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Congenital Heart Disease - ATI: Nursing Care of Children

Terms in this set (30)

congenital heart diseases that result in increased pulmonary blood flow
Atrial Septal Defect (ASD), Ventral Septal Defect (VSD), & Patenet Ductus Arteriosus (PDA)
Expected FIndings for Defects that Increase Pulmonary Blood Flow
Defects with increased pulmonary blood flow allow blood to shift from the high pressure left side of the heart to the right, lower pressure side of the heart.
●● Increased pulmonary blood volume on the right side of the heart increases pulmonary blood flow.
●● These defects include signs and symptoms of heart failure.
Ventricular Septal Defect (VSD)
A hole in the septum between the right and left ventricle that results in increased pulmonary blood flow (left‑to‑right shunt). A LOUD, HARSH MURMUR AUSCULTATED AT RIGHT STERNAL BORDER. Heart Failure can occur. MANY CLOSE SPONTANEOUSLY.
Therapeutic Procedures for VSD
NONSURGICAL PROCEDURE: Closure during cardiac catheterization.
SURGICAL PROCEDURES: Pulmonary artery banding. Complete repair with patch
Atrial Septal Defect (ASD)
A hole in the septum between the right and left atria that results in increased pulmonary blood flow (left‑to‑right shunt). A LOUD, HARSH MURMUR WITH FIXED SPLIT SECOND HEART SOUND can be heard. Heart failure can occur. Possibly Asymptomatic
Therapeutic Procedures for ASD
NONSURGICAL PROCEDURE: Closure during cardiac catheterization.
SURGICAL PROCEDURE: Patch closure
Patent Ductus Arteriosus
A condition in which the normal fetal circulation conduit between the pulmonary artery and the aorta fails to close and results in INCREASED PULMONARY BLOOD FLOW (left‑to‑right shunt). MURMUR SOUND: MACHINE HUM. WIDE PULSE PRESSURE. BOUNDING PULSES. Possibly Asymptomatic. Heart failure can occur
Therapeutic Procedures for PDA
NONSURGICAL PROCEDURES: Administration of INDOMETHACIN. Insertion of coils to occlude PDA during cardiac catheterization.
SURGICAL PROCEDURE: Thoracoscopic repair
congenital heart diseases that result in decreased pulmonary blood flow: have an
obstruction of pulmonary blood flow and an anatomic defect (ASD or VSD) between the right and left sides of the heart. In these defects, there is a right to left shift allowing deoxygenated blood to enter the systemic circulation. Hypercyanotic spells (blue, or "Tet," spells) manifest as acute cyanosis and hyperpnea.
Tetralogy of Fallot & Tricuspid Artresia
Tricuspid Artresia
A complete closure of the tricuspid valve that results in MIXED BLOOD FLOW. An atrial septal opening needs to be
present to allow blood to enter the left atrium. Infants: CYANOSIS, DYSPNEA, TACHYCARDIA. Older children: HYPOXEMIA, CLUBBING of fingers
Surgical Procedures Indicated for Tricuspid Artresia
3 Stage Surgery: Shunt Placement, Glenn Procedure, Modified Fontan Procedure
Tetralogy of Fallot
Four defects that result in mixed blood flow: PULMONARY STENOSIS, VENTRICULAR SEPTAL DEFECT, OVERRIDING AORTA, RIGHT VENTRICULAR HYPERTROPHY. Cyanosis at birth: progressive CYANOSIS over the first year of life. SYSTOLIC MURMUR. Episodes of acute cyanosis and HYPOXIA (blue or "TET" SPELLS)
Surgical Procedures Indicated for Tetralogy of Fallot
Shunt Replacement until ability to undergo primary repair. Complete Repair within the first year of life
congenital heart diseases that result in obstruction of blood flow (blood flow exiting the heart meets an area of narrowing (stenosis), which causes obstruction of blood flow)
Coarctation of the Aorta, Pulmonary Stenosis, Aortic Stenosis
obstructive defects
The pressure that occurs before the defect is increased (ventricle) and the pressure that occurs after the defect is decreased. This results in a decrease in cardiac output. These children can present with signs of heart failure
Pulmonary Stenosis
A narrowing of the pulmonary valve or pulmonary artery that results in obstruction of blood flow from the ventricles. SYSTOLIC EJECTION MURMUR. Asymptomatic (possibly). CYANOSIS varies with defect, worse with severe narrowing. CARDIOMEGALY. Heart failure
Therapeutic Procedures for Pulmonary Stenosis
NONSURGICAL PROCEDURE: Balloon angioplasty with cardiac catheterization. SURGICAL PROCEDURES:
INFANTS: Brock procedure
CHILDREN: pulmonary valvotomy
Aortic Stenosis
A narrowing of the aortic valve. INFANTS: Faint pulses, hypotension, tachycardia, poor feeding tolerance. CHILDREN: Intolerance to exercise, dizziness, chest pain, possible ejection murmur
Therapeutic Procedures for Aortic Stenosis
NONSURGICAL PROCEDURE: Balloon dilation with cardiac catheterization.
SURGICAL PROCEDURES: Norwood procedure. Aortic valvotomy
Coarctation of the Aorta
A narrowing of the lumen of the aorta, usually at or near the ductus arteriosus, that results in obstruction of blood flow from the ventricle. Elevated blood pressure in the arms. Bounding pulses in the upper extremities. Decreased blood pressure in the lower extremities. Cool skin of lower extremities. Weak or absent femoral pulses. Heart failure in infants. Dizziness, headaches, fainting, or nosebleeds in older children
Therapeutic Procedures for Coarctation of the Aorta
NONSURGICAL PROCEDURES: Infants and children: Balloon angioplasty. Adolescents: Placement of stents.
SURGICAL PROCEDURE: Repair of defect recommended for infants less than 6 months of age
Transposition of the Great Arteries
a mixed congenital defect; a condition in which the aorta is connected to the right
ventricle instead of the left, and the pulmonary artery is connected to the left ventricle instead of the right. A septal defect or a PDA must exist in order to oxygenate the blood. MURMUR depending on presence of associated defects. Severe to less CYANOSIS depending on the size of the associated defect. CARDIOMEGALY. Heart failure
Surgical Procedure Indicated for Transposition of the Great Arteries
switching the arteries within the first 2 weeks of life
Truncus Arteriosus
a mixed congenital defect; a failure of septum formation, resulting in a single vessel that comes off of the ventricles:
●● Heart failure
●● Murmur
●● Variable cyanosis
●● DELAYED GROWTH
●● Lethargy
●● Fatigue
●● Poor feeding habits
Surgical Procedure Indicated for Trunctus Arteriosus
Surgical Repair within the 1st month of life
Hypoplastic Left Heart Syndrome
Left side of the heart is underdeveloped. An ASD or patent foramen ovale allows for oxygenation of the blood.
●● Mild cyanosis
●● Heart failure
●● Lethargy
●● Cold hands and feet
●● Once PDA closes, progression of cyanosis and decreased cardiac output result in EVENTUAL CARDIAC COLLAPSE
Surgical Procedure Indicated for Hypoplastic Left Heart Syndrome
Surgery in 3 Stages (shortly after birth): Norwood Procedure, Glenn Shunt, Fontan Procedure
congenital heart diseases that result in mixed blood flow
transposition of the great arteries, truncus arteriosus, hypoplastic left heart syndrome
Maternal Factors that Contribute to Congenital Heart Disease
infection, alcohol (or other substance abuse during pregnancy), diabetes mellitus
Genetic Factors that Contribute to Congenital Heart DIsease
family history, syndromes (such as Trisomy 21/"Down Syndrome"), presence of other congenital anomalies or chromosomal abnormalities
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