NR602 Week 6: Homework- MyEvaluations Log

Cardiac anomalies affect almost 8 in 1,000 children, with 90% of these patients living well into adulthood (Hay, Levin, Deterding, & Abzug, 2018). The majority of children are noted to have a murmur at some point in their life noted on routine physical examinations, but less than 1% of all murmurs are caused by a congenital defect (Hay et al., 2018).

The NP should review the differences between fetal and non-fetal circulation and have a working knowledge of the locations and closure times for open fetal circulation routes. Please note the location of the following fetal shunts.

McCance, K.L. & Huether, S.E (2015). Pathophysiology: the biologic basis for disease in adults & children (6th ed.). St. Louis: Mosby.

Murmurs are the most common finding leading to a cardiology referral in children. New onset, worsening, or murmurs associated with other symptoms should always be evaluated further by a pediatric cardiologist. In documenting murmurs, the following should be noted.

There are several types of innocent murmurs. Two of the most common are below. Can you match the murmur with its definition?

Congenital Cardiac Disease

Congenital cardiac anomalies and the structure of the heart should be known by the NP. Many anomalies are noted prior to birth now due to ultrasonography, but many can still go undetected. For example, Coarctation of the aorta can be missed until the child is well into their first year of life or has presenting symptoms. Do not assume that you will not find congenital cardiac defects in children outside of the newborn period and be aware of signs and symptoms of disease. The following are listings of acyanotic and cyanotic heart diseases.