MCN 374: Peds Exam 2

Cardiovascular assessment: inspection - Answer- -color -WOB -general appearance -breathing effort -jugular distention Cardiovascualr assessment: palpation - Answer- -cap refill -pulses for amplitude -rate (tachy, brady, asystole) -rhythm (regular vs. irregular) -skin temp -edema Cardiovascular assessment" auscultation - Answer- -murmur -heart sounds Prenatal circulation - Answer- -Oxygenation occurs in placenta -travels down ubliical arteries and enters ductus venosus-- enters RA-- oxygenated blood mixes with deoxygenated and travel through foramen ovale-- blood enter LA through foramen ovale-- blood travels to LV then through ductus arteriosus Pulmonary vascular resistance = ________ in prenatal circulation - Answer- HIGH (lack of lung perfusion) Systemic vascular resistance = _________ in prenatal circulation - Answer- LOW (placenta holding most blood volume) Postnatal Circulation - Answer- -Oxygenation occurs in lungs -Pulmonary vascular resistance DEC due to presence of O2 -systemic resistance INC due to removal of placenta -Ductus arteriosus closes in first 24-48hrs Why is it important to screen for congenital heart defects - Answer- Early detection can DEC infant morbidity/mortality Procedure of congenital heart defect screening - Answer- *done when baby 24hrs or shortly before discharge 1. place pulse ox reader on right hand and either foot 2. monitor pre and post ductal sites for 5min 3. record findings CHD screening results - Answer- -90% sat in right hand or foot = FAIL -90-95% in hand/foot OR 3% difference btw hand/foot = REPEAT