Pediatrics Exam 2
Unit 3+4: Cardiac
Chapter 3: Fetal Circulation pg. 67-69
Chapter 17: Childhood Cardiac Conditions pg. 552-575, 577, 583-585
Fetal Circulation Structure
• Umbilical Vein
o Oxygenated blood that flows from the mother through the placenta to the baby empties into
the inferior vena cava through the…. DUCTUS VENOSUS
• Ductus Venosus
o A vascular channel that connects the umbilical vein to the inferior vena cava (then empties
into the right atrium), then passes through the… FORAMEN OVALE
• Foramen Ovale
o An opening in the septum between the right and left atria, where blood flows to the left
atrium, then the left ventricle, and onto the aorta. Then travels to the body and extremities.
Blood then returns to the superior vena cava, then to the right atrium and the right ventricle,
then to the pulmonary artery. Then bypasses the lungs and enters the aorta through the…
DUCTUS ARTERIOSUS
• Ductus Arteriosus
o A vascular channel between the pulmonary artery and the descending aorta. Remaining blood
flows to the lungs, then back to the pulmonary vein, and then into the… UMBILICAL
ARTERIES
• Umbilical Arteries
o Deoxygenated blood that flows from the baby to the placenta to be reoxygenated and
recirculated
• Placenta
o Site of oxygenation and waste elimination
• Changes at birth:
o Ductus Venosus, Foramen Ovale, Ductus Arteriosus close
• Pediatric Cardiac Dysfunction Indications:
o Poor feeding, Tachypnea/tachycardia, failure to thrive, developmental delays
• Cardio Review:
o Heart Rate x Stroke Volume = Cardiac Output
o Goal of heart disease therapy:
§ Decrease the preload and afterload
§ Increase contractility
o Shunt: blood flow between an opening through two structures/vessels in the heart
o Murmur: sound heard in the heart: reflecting blood flow (thrill)
• Pediatric considerations:
o Innocent murmur= normal
o Children= limited ability to increase stroke volume in response to decreased cardiac output
, Cardiac Defects:
Congenital: Anatomic abnormal function
Acquire: infection, autoimmune response
Cyanotic: T’s + hypoplastic
• CHF (Congestive Heart Failure)
o Etiology:
§ CHD, dysrhythmias, cardiomyopathy, Kawasaki’s
o Pathophysiology:
§ Heart- can’t pump blood FORWARD effectively, decreased cardiac output, and fluid
buildup in lungs and body
o Clinical Manifestations:
§ Tachycardia, fatigue, decreased BP, decreased urine output, cool extremities,
Tachypnea, dyspnea, cyanosis, Edema, PERIORBITAL EDEMA, ascites,
hepatomegaly, JVD
§ Sound: Crackles: pulmonary fluid
• Heart murmur, s3, 5th intercostal left midclavicular
o Diagnosis:
§ B-type natriuretic peptide, Chest X-ray, Echo, MRI, Cardiac Cath
o Medical Care:
§ Medication: Captopril (ACE Inhibitor), Digoxin (Cardiac Glycoside), Furosemide
(loop diuretic)
§ Surgical: Cardiac Cath: diagnostic + repair (through femoral artery)
• Pressure dressing, monitor VS, check pulses BELOW the site
• Extremity immobilized, 6 hr. bed, 24 hr. quiet play
o Nursing Care:
§ Monitor VS, comfort (fluid in brain/tummy), oxygenation
§ Diet:
• ASD (Atrial) and VSD (Ventricular) Septal Defect (Increased Pulmonary Blood Flow)
o Pathophysiology: Abnormal connection between the two sides of the heart, increased blood
volume on the right side of the heart
o Clinical Manifestations:
Unit 3+4: Cardiac
Chapter 3: Fetal Circulation pg. 67-69
Chapter 17: Childhood Cardiac Conditions pg. 552-575, 577, 583-585
Fetal Circulation Structure
• Umbilical Vein
o Oxygenated blood that flows from the mother through the placenta to the baby empties into
the inferior vena cava through the…. DUCTUS VENOSUS
• Ductus Venosus
o A vascular channel that connects the umbilical vein to the inferior vena cava (then empties
into the right atrium), then passes through the… FORAMEN OVALE
• Foramen Ovale
o An opening in the septum between the right and left atria, where blood flows to the left
atrium, then the left ventricle, and onto the aorta. Then travels to the body and extremities.
Blood then returns to the superior vena cava, then to the right atrium and the right ventricle,
then to the pulmonary artery. Then bypasses the lungs and enters the aorta through the…
DUCTUS ARTERIOSUS
• Ductus Arteriosus
o A vascular channel between the pulmonary artery and the descending aorta. Remaining blood
flows to the lungs, then back to the pulmonary vein, and then into the… UMBILICAL
ARTERIES
• Umbilical Arteries
o Deoxygenated blood that flows from the baby to the placenta to be reoxygenated and
recirculated
• Placenta
o Site of oxygenation and waste elimination
• Changes at birth:
o Ductus Venosus, Foramen Ovale, Ductus Arteriosus close
• Pediatric Cardiac Dysfunction Indications:
o Poor feeding, Tachypnea/tachycardia, failure to thrive, developmental delays
• Cardio Review:
o Heart Rate x Stroke Volume = Cardiac Output
o Goal of heart disease therapy:
§ Decrease the preload and afterload
§ Increase contractility
o Shunt: blood flow between an opening through two structures/vessels in the heart
o Murmur: sound heard in the heart: reflecting blood flow (thrill)
• Pediatric considerations:
o Innocent murmur= normal
o Children= limited ability to increase stroke volume in response to decreased cardiac output
, Cardiac Defects:
Congenital: Anatomic abnormal function
Acquire: infection, autoimmune response
Cyanotic: T’s + hypoplastic
• CHF (Congestive Heart Failure)
o Etiology:
§ CHD, dysrhythmias, cardiomyopathy, Kawasaki’s
o Pathophysiology:
§ Heart- can’t pump blood FORWARD effectively, decreased cardiac output, and fluid
buildup in lungs and body
o Clinical Manifestations:
§ Tachycardia, fatigue, decreased BP, decreased urine output, cool extremities,
Tachypnea, dyspnea, cyanosis, Edema, PERIORBITAL EDEMA, ascites,
hepatomegaly, JVD
§ Sound: Crackles: pulmonary fluid
• Heart murmur, s3, 5th intercostal left midclavicular
o Diagnosis:
§ B-type natriuretic peptide, Chest X-ray, Echo, MRI, Cardiac Cath
o Medical Care:
§ Medication: Captopril (ACE Inhibitor), Digoxin (Cardiac Glycoside), Furosemide
(loop diuretic)
§ Surgical: Cardiac Cath: diagnostic + repair (through femoral artery)
• Pressure dressing, monitor VS, check pulses BELOW the site
• Extremity immobilized, 6 hr. bed, 24 hr. quiet play
o Nursing Care:
§ Monitor VS, comfort (fluid in brain/tummy), oxygenation
§ Diet:
• ASD (Atrial) and VSD (Ventricular) Septal Defect (Increased Pulmonary Blood Flow)
o Pathophysiology: Abnormal connection between the two sides of the heart, increased blood
volume on the right side of the heart
o Clinical Manifestations:
