CHD QUESTIONS AND ANSWERS 100% CORRECT
Lesion or defect of the heart, most common congenital defect. Correct Answer: Congenital heart
... [Show More] disease
Children with certain genetic defects have an extremely high incidence of cardiac disorders, including children with chromosome aberrations, most specifically trisomy 21 known as________ __________. Correct Answer: Down syndrome
True or False:
Some children with non-hereditary conditions, such as fetal alcohol syndrome (FAS) are at an increased risk for CHD. Correct Answer: True
True or False:
A family hx of CHD increases the risk for giving birth to a child with CHD. Correct Answer: True
Shunting, or blood flow through an abnormal opening in the heart or great vessels, occurs when:
1) There is an abnormal opening or connection between the cardiac chambers or great arteries
2) The pressure is ______ on one side of the heart
3)The O2 saturation is ________ or ________ Correct Answer: higher
increased or decreased
Normally the _____ side of the heart is a low-pressure, desaturated system Correct Answer: right
Normally the _____ side of the heart is a high-pressure, fully saturated system Correct Answer: left
Health history Correct Answer: Inquire about a family hx of CHD, sudden death or fetal/infant death
Ask about prenatal care, maternal illnesses, infections, meds taken during pregnancy
Discuss feeding difficulties
Inspection (color) Correct Answer: Assess skin color in natural light
oral mucous membranes, neal beds and conjunctiva
Assess hands, feet, and face
Assess body for differential cyanosis or color differences
Inspection (activity level) Correct Answer: Assess the child sitting and laying
Observe level of activity and position of comfort
Observe color changes with activity, feeding, crying, exercise tolerance
Inspection (chest) Correct Answer: Assess precordial activity, chest movement (including symmetry), and chest shape (including convex or concave)
Assess for sternotomy or thoracotomy incisions.
Inspection (R. pattern) Correct Answer: Observe WOB at rest and with activity
Look for signs of R. alteration or distress (tachypnea, retractions, nasal flaring, crackles, grunting, and head bobbing are late signs of distress and may indicate impending R. failure)
Auscultation Correct Answer: Heart sounds:
Identify 1st and 2nd heart sounds
Identify additional heart sounds (S3, S4)
Identify presence of murmurs, clicks, precordial friction rubs
Palpation Correct Answer: Temperature:
Compare trunk and extremities
Pulses:
Compare central and distal pulses
BP:
Assess in all 4 extremities during initial assessment
Cap refill:
Chest:
With fingertips locate the PMI
Assess for presence of vibatory thrills, heaves or lifts, or friction rubs
Abdomen:
There may be an increased incidence of CHD, cardiomyopathies, arrhythmias, or hypercholesterolmia in some families.
Chronic maternal illness such as diabetes, perinatal infections such as _______, and certain medications such as _______ have been linked to CHD. Correct Answer: rubella
lithium
________, ___________, or restlessness may indicate poor cardiac function. Correct Answer: lethargy, irritablity
S1 is best heard Correct Answer: at the apex of the heart
S2 is best heard Correct Answer: at the base
S__ can be heart at the at the apex and can be a normal finding or reflect CHD Correct Answer: 3
S4 can be heard at the apex and reflects ______ disease. Correct Answer: cardiac
A ______ is an extra heart sound (S3 or S4), common in CHF. Correct Answer: gallop
Murmurs are caused by ______ blood flow. Correct Answer: turbulent
Murmurs are described according to _______, _______ within the cardiac cycle, intensity, pitch, quality, and duration. Correct Answer: location, timing
Clicks reflect? Correct Answer: abnormal valve motion
Precordial friction rubs can reflect pericardial _________. Correct Answer: inflammation
Weak or absent pulses in the lower extremities may indicate? Correct Answer: COA
Normal capillary refill Correct Answer: <2seconds
L-R shunting lesions increase _______ blood flow.
Some examples include: Correct Answer: pulmonary
ASD, VSD, PDA, AVSD, endocardial cushion defect
Obstructive or stenotic lesions decrease cardiac _______.
Some examples include: Correct Answer: outflow
Pulmonary stenosis
Aortic stenosis
COA
Cyanotic lesions with decreased pulmonary blood flow examples: Correct Answer: TOF
Tricuspid valve abnormalities
Pulmonary atresia with intact ventricular septum
Cyanotic lesions with increased pulmonary blood flow examples: Correct Answer: Truncus arteriosus
Hypoplastic left heart syndrome
Transposition of the great arteries
Left-sided heart pressures, which normally exceed right-sided pressures, cause saturated blood to shunt through any abnormal opening in the heart, aorta or pulmonary artery. Results in a volume overload in the R side of the heart and in the _______ artery. This describes L-R shunting Correct Answer: pulmonary
Assessment:
Tachycardia- To compensate for _______ state
Decreased peripheral perfusion-Resulting in ______extremities, ______ cap refill, ______pulses
Heart murmurs
Cyanosis (some acyanotic)
Dysrhytmias
Active precordium (feel or see)
Pulmonary congestion (_____, coarseness)-d/t fluid in the heart, this makes the heart an ________ pump. [Show Less]