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
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URSING)

, Peds Exam 2 Study Guide ie ie ie ie




Heart Chambers:
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• Right Atrium (Collecting chamber) -
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Peripheral venous return from the superior & inferior vena cava & coronary sinus (70% O2 Sat).
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• Right Ventricle (Pumping chamber) -
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Receives blood from the RA thru the tricuspid valves, then
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pumps the low O2 blood to the lungs via the pulmonary a
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rtery.
• Left Atrium (Collecting chamber) -
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Receives fully oxygenated blood from lungs thru the pu
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lmonary veins (100% O2 Sat)
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• Left Ventricle (Pumping chamber) -Blood comes from
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the LA thru the bicuspid valves, then pumps it into the systemic circulation via the aorta.
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Heart Valves
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• 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
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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
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gitation into LV ie ie




o Pulmonary Valve - ie ie



Located at the junction of the RV & Pulmonary Artery, prevents regurgitation into R
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V.
Heart Vessels
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• Vena Cava -Carries blood from body into right atrium
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o Superior VC - ie ie


enters from above heart, head, arms, & upper body
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o Inferior VC - ie ie


enters from below heart, legs, abd organs, & lower part of t
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, he body
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o Pulmonary Arteries -Only artery that carries nonO2 blood
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o Pulmonary Veins -Only vein that carries O2 rich blood
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, Normal Flow ie



 Blood enters the heart thru the superior & inferior vena cava into the right atrium.
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 R atrium contracts, pushes blood thru the tricuspid into the R ventricle.
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 R ventricle contracts, sending blood through the pulmonary valve into
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the pulmonary arteries and to the lungs for oxygenation.
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 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
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into the left ventricle. ie ie ie



 Left ventricle contracts, pushing blood thru the aortic valve into the
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aorta & out to the body. ie ie ie ie ie




Cardiac Output (CO)
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• Amount of blood ejected from both ventricles per minute
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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)
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• Amount of blood ejected by left ventricle each heartbeat
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o SV = Preload x Afterload x Contractility
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Preload = Fluid Volume
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• End diastolic pressure of heart when ventricle is filled w/blood
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• Amount of blood returning to the heart that “loads” it up for the next beat
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Afterload (aortic impedance/wall stress)
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• Amount of pressure that heart must work against to eject blood during systole (ventricular
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contraction)
Contractility
• The force exerted at contraction, ejecting a stroke volume at a given afterload (arterial pressure) &
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preload (end-diastolic volume) ie ie




Goals of Therapy for Heart Disease
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• 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
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