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PEDIATRIC HEALTH EXAM4 STUDY GUIDE PEDS - PROFESSOR FLYNN PEDS EXAM STUDY GUIDE.pdf
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PEDIATRIC HEALTH EXAM4 STUDY GUIDE PEDS - PROFESSOR FLYNN PEDS EXAM4 2024-2025 STUDY GUIDE
PEDIATRIC HEALTH EXAM4 STUDY GUIDE
PEDS - PROFESSOR FLYNN PEDS EXAM 4
2024-2025 STUDY GUIDE
Module 8 (Cardiac):
Know where the issue is in the heart (lecture stuff)
● Increased pulmonary blood flow: blood has already been oxygenated and keeps
going back to lungs to be oxygenated- NO CYANOSIS
○ Meds: not prostaglandin E1 keeps it open don't give this
○ s/s: pulmonary edema, fatigue, dyspnea, murmur, dysrhythmia, respiratory
issues
● Decreased Pulmonary Blood Flow
○ ductal dependent: NEED to stay open
○ Meds: prostaglandin E1 drip, cannot stop
Common Interventions for Cardiac Kids
● cluster care
● provide periods of rest
● decrease crying
● daily weights
● monitor I&Os
● keep HOB elevated
● feed every 3 hours (PO first, then gavage)
● administer humidified O2 PRN
● admin medications: digoxin (HR apical for 60 seconds before admin) & diuretics
General signs and symptoms of heart disease in kids
● Failure to thrive
○ Due to a combination of low energy intake and high energy
demands
● Clubbing of fingers
○ Due to chronic hypoxia
● Developmental disabilities
○ Brain doesn't get enough oxygen
○ there are other abnormalities that affect the heart and brain
○ small for age, delayed in milestones
○ hard time gaining weight
● Respiratory symptoms
○ shallow, rapid respirations
○ respiratory distress and cyanosis during the feedings
pg. 1
, PEDIATRIC HEALTH EXAM4 STUDY GUIDE PEDS - PROFESSOR FLYNN PEDS EXAM
4 2024-2025 STUDY GUIDE
○ Increased work of breathing
○ Grunting
○ Nasal flaring
○ Retractions
○
● Cardiac symptoms
○ Prolonged cap refill
○ chest deformities: Barrel chest, caves in
○ Bounding pulse
○ weak/ thready pulse
○ Peripheral edema
○ Cold hands and feet
○ Wide pulse pressure
○ Cyanosis (48 hours after not normal, unless feet)
○ erythema (redness in fingers and toes)
○ pale/mottled/gray skin
○ Murmurs
○ Tachycardia or bradycardia
Risk factors for congenital heart defects / heart disease in kids
● Genetic risk factors: (most common): congenital heart disease in family hx,
certain syndromes (Down’s, Turner’s, & Duchenne’s muscular dystrophy),
presence of congenital abnormalities
● Maternal Risk Factors: infection, alcohol/substance abuse, diabetes mellitus (not
for test)
● Congenital heart defects by categories:
○ Increased Pulmonary Blood Flow:
■ Types: patent ductus arteriosus (PDA), atrial septal defect (ASD) or
pg. 2
, PEDIATRIC HEALTH EXAM4 STUDY GUIDE PEDS - PROFESSOR FLYNN PEDS EXAM
4 2024-2025 STUDY GUIDE
patent foramen ovale (PFO), ventricular septal defect (VSD) ○
Decreased Pulmonary Blood Flow:
■ tetralogy of fallot, tricuspid atresia, eisenmenger syndrome
○ Obstructive Disorders:
■ coarctation of the aorta, aortic stenosis, pulmonary atresia
○ Mixed Disorders:
■ transposition of the great vessels, truncus arteriosus, hypoplastic left
heart syndrome,
PDA/Patent Ductus Arteriosus (Increased Pulmonary Blood Flow)
Ductus arteriosus connects the aorta to the pulmonary artery outside of the heart.
Leftto-right shunting occurs through the duct that will then connect the pulmonary
artery (non oxygenated) with the aorta (oxygenated)
● Signs and symptoms:
○ Heart murmur (some infants can have no murmur)
○ Wet lung sounds→ crackles
○ Tachypnea
○ Increased work of breathing or apnea
○ Poor feeding
○ Poor weight gain and growth
○ Fatigue
○ Sweating with feeding ○
Excessive fluid weight gain
● Treatment: want to CLOSE it
○ give medications to close it:
■ ibuprofen, indomethacin, or paracetamol (acetaminophen)
■ acetaminophen given regularly (not a one and done dose)
○ may require surgical management via ligation of duct or steel coiling
ASD/Atrial Septal Defect or PFO/Patent Foramen Ovale (Increased Pulmonary Blood
Flow)
pg. 3
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