NURS 232 EXAM 4 Questions with Correct Answers| Latest Update Guaranteed Success
pressure in fetal lungs is high or low? high because it is not the source of gas exchange, so it
needs less blood. majority of the blood is being sent to the placenta where it IS the source of
gas exchange
placenta is under high or low pressure? LOW because blood flows down path of least
resistance
side of the heart with higher pressure? left bc has to pump to entire body
how long after birth does normal pressure occur? 8 weeks
shunt/shunting blood is going where it is not supposed to
which shunting is more critical? right to left
blood is shunted into the left ventricle and out to the body instead of to the lungs to get
oxygenated.
left to right shunt results in CHF bc blood not being pumped to body and more in the heart
cause of congenital heart defects? unknown - but combination of environmental and
genetics (genomics)
prevention of CHD? multivitamins, including folic acid, by women at time of conception may
decrease incidence
risk factors for CHD -maternal infection during pregnancy (rubella, coxsackie B5)
,-fetal exposure to lithium, phenytoin, warfarin, and alcohol
-maternal age over 40
-maternal metabolic disorders (T1D,, PKU)
-paternal alcoholism (active ETOH abuse at conception)
-sibling with CHD
-chromosomal abnormality such as Down's
major cause of death in the first year of life (after prematurity) congenital heart defects
most common heart defect ventricular septal defect (VSD)
T/F: children with CHD often have another recognized anomaly (trisomy 21, 13, 18) true
classification of CHD: increased pulmonary blood flow ASD - atrial septal defect
VSD - ventricular septal defect
PDA - patent ductus arteriosus
classification of CHD: decreased pulmonary blood flow TOF, pulmonic stenosis, TGA
increased pulmonary blood flow defects Abnormal connection between two sides of heart
--Either the septum or the great vessels
Increased blood volume on right side of heart
Increased pulmonary blood flow
Decreased systemic blood flow
presentation: lungs are wet, crackles present, similar to CHF in adults
, ventricular septal defect (VSD) -most common congenital heart defect
-hole can vary in size
-size of defect determines severity of symptoms
-can be only ventricular defect or in combination with another defect
-left to right shunt
-systolic murmur (louder the murmur, smaller the defect!) (caused by the turbulence from
increased blood flow)
-may close spontaneously within 6 months (therefore treatment for first 6 months is to
monitor)
VSD nursing interventions -eating is exercise, so nipple for 20 min, gavage feed the rest.
-increase the kcals of the formula/milk
-results in CHF 15% of the time
Do parents of CHD/VSD kids need to restrict their activity? No, they (kids) will self restrict
Atrial Septal Defect (ASD) -left to right shunt between the atrias
-increased pulmonary blood flow
-may have atrial dysrhythmias
-may not be diagnosed until preschool years if small or moderate
S/Sx of ASD usually well tolerated, but common symptoms: pulmonary congestion, CHF,
tiring, and poor growth if large defect.
pulmonary vascular changes after decades
patent ductus arteriosus (PDA) passageway (ductus arteriosus) between the aorta and the
pulmonary artery remains open (patent) after birth
pressure in fetal lungs is high or low? high because it is not the source of gas exchange, so it
needs less blood. majority of the blood is being sent to the placenta where it IS the source of
gas exchange
placenta is under high or low pressure? LOW because blood flows down path of least
resistance
side of the heart with higher pressure? left bc has to pump to entire body
how long after birth does normal pressure occur? 8 weeks
shunt/shunting blood is going where it is not supposed to
which shunting is more critical? right to left
blood is shunted into the left ventricle and out to the body instead of to the lungs to get
oxygenated.
left to right shunt results in CHF bc blood not being pumped to body and more in the heart
cause of congenital heart defects? unknown - but combination of environmental and
genetics (genomics)
prevention of CHD? multivitamins, including folic acid, by women at time of conception may
decrease incidence
risk factors for CHD -maternal infection during pregnancy (rubella, coxsackie B5)
,-fetal exposure to lithium, phenytoin, warfarin, and alcohol
-maternal age over 40
-maternal metabolic disorders (T1D,, PKU)
-paternal alcoholism (active ETOH abuse at conception)
-sibling with CHD
-chromosomal abnormality such as Down's
major cause of death in the first year of life (after prematurity) congenital heart defects
most common heart defect ventricular septal defect (VSD)
T/F: children with CHD often have another recognized anomaly (trisomy 21, 13, 18) true
classification of CHD: increased pulmonary blood flow ASD - atrial septal defect
VSD - ventricular septal defect
PDA - patent ductus arteriosus
classification of CHD: decreased pulmonary blood flow TOF, pulmonic stenosis, TGA
increased pulmonary blood flow defects Abnormal connection between two sides of heart
--Either the septum or the great vessels
Increased blood volume on right side of heart
Increased pulmonary blood flow
Decreased systemic blood flow
presentation: lungs are wet, crackles present, similar to CHF in adults
, ventricular septal defect (VSD) -most common congenital heart defect
-hole can vary in size
-size of defect determines severity of symptoms
-can be only ventricular defect or in combination with another defect
-left to right shunt
-systolic murmur (louder the murmur, smaller the defect!) (caused by the turbulence from
increased blood flow)
-may close spontaneously within 6 months (therefore treatment for first 6 months is to
monitor)
VSD nursing interventions -eating is exercise, so nipple for 20 min, gavage feed the rest.
-increase the kcals of the formula/milk
-results in CHF 15% of the time
Do parents of CHD/VSD kids need to restrict their activity? No, they (kids) will self restrict
Atrial Septal Defect (ASD) -left to right shunt between the atrias
-increased pulmonary blood flow
-may have atrial dysrhythmias
-may not be diagnosed until preschool years if small or moderate
S/Sx of ASD usually well tolerated, but common symptoms: pulmonary congestion, CHF,
tiring, and poor growth if large defect.
pulmonary vascular changes after decades
patent ductus arteriosus (PDA) passageway (ductus arteriosus) between the aorta and the
pulmonary artery remains open (patent) after birth
