Perfusion

Question 1

To obtain Heart Rate ….

Answer 1

-Assess apical pulse

Question 2

Acyanotic

Answer 2

• Increased pulm blood flow, obstruction to blood flow from ventricles
  1. Atrial septal defect
  2. Ventricular septal defect

Question 3

Cyanotic

Answer 3

• Decreased pulm blood flow
  1. TOF

Question 4

Cyanotic

Answer 4

• Mixed blood flow
• Transposition of great arteries

Question 5

Ventricular Septal Defect

Answer 5

• Increased pulm flow
• High pressure in LV –> RV
• ACYANOTIC!
• Tachy, murmor, poor weight, periorbital edema
• CHF is common!
• Prevent irreversible pulm vascular disease
• Banding, sutures, patches, catheter closure

Question 6

Tetralogy of Fallot

Answer 6

• Decreased pulm flow
• RV –> LV
  1. VSD
  2. Pulm Stenosis
  3. Overiding aorta
  4. RV Hypertrophy
• CYANOTIC!
• Cyanotic at birth, murmor, poor weight gain, hypoxemia, tet spells *
• CHF is UNCOMMON
• Early management is key: Palliative shunt or complete repair

Question 7

Tetralogy of Fallot 4 Defects

Answer 7

1. VSD
2. Pulm Stenosis
3. Overiding aorta
4. RV Hypertrophy

Question 8

Obstruction to systemic blood flow…

Answer 8

Coarction of the aorta

Question 9

Coarction of the Aorta

Answer 9

• Localized narrowing near insertion of the ductus arteriosus
• Increase pressure proximal to defect and decreased pressure distal to defect
• ACYANOTIC!
• HBP before point
• LBP after point
• Shock!
• HIGH BP and Bounding Pulses in Upper Extremeties
• Low BP and Weak Femoral Pulses Lower Extremeties
• CHF Common + Pulmonary Edema

Question 10

Mixed Defect

Answer 10

Transposition of Great Arteries
- Decreased pulm blood flow
- Post natal survival is dependent on mixing of the systemic and pulm blood
- Hypoxemia and CHF

Question 11

Transposition of Great Arteries

Answer 11

• Blood on right side never gets oxygenated
• Blood on left side never gets deoxygenated
• Two separate parallel circuits:
• Unoxygenated blood circulates through systemic circulation
• Oxygenated blood circulates through the pulm circulation
• Need communication between the 2 circuits
• CYANOTIC ( R —> L )

Question 12

Treatment for Transposition of Great Arteries

Answer 12

• Prostaglandin E
• Vasodilator , keeps ductus arteriosus open to promote O2 saturation above 75%
• Ballon septostomy
• Arterial switch sugrical procedure

Question 13

Right Sided HF

Answer 13

• Rest of Body
• RV unable to pump blood into PA
• Pushes blood back into the body
• S/S: Swelling of legs and hands, weight gain, pitting edema, JVD, Irregular HR, ascites

Question 14

Left Sided HF

Answer 14

• Lungs
• LV unable to pump blood to systemic
• Blood goes back into lungs
• Pulm edema and pressure
• S/S: Dyspnea, rales, orthopnea, weakness, nagging cough, blood tinged sputum, weight gain

Question 15

Digoxin

Answer 15

• Improves myocardial contractility
• Inc CO, Dec heart size and edema
• Check potassium
• Check apical pulse prior to admin *

Question 16

Digoxin Toxicity

Answer 16

• N/V
• Brady
• Double Vision
• Anorexia
• No missed dose
• Keep med locked up

Question 17

Blood flows from …

Answer 17

• High to low pressure

Question 18

Right sided pressure is …

Answer 18

• Lower than left sided pressure so typically
• L –> R Shunting occurs