NSG 3600 PEDS EXAM 2 - EXAM 2 NOTES EXAM QUESTIONS AND CORRECT ANSWERS WITH RATIONALE

NSG 3600 PEDS EXAM 2 - EXAM 2
NOTES EXAM QUESTIONS AND
CORRECT ANSWERS WITH
RATIONALE
PEDIATRICS (GALEN COLLEGE OF N
ie ie ie ie




URSING)

, Peds Exam 2 Study Guide ie ie ie ie




Heart Chambers:
ie




• Right Atrium (Collecting chamber) -
ie ie ie ie




Peripheral venous return from the superior & inferior vena cava & coronary sinus (70% O2 Sat).
ie ie ie ie ie ie ie ie ie ie ie ie ie ie i e




• Right Ventricle (Pumping chamber) -
ie ie ie ie




Receives blood from the RA thru the tricuspid valves, then
ie ie ie ie ie ie ie ie ie i




pumps the low O2 blood to the lungs via the pulmonary a
e ie ie ie i e ie ie ie ie ie ie ie




rtery.
• Left Atrium (Collecting chamber) -
ie ie ie ie




Receives fully oxygenated blood from lungs thru the pu
ie ie ie ie ie ie ie ie




lmonary veins (100% O2 Sat)
ie ie ie i e




• Left Ventricle (Pumping chamber) -Blood comes from
ie ie ie ie ie ie




the LA thru the bicuspid valves, then pumps it into the systemic circulation via the aorta.
ie ie ie ie ie ie ie ie ie ie ie ie ie ie ie




Heart Valves
ie




• Atrioventricular (AV) Valves ie ie




o Tricuspid (3 cusps/ “doors”) - ie ie ie ie




Connects RA to RV, opens to allow blood to flow thru to ch
ie ie ie ie ie ie ie ie ie ie ie ie




ambers & closes to prevent backflow ie ie ie ie ie




o Bicuspid/ Mitral Valve (2 cusps) - ie ie ie ie ie



Connects LA to LV, with same concept ie ie ie ie ie ie




• Semilunar Valves (both are tricuspid) ie ie ie ie




o Aortic Valve - ie ie



Located btwn LV & ascending aorta, prevents regur
ie ie ie ie ie ie ie



gitation into LV ie ie




o Pulmonary Valve - ie ie



Located at the junction of the RV & Pulmonary Artery, prevents regurgitation into R
ie ie ie ie ie ie ie ie ie ie ie ie ie



V.
Heart Vessels
ie




• Vena Cava -Carries blood from body into right atrium
ie ie ie ie ie ie ie ie



o Superior VC - ie ie


enters from above heart, head, arms, & upper body
ie ie ie ie ie ie ie ie



o Inferior VC - ie ie


enters from below heart, legs, abd organs, & lower part of t
ie ie ie ie ie ie ie ie ie ie ie

, he body
ie



o Pulmonary Arteries -Only artery that carries nonO2 blood
ie ie ie ie ie ie ie


o Pulmonary Veins -Only vein that carries O2 rich blood
ie ie ie ie ie ie ie ie

, Normal Flow ie



 Blood enters the heart thru the superior & inferior vena cava into the right atrium.
ie ie ie ie ie ie ie ie ie ie ie ie ie ie



 R atrium contracts, pushes blood thru the tricuspid into the R ventricle.
ie ie ie ie ie ie ie ie ie ie ie



 R ventricle contracts, sending blood through the pulmonary valve into
ie ie ie ie ie ie ie ie ie ie


the pulmonary arteries and to the lungs for oxygenation.
ie ie ie ie ie ie ie ie



 Oxygenated blood returns to the heart via the pulmonary veins into the ie ie ie ie ie ie ie ie ie ie ie ie



left atrium. ie



 Left atrium contracts, moving blood thru the mitral (bicuspid) valve
ie ie ie ie ie ie ie ie ie ie



into the left ventricle. ie ie ie



 Left ventricle contracts, pushing blood thru the aortic valve into the
ie ie ie ie ie ie ie ie ie ie ie


aorta & out to the body. ie ie ie ie ie




Cardiac Output (CO)
ie ie




• Amount of blood ejected from both ventricles per minute
ie ie ie ie ie ie ie ie




o CO = SV x HR ie ie ie ie




• Components of CO- SV, Contractility, HR, & Afterload ie ie ie ie ie ie ie




Stroke Volume (SV)
ie ie




• Amount of blood ejected by left ventricle each heartbeat
ie ie ie ie ie ie ie ie




o SV = Preload x Afterload x Contractility
ie ie ie ie ie ie




Preload = Fluid Volume
ie ie ie




• End diastolic pressure of heart when ventricle is filled w/blood
ie ie ie ie ie ie ie ie ie




• Amount of blood returning to the heart that “loads” it up for the next beat
ie ie ie ie ie ie ie ie ie ie ie ie ie ie




Afterload (aortic impedance/wall stress)
ie ie ie




• Amount of pressure that heart must work against to eject blood during systole (ventricular
ie ie ie ie ie ie ie ie ie ie ie ie ie ie




contraction)
Contractility
• The force exerted at contraction, ejecting a stroke volume at a given afterload (arterial pressure) &
ie ie ie ie ie ie ie ie ie ie ie ie ie ie ie ie




preload (end-diastolic volume) ie ie




Goals of Therapy for Heart Disease
ie ie ie ie ie




• Decrease Preload & Afterload ie ie ie




o Meds: Captopril (ACEs-prils), Bumetanide, Furosemide/thiazides, ie ie ie ie




• Increase Contractility ie




o Meds: Digoxin (cardiac Glycoside), Dopamine, Dobutamine ie ie ie ie ie




• Overall decreasing stress on the heart
ie ie ie ie ie