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53 Cards in this Set
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- Back
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sx tx of a PDA?
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ligation of the patent ductus arteriosus in closed-heart operation.
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what med to tx PDA?
what meds to close pharmacologically? |
Digoxin(<100bpm=hold)
Diuretics (Lasix), Indomethacin (Indocin) to achieve pharmacologic closure. |
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defect occurring when the ventricular septum fails to complete its formation between the ventricles, resulting in a left-to-right shunt.
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VENTRICULAR SEPTAL DISORDER
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s/s of VENTRICULAR SEPTAL DISORDER?
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respiratory distress, tachycardia, tachypnea, pale, "failure to thrive
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what does cxr show in VENTRICULAR SEPTAL DISORDER?
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cardiomegaly with a large L atrium and ventricle
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sx for VENTRICULAR SEPTAL DISORDER?
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pulmonary artery banding to prevent heart failure and permanent correction with a patch later when the heart is larger
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what meds for VENTRICULAR SEPTAL DISORDER?
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Digoxin, and diuretics
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what 3 heart defects result in increased Pulmonary Blood Flow?
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Atrial Septal Defect (ASD)
Patent Ductus Arteriosus (PDA) Ventricular Septal Defect (VSD) |
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is the baby w/increased Pulmonary Blood Flow cyanotic?
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no
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major problem w/increased pulmonary blood flow in newborn?
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chf
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increased pulmonary blood flow in newborn = shunting from ___ to ___
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left to right
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Decreased Pulmonary Blood Flow in newborn= shunting from ___ to ___
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Right to left shunt
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Decreased blood flow to the lungs=_____
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cyanosis
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TETRALOGY OF FALLOT: (TOF) is one of the cyanotic heart diseases what 4 problems make up?
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VSD
Pulmonary Valve stenosis Aorta overriding the septum Right Ventrical hypertophic wall |
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which TOF is High on septum -- Right to left shunt
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VSD
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which TOF results in Pulmonary flow is decreased
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Pulmonary Valve stenosis
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which TOF is because of other 3?
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Right Ventrical hypertophic wall
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what risk factors for TOF?
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maternal rubella, poor prenatal nutrition, maternal alcoholism (FAS), mother over 40 years old, diabetes. and use of thalidomide.
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what are most of the s/s of TOF related to?
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respiratory problems
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what happens to growth in TOF?
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decrease
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what posits do kids take in tof? what do the posits cause?
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Squatting seen in older children while knee chest postion is seen in infants, which decreases venous return by occluding the femoral vein by hip flexion
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the posits in TOF decrease venous return by occluding the femoral vein by hip flexion and lead to___?
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Decreased work load of heart and allows for higher O2 levels into aorta
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describe the nails in TOF?
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Clubbing
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Compensentory Mechanics in TOF?
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increased RBC or polycythemia
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what posit to help w/TOF?
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knee chest
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what med for sedation in TOF?
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morphine
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what meds to relax the infundibulum (The outflow portion of the right ventricle) in TOF?
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beta blockers(propanolol, esmolol_
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what meds increase systemic vascular resistance in TOF?
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phenylephrine
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pt w/TOF is @ risk for what problems?
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brain abesses and Endocarditisis
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Hypoxic Blood flow in TOf is sluggish and increases risk of ____ and ___?
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CVA and Embolisms
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Episodes when cynaosis is occuring markedly
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TOF spells
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NSG int for TOF spells?
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Flex knees/hips, O2
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congenital hematologic disease that causes impaired circulation, chronic ill health and premature death
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sickle cell
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who gets sickle cell?
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African populations and people from Puerto Rico, Turkey, India, the Middle East and the Mediterranean
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describe rbc in sickle cell?
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rigid and rough, forming an elongated sickle shape and impairing circulation by clumping together ("vaso-occlusive"
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what can sickling?
give examples of when sickling occurs in sickle cell? |
This happens ("sickling") during periods of hypoxia which can be provoked by infection, blood loss, strenuous exercise, high altitude, unpressurized aircraft, cold and vasoconstrictive drugs
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which organ is affected earliest by sickling? what happens to it?
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spleen
Becomes enlarged and fillled with sickle cells |
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what does a non functional spleen lead to?
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infection(sickle cell kids 200-300 times more likely to get infection than normal kid)
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what liver problems w/sickle cell?
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enlarged b/c clumping RBC leading to bilirubin levels(jaundice), chirrous of the livef
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what kidney problems in sickle cell?
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Inability to concentrate urine, blood in urine
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what bone changes in sickle cell?
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X rays show charactersitic changes in bone. Increase risk of bone infection, usually salmonela
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what bone is affected w/necrosis in sickle cell?
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head of femur
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what maybe the 1st s/s of hand foot syndrome?
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infection of small bone of hands & feet with swelling;
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s/s of sickle cell?
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aching bones, jaundice, pallor, tachycardia, frequent infections, joint swelling and leg ulcers
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how sickle cell is passed down?
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by an autosomal recessive trait: the child inherits the gene that produces hemoglobin S from two healthy parents who carry the defective gene
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If two parents have sickle cell trait, there is a ___% chance with each pregnancy that the child will?
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25
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where are the leg ulcers of sickle cell usually seen?
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ankles
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is sickle cell crisis painful?
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yes
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what might rbc be in sickle cell?
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decreased RBC --5 to 11 g/dl
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what labs to monitor for sickle cell?
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check Hgb and Hct.) , elevated WBC and platelet counts, decreased ESR
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why is ESR decsreased in sickle cell?
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lowered by sickle shape
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what does Hb electrophoresis show in sickle cell?
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HbS, the wrong amino acid.
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what to do to prevent sickle cell crisis?
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iron and folic acid supplements, prevent dehydration, and analgesics for pain
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