HESI PEDS CARDIOVASCULAR DISORDERS

HESI PEDS CARDIOVASCULAR DISORDERS

( LATEST 2024 / 2025 ) ACTUAL QUESTIONS AND ANSWERS

100% CORRECT

• HINT

Basic difference between cyanotic and acyanotic defects::

Answer:

Acyanotic: has abnormal circulation; however, all blood entering the systemic

circulation is OXYGENATED

Cyanotic: has abnormal circulation with UNOXYGENATED blood entering

systemic circulation

• CHF

Congestive HF is more often associated with defects:

Answer:

Acyanotic defects

• CHF

Condition in which the heart is unable to pump effectively the volume of blood

that is presented to it:

Answer:

Nursing assessment Tachypnea, SOB Tachy; difficulty feeding Cyanosis Grunting, wheezing, pulmonary congestion Edema (face, eyes of infants), weight gain Diaphoresis (**esp head**) Hepatomegaly

• Hint CHF is a common complication of congenital heart disease It reflects the increased workload of the heart caused by shunts or obstructions

The two objectives in treating CHF:

Answer:

are to reduce the workload of the heart and increase CO

• Nursing plans and interventions CHF:

Answer:

Monitor vitals; report signs of increasing distress Assess resp functioning frequently Elevate HOB or use infant seat Administer Digoxin and diuretics as prescribed Weigh frequently Low sodium diet or formula Gavage feed infants if unable to get adequate nutrition by mouth Continue care for infant or child with congenital defect as indicated

• Rheumatic fever inflammatory disease

• rheumatic fever is the most common cause of ACQUIRED heart disease in

children. It usually affects the aortic and mitral valves of heart

• rheumatic fever is associated with an antecedent betahemolytic streptococcal

infection

• Rheumatic fever is a collagen disease the injures the HEART, BLOOD

VESSELS, JOINTS, and SQ tissue:

Answer:

Nursing assessment:

chest pain, SOB (carditis) tachycardia, even during sleep migratory large joint pain chorea (irregular involuntary movements) rash (erythema marginatum) SQ nodules over bone prominences Fever

Labs: elevated ESR; elevated ASO titer

• Congenital heart disorders Heart anomalies that develop in UTERO and manifest at birth or shortly

Thereafter -they may be categorized as:

Answer:

ACYANOTIC: ventricular septal defect (VSD), atrial septal defect (ASD), patent

ductus arteriosus (PDA), coarctation of aorta, aortic stenosis (AS) or CYANOTIC: tetrology of fallot, truncus arteriosus, tranposition of great vessels:

Acyantotic include: L to R shunts or INCREASED PULMONARY blood flow

Obstructive defects Cyanotic include: R to L shunts or DECREASED pulmonary

blood flow Mixed blood flow

• ACYANOTIC HEART DEFECTS

**Ventricular septal defect (VSD; increased pulmonary blood flow)**

• there is a HOLE between the ventricles

• oxygenated blood from LEFT ventricle is shunted to RIGHT ventricle and

RECIRCULATED to the lungs

• small defects may close spontaneously
• large defects cause Eisenmenger syndrome or congestive heart failure

and require surgical closures:

Answer:

**Atrial septal defect** (ASD; Increased pulmonary blood flow)

• there is a hole between the atria
• oxygenated blood from L atrium shunted to R atrium and lungs
• most defects do not compromise children seriously
• surgical closure is recommended BEFORE SCHOOL age. it can lead to

significant problems, such as congestive HF or atrial dysrhythmias later in life if not corrected

• ACYANOTIC HEART DEFECTS

**Patent ductus arteriosus** (PDA: increased pulmonary blood flow)

• there is an abnormal opening between the aorta and the pulmonary artery
• it usually closes with 72 hrs after birth**
• if it remains patent, oxygenated blood from AORTA returns to the

PULMONARYARTERY

• INCREASED blood flow to the lungs causes PULMONARY HTN
• it may require medical intervention with INDOMETHACIN (INDOCIN)

administration or surgical closure:

Answer:

**coarctation of aorta** (OBSTRUCTION of blood flow from ventricles)

• there is an obstructive NARROWING of the aorta
• the most common sites are the aortic valve and the aorta near the ductus

arteriosus

• a common finding is HTN IN UPPER EXTREMS and DECREASED or

ABSENT pulses in lower extrems

• it may require surgical correction

• Patent ductus arteriosus may require medical intervention with (2):

Answer:

indomethacin (indocin) administration or surgical closure

• Common finding in coarctation of aorta:

Answer:

HTN in upper extremities and decreased or absent pulses in lower extremities

• ACYANOTIC HEART DEFECTS

**aortic stenosis** (AS; obstruction of blood flow FROM ventricles):

Answer:

• it is an obstructive narrowing immediately before, at or after the AORTIC valve

(mostcommonly valvular)

• **oxygenated blood flow from L ventricle into systemic circulation

diminished**

• symptoms are caused by low CO
• may require surgical correction

• Common finding in aortic stenosis

Why?:

Answer:

oxygenated blood flow from L ventricle into systemic circulation diminished Symptoms caused by low CO

• Traditional 3 Ts of CYANOTIC Heart defects

**tetrology of fallot** is a combo of 4 defects:

1. VSD