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Pediatric CCRN Exam

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3 causes for Fetal shunt closure When does the Ductus Arteriosus close? When does the Foramen Ovale Close? What does Cardiac Output measure? Cardiac Output is the measure of what? How is cardiac output calculated? Define Preload Two factors contributing to DECREASE in preload Define Afterload Define Contractility Name one factor that decreases contrac￾tility in the heart How does dopamine affect heart func￾tion Describe the conduction pathway of the heart Define Chronic Heart Failure 1. increase in aterial oxygen tension 2. decreased prostaglandins 3. decreased adenosine levels within 10-24 hours of birth When LA pressure exceeds RA pressure (can stay open for 6mo to a year) Efficiency of the heart Volume of blood pumped by the heart in one minute Stroke volume x heart rate Elasticity of the heart when the ventricles are at max fill 1. dehydration 2. vasodilation Resistant force that the ventricles must pump against. Work that the ventricles must do to push blood through the aorta into the periphery of the body The amount of force exerted by the heart with each contraction hypoxemia increases contractility and stroke volume SA node - Atrium - AV node - Bundle of His - Ventricle - Purkinje Fibers The hearts inability to pump oxygenated blood to the body due to abnormalities in the heart and other areas of the body. Contributing to edema, ess, ac￾tivity intolerance, and growth failure 1. Activation of the Sympathetic Nervous System Pediatric CCRN Exam 2 / 28 Name 2 compensatory mechanisms of Chronic Heart Failure Describe Right Sided Heart Failure Describe Left Sided Heart Failure Name 3 causes of Chronic Heart Failure in Children List Manifestations of Impaired Myocar- dial function List manifestations of Right Sided Heart Failure List manifestations of Left Sided Heart Failure 2. Cardiac reserve; i.e. hypertrophy and dilation of cardiac muscle RV is unable to pump blood efficiently into the Pulmonary artery, so blood backs up into veins and periphery of body LV is unable to effectively pump blood into aorta and out into body, so blood backs up into pulmonary outlets and in- creases pressure in LA 1. Structural Abnormalities 2. Failure of the heart muscle 3. excessive demands on normal heart muscle 1. tachycardia 2. Sweating 2. Decreased UOP 3. fatigue 4. anorexia 5. decrease interest in activities 6. cardiomegaly 7. pale/cool extremities 8. decreased BP 1. weight gain 2. edema 3. hepatomegaly 4. ascites 5. distended neck veins 1. Tachycardia 2. dyspnia 3. Activity intolerance 4. persistent cough 5. cyanosis 6. wheezing/grunting 7. orthopnea

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