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Principles III, Exam I
CHD Slides 25-32
11
Nursing
Graduate
02/06/2010

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Cards

Term
Describe the characteristics of a PDA murmur
Definition
impinges on diastole, heard over mid to left sternal border, hard to hear if neonate is on ventilator
Term
What is the most common approach for PDA repair?
Definition
Left lateral
Term
What are your fluid/blood replacement priorities with PDA closure?
Definition
T&C 1 unit PRBC (have unit in room at start), fluid warmers, T&C 1 unit plsma, albumin 5% in room, preservative free o.9NS
Term
Where is preductal and postductal pressures monitored?
Definition
Preductal - right arm, postductal - left arm
Term
How should monitors be placed in PDA repair?
Definition
BP on right arm, sat monitor on right arm, sat monitor also on left arm or lower extremities, esophageal stethoscope/temperature probe
Term
What are the pulse pressures like in PDA? What does PDA ligation do to the diastolic pressure and pulses?
Definition
Widened, improves disastolic pressure and pulse strength
Term
What is the preferred method of anesthesia to repair the PDA? What is an alternative anesthetic plan?
Definition
High dose fentanyl (10-50mcg/kg) and pancuronium 0.1mg/kg. Alternatively, sevo can be used in moderate amounts, unless the EF is poor.
Term
How is bradycardia handled intraoperatively when repairing a PDA?
Definition
the surgeon must immediately stop and allow lung re-expansion.
Term
What are causes of hypotension in PDA repair?
Definition
loss of circulating volume (blood loss or evaporation) or due to chest compression that causes decreased venous return
Term
what are potential complications of PDA repair?
Definition
recurrent laryngeal nerve injury, tearing the PDA, clamping of the aorta, destruction of the thoracic duct, clamping of the pulmonary artery, clamping the carotid artery, clamping of a bronchus
Term
How is albumin 5% dosed?
Definition
Albumin is a colloid and is therefore dosed based on the 1:1 rule (1ml fluid loss is replaced with 1ml colloid)
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