Cyanotic heart defects Flashcards
cyanotic defects
caused by defects that result in decreased pulmonary blood flow
what side of the heart is pressure greater in, in cyanotic defects?
pressure is greater on the pulmonic side so blood shunts from RT to LT
mixed oxygenated and deoxygenated blood flows to the systemic circulation resulting in hypoxia
symptoms of cyanotic heart defects
cyanosis
polycythemia
digital clubbing
altered ABG’s
general interventions for cyanotic heart defects
good skin care
supplemental O2
monitor and prevent dehydration
developmentally appropriate preparation for tests and procedures
nursing considerations for cyanotic heart defects
alteration in oxygenation
anxiety caused by cyanosis
dehydration
prevention and accurate assessment of respiratory infections.
decreased pulmonary blood flow disorders
tetralogy of fallot
tricuspid atresia
tetralogy of Fallot
combination of 4 defects
present at birth
cause oxygen-poor blood to flow out of the heart and into the rest of the body.
clinical manifestations of tetralogy of fallot
heart murmur with thrill polycythemia hypoxic episodes (squatting position) metabolic acidosis poor growth clubbing exercise intolerance
what does surgery do for tetralogy of fallot kids?
improved quality of life and longevity
done is stages starting at 6 months old
what are the stages of surgery of tetralogy of fallot?
blalock-taussing shunt
VSD repair
pulmonary valvotomy
what to do for hypercyanotic spells
employ calm comforting approach
knee-chest position
100% O2 by face mask
give morphine
IV fluid replacement and volume expansion if needed
repeat morphine
** do each intervention one at a time, and when it works you can stop**
tricuspid atresia
failure of tricuspid valve to develop resulting in no communication between right atrium and left ventricle resulting in severe right hypoplasia or absence of right ventricle
** need foramen ovale to stay open
clinical manifestations of tricuspid atresia
cyanosis
caused by the loss of patent foramen ovale
give prostaglandin E to keep it open
treatment of tricuspid atresia
prostaglandin E to keep foramen ovale open
Digoxin and Diuretics
palliative surgical repair to improve pulmonary blood flow
mixed blood flow heart defects
transposition of the great arteries
truncus arteriosus
hypoplastic left heart
transposition of the great arteries
pulmonary arteries arise from LT ventricle and the Aorta arises from right ventricle. no communication between the systemic and pulmonary circulations
signs and symptoms of transposition of the great arteries
increasing cyanosis as foramen ovale closes
treatment of transposition of the great arteries
arterial switch procedure in the first weeks of life
IV prostaglandin E to keep foramen ovale open and/or balloon atrial septoplasty
Truncus arteriosus
pulmonary artery and aorta fail to divide during embryonic development. One single large ventricle empties both ventricles
clinical manifestations of truncus arteriosus
cyanosis
CHF
heart murmer
treatment of truncus arteriosus
surgical repair during the first few months of life
digoxin and diuretics
hypoplastic left heart syndrome (HLHS)
aortic valve atresia, mitral atresia or stenosis, small or absent left ventricle, severe hypoplasia of the ascending aorta and aortic arch *NEED TRANSPLANT* under developed LT side of heart small left ventricle aortic atresia descending aorta receives blood via PDA
signs and symptoms of HLHS
cyanosis weak, peripheral pulses cool extremities respiratory distress often times no murmur
therapeutic management of HLHS
prostaglandin E to keep PDA open
fontan procedure
norwood procedure
TRANSPLANT
fontan procedure
direct blood flow to pulmonary artery from RA
norwood procedure
anastomosis of main PA to the aorta, shunt from RV to PA
complications of heart surgery
CHF dysrhythmias cardiac tamponade atelectasis pneumothorax pulmonary edema pleural effusions cerebral edema brain damage hemorrhage or anemia
