Exam (elaborations)
Peds Exam 2 Cardiovascular Review
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Peds Exam 2 Cardiovascular Review Peds Exam 2 Cardiovascular Review Peds Exam 2 Cardiovascular Review
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Peds Exam 2 Cardiovascular ReviewCirculatory Changes From Gestation to Birth - ANS •The fetal heart rate is present on about
postconceptual day 17.
•The four chambers of the heart and arteries are formed during gestational weeks 2 through 8.
•During fetal development, oxygenation of the fetus occurs via the placenta; the lungs, though
perfused, do not perform oxygenation and ventilation
Circulatory Changes From Gestation to Birth
an opening between the atria, allows blood flow from the right to the left atrium. - ANS •The
foramen ovale
Circulatory Changes From Gestation to Birth
allows blood flow between the pulmonary artery and the aorta, shunting blood away from the
pulmonary circulation. - ANS •The ductus arteriosus
Health History of the Present Illness - ANS •When the symptoms started and how they progressed
•Any treatments and medications used at home
•History of orthopnea, dyspnea, easy fatigability, growth delays, squatting, edema, dizziness,
frequent pneumonia
•Poor feeding, fatigue, lethargy, vomiting, failure to thrive
Past Health History - ANS •Problems occurring after birth associated congenital malformation
•Frequent infections
•Chromosomal abnormalities
•Prematurity
•Autoimmune disorders
Characteristics of Murmurs - ANS •Location
•Relation to the heart cycle and duration
•Intensity:
,-grade I, soft and hard to hear
-grade II, soft and easily heard
-grade III, loud without thrill; grade IV, loud with a precordial thrill;
-grade IV, loud, audible with a precordial thrill
-grade V, loud, audible with a stethoscope
- grade VI, very loud, audible with a stethoscope or with the naked ear
•Quality: harsh, musical, or rough; high, medium, or low pitch
•Variation with position (sitting, lying, standing)
Cardiac Dysfunction in Pediatrics
•Congenital - ANS -Anatomic abnormalities present at birth
Congenital heart disease: Structural anomalies that are present at birth, CHD accounts for the largest
percentage of all birth defects
Cardiac Dysfunction in Pediatrics
•Congenital
Types - ANS -Acyanotic (ASD, VSD, PDA)
-Obstructive (Coarctation of the Aorta)
-Cyanotic (Tetralogy of Fallot)
Cardiac Dysfunction in Pediatrics
•Acquired - ANS -Occur after birth
-May result from
•Infection
•Autoimmune disease
Acquired heart disease: Disorders that occur after birth Heart failure (most common) Develops from
a wide range of causes, or can occur as a complication or long-term effect of CHD examples
Rheumatic fever
, Cardiomyopathy
Infective endocarditis
Hyperlipidemia
Hypertension
Kawasaki disease
CHD accounts for the _______ percentage of all birth defects - ANS largest
Many congenital heart defects result in - ANS heart failure
As the newborn breathes for the first time, the lungs inflate, reducing - ANS pulmonary vascular
resistance to blood flow. As a result, pulmonary artery pressure drops. Subsequently, pressure in the
right atrium decreases. Blood flow to the left side of the heart increases the pressure in the left
atrium. This change in pressure leads to closure of the foramen ovale.
The drop in pressure of the pulmonary artery promotes closure of the - ANS ductus arteriosus
The ductus venosus, located between the left umbilical vein and the inferior vena cava, closes
because of a - ANS lack of blood flow and vasoconstriction
1-6 yo the heart is ______ times the birth size - ANS four
Between 6 and 12 years of age, the child's heart is 10 times the size it was at birth
At birth, the ventricle walls are - ANS similar in thickness, but with time the left ventricular wall
thickens
Right ventricular function dominates at birth, and over the first few months of life, - ANS left
ventricular function becomes dominant
The infant's and child's blood vessels widen and increase in length over time. The average infant's BP
is about - ANS 80/55 mm Hg
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