With the hypoxic conditions in the capillaries, erythropoietin is released to signal increased production of red blood cells (RBCs). The increased production of RBCs results in an increased hematocrit.

tetralogy of Fallot

a congenital malformation of the heart involving four distinct defects Tetralogy of Fallot defects cause oxygen-poor blood to flow out of the heart and into the rest of the body. Risk factors include a viral illness such as rubella during pregnancy, maternal alcoholism, or a family history of the condition. Symptoms include blue-tinged skin and shortness of breath. Surgery is typically performed the first year of life, followed by ongoing care.

gavage feedings

a feeding done using a tube that is passed through the nares and into the stomach; the food is in liquid form, usually at room temperature

glomerulonephritis

inflammation of the glomeruli of the kidney

An infant is admitted to the pediatric intensive care unit (PICU) after open-heart surgery for the repair of a ventricular septal defect. nursing assessments in order of priority. 1) respiratory status 2) HR 3) IV catheter 4) Operative Site 5) Urinary output

Replenishment of body fluids is a significant intervention after surgery; the patency of the catheter must be maintained and the flow rate monitored to ensure that an excessive amount is not instilled and affecting the delicate fluid balance in an infant. An increase in the heart and respiratory rates and a decrease in blood pressure may indicate bleeding. Urine output should be checked hourly

Stridor adventitious breath sound. high-pitched, shrill, harsh generally occurs on inspiration, but may occur on expiration.

Stridor occurs with laryngeal obstruction (upper airway obstruction) and is associated with croup syndromes.

acrocyanosis

Temporary cyanotic condition, usually in newborns resulting in a bluish color around the lips, hands and fingernails, feet and toenails. May last for a few hours and disappear with warming.

wheeze a continuous, high-pitched, squeaky, musical sound best heard on exhalation.

Wheezes are commonly heard over all lung fields. A wheeze is caused by narrowing of the lumen of the respiratory passages. It is associated with asthma, bronchitis, croup syndromes, lung infections, pulmonary edema, emphysema, and other chronic obstructive lung conditions.

discharge instructions cardiac catheterization Give sponge baths for 3 days to prevent infection

insertion site should not be submerged in water; sponge baths limit trauma and infection at the insertion site. Fluids should be encouraged to enhance excretion of the contrast medium used during the procedure. The child is sent home without a pressure dressing.

position the nurse place a 4-year-old child during the immediate postoperative period after cardiac catheterization?

supine with bed flat The child should be kept flat for 6 hours during the postprocedure period to avoid flexion at the hip, slowing blood flow and promoting clot formation in this area. If the vascular enclosure device is implanted at the catheter insertion site, the postprocedure period is shortened to 2 hours. The semi-Fowler position should be avoided because the hips are flexed.

APGAR score components

*A*ppearance: pink all over = 2 *P*ulse: > 100 bpm = 2, < 60 = 0 *G*rimace: sneeze, cough, loud cry = 2 *A*ctivity: active movement = 2 *R*espiration: strength, not rate

congenital right-to-left shunt defect

A right-to-left shunt allows deoxygenated systemic venous blood to bypass the lungs and return to the body.

what a patent ductus arteriosus (PDA) is

Before birth, oxygenated fetal blood is shunted directly into the systemic circulation by way of the ductus arteriosus, a connection between the pulmonary artery and the aorta. After birth, the increased oxygen tension causes a functional closure of the ductus arteriosus. Occasionally, particularly in preterm infants, this vessel remains open, a condition known as patent ductus arteriosus.

Crackles (rales) They are fine, short, interrupted crackling sounds that are best heard on inspiration, but may be heard on expiration.

Crackles are heard on auscultation of the base of the lung as air passes over secretions retained within the alveoli.