NCM109 Part 2: Congenital Heart Defects Nursing Notes PDF

s ECG monitoring\ Medications Management: Diuretics, vasodilators.\ Fluid management: Balancing fluid intake\ Nutritional support: High-calorie diet,\ Infection prevention: vaccinations, antibiotic prophylaxis.\ Treatment:\ Surgical repair: Closure of VSD (patch or direct closure)\ Catheter-based in...

s ECG monitoring\ Medications Management: Diuretics, vasodilators.\ Fluid management: Balancing fluid intake\ Nutritional support: High-calorie diet,\ Infection prevention: vaccinations, antibiotic prophylaxis.\ Treatment:\ Surgical repair: Closure of VSD (patch or direct closure)\ Catheter-based interventions: Device closure\ Heart transplantation: Replacement of the heart (in severe cases).\ \ Health Teaching:\ Disease explanation: understanding VSD.\ Medication adherence: importance of medication regimen.\ Follow-up care: regular heart checks.\ Infection prevention: hand hygiene, vaccination.\ Nutritional counseling: balanced diet.\ Activity restrictions: avoiding strenuous activities.\ \ \ Nursing Diagnoses:\ 1.Decreased cardiac output: related to VSD.\ 2. Impaired gas exchange: related to respiratory distress.\ 3. Activity intolerance: related to fatigue.\ 4. Anxiety: related to uncertainty.\ 5. Risk for infection: related to compromised immune system.\ \ \ Atrial Septal Defect (ASD): is a congenital heart defect characterized by an opening in the septum separating the right and left atria.\ \ Etiology:\ Genetic mutations: Chromosomal abnormalities (ex. Down syndrome).\ Environmental factors: Maternal diabetes, rubella infection.\ Family history: Increased risk if parents or siblings have ASD.\ Chromosomal abnormalities: Turner syndrome\ \ \ \ \ \ \ \ Disease Process:\ Abnormal fetal development during embryogenesis,\ Failure of septal closure between atria.\ Left-to-right shunting: oxygenated blood flows from left atrium to right atrium.\ Increased pulmonary blood flow, potential for pulmonary hypertension.\ \ \ Signs and Symptoms\ \ Cyanosis:\ Shortness of breath\`\ Fatigue\ Failure to thrive: poor weight gain\ Feeding difficulties\ Sweating\ Palpitations: irregular heartbeats\ Recurrent respiratory infections\ \ \ Nursing Management:\ Oxygen therapy\ Cardiac monitoring: Continuous ECG monitoring.\ Medication management: diuretics, vasodilators.\ Fluid management: balancing fluid intake.\ Nutritional support: high-calorie diet.\ Infection prevention: vaccinations, antibiotic prophylaxis.\ \ \ \ Treatment:\ Surgical repair: Closure of ASD (patch or direct closure)\ Catheter-based intervention:\ Heart transplantation: replacement of the heart (in severe cases).\ \ \ \ \ Health Teaching:\ Disease explanation: understanding ASD.\ Medication adherence: importance of medication regimen.\ Follow-up care: regular health checks.\ Infection prevention: Hand hygiene, vaccination.\ Nutritional counseling: balanced diet:\ Activity restrictions: avoiding strenuous activities.\ \ \ Nursing Diagnoses:\ Decreased cardiac output: related to ASD.\ Impaired gas exchange: related to respiratory distress.\ Activity intolerance: related to fatigue.\ Anxiety: related to uncertainty.\ Risk for infection: related to compromised immune system.\ \ \ TETRALOGY OF FALLOT (TOF): is a congenital heart defect characterized by four main anomalies: Ventricular septal defect (VSD), Pulmonary stenosis, Right Ventricular hypertrophy, and overriding of the aorta.\ \ \ Etiology:\ Genetic mutations: Chromosomal abnormalities (Down syndrome)\ Environmental factors: Maternal diabetes, rubella infection.\ Family history: Increased risk if parents or siblings have TOF.\ Chromosomal abnormalities: Deletion of Chromosomes 22q11.\ \ \ Disease Process:\ Abnormal fetal development during embryogenesis.\ Four characteristics anomalies:\. Ventricular septal defect (VSD)\. Pulmonary Stenosis (narrowing of the pulmonary valve)\. Right Ventricular hypertrophy (thickening of the ventricles)\. Overriding aorta (aorta positioned over VSD).\ Right-to-left shunting: deoxygenated blood flows from right ventricle to left ventricle.\ Decreased pulmonary blood flow, potential for cyanosis.\ \ Signs and Symptoms:\ Cyanosis: bluish discoloration of skin and mucous membrane.\ Shortness of breath.\ Fatigue\ Failure to Thrive\ Feeding difficulties\ Sweating\ Palpitations\ Recurrent respiratory infections\ Clubbing: enlarged fingertips\ Polycythemia: increased RBC\ \ \ Nursing Management:\ Oxygen therapy\ Cardiac monitoring\ Medication management\ Fluid replacement: balance fluid intake\ Nutritional support\ Infection prevention\ Comfort measures: pain management, relaxation techniques.\ \ Treatment:\ Surgical repair: complete repair (Closure of VSD)\ Heart transplantation: replacement of the heart (in severe cases)\ \ Nursing diagnoses:\ Decreased cardiac output: related to TOF\ Impaired gas exchange: related to respiratory distress\ Activity intolerance: related to fatigue\ Anxiety\ Risk for infection: related to compromised immune system\ Deficient fluid volume: related to dehydration\ \ 4.TRANSPOSITION OF THE GREAT ARTERIES (TGA)- is a congenital heart defect where the two main arteries carrying blood away from the heart are reversed. The aorta arises from the right ventricle, and the pulmonary artery arises from the left ventricle.\ \ Etiology:\ Genetic mutations. (Down syndrome)\ Environmental factors (maternal diabetes, rubella infection).\ Family history\ Chromosomal abnormalities: deletion of chromosome 22q11.\ \ Disease Process:\ Reversal of the great arteries during fetal development.\ Oxygenated blood from the lungs returns to the left ventricle, then flows back to the lungs.\ Deoxygenated blood from the body returns to the right ventricle then flows to the aorta and systemic circulation.\ Severe cyanosis: Inadequate oxygenation of blood.\ \ \ Signs and Symptoms:\ Severe cyanosis\ Respiratory distress: shortness of breath\ Fatigue\ Failure to thrive\ Feeding difficulties\ Sweating\ Palpitations\ Clubbing: enlarged fingers\ \ Nursing Management:\ Oxygen therapy\ Cardiac monitoring\ Medication management\ Fluid management\ Nutritional support\ Infection prevention\ Comfort measures\ \ \ Treatment:\ Arterial switch operation: Surgical correction (reversing the great arteries).\ Rastelli procedure: creating a tunnel between the left ventricle and aorta.\ Heart transplantation.\ \ Health Teaching:\ Disease explanation.\ Medication adherence.\ Follow-up care.\ Infection prevention.\ Nutritional counseling\ Activity restrictions\ \ Nursing Diagnoses:\ Decreased cardiac output: related to TGA\ Impaired gas exchange: related to respiratory distress.\ Activity intolerance: related to fatigue.\ Anxiety: related to uncertainty.\ Risks to infection: related to compromised immune system.\ Deficient fluid volume: related to dehydration.\ \ \ PATENT DUCTUS ARTERIOSUS (PDA): is a congenital heart defect where the ductus arteriosus, a fetal blood vessel connecting the aorta and pulmonary artery, fails to close at birth.\ \ \ Etiology:\ Genetic mutations: (down syndrome)\ Environmental factors.\ Family history: increased risk if parents or siblings have PDA.\ Premature birth: increased risk in preterm infant.\ Chromosomal abnormalities: deletion of Chromosome 22q11.\ \ \ Disease Process:\ Failure of ductus arteriosus closure after birth.\ Left-to-right shunting: Oxygenated blood from the aorta flows into pulmonary artery.\ Increased pulmonary blood flow, potential for pulmonary hypertension.\ Overload on left heart, potential for cardiac failure.\ \ Signs and Symptoms:\ Cyanosis\ Respiratory distress\ Fatigue\ Failure to Thrive\ Feeding difficulties\ Sweating\ Palpitations\ Recurrent respiratory infections\ Bounding pulse: strong, forceful pulses.\ \ \ Nursing management:\ Oxygen therapy\ Cardiac monitoring\ Medication Management: diuretics, vasodilators\ Fluid management\ Nutritional support\ Infection prevention\ Comfort measures: pain management, relaxation techniques\ \ \ Treatment:\ Surgical ligation: Surgical closure of PDA\ Pharmacological closure: Indomethacin or Ibuprofen therapy\ \ \ \ Health Teaching:\ Disease explanation\ Medication adherence\ Follow-up care\ Infection prevention\ Nutritional counseling\ Activity restrictions\ \ \ Nursing Diagnoses:\ Decreased cardiac output: related to PDA.\ Impaired gas exchange: related to respiratory distress.\ Activity intolerance: related to fatigue\ Anxiety: related to uncertainty\ Risk for infection: related to compromised immune system.\ Deficient fluid volume: related to dehydration.\ \ \ COARCTATION OF THE AORTA: is a congenital heart defect characterized by narrowing of the aortic isthmus, typically at the junction of the aortic arch and descending aorta.\ \ Etiology:\ Genetic mutations: Chromosomal abnormalities (ex. Turner syndrome)\ Environmental factors\ Family history: increased risk if parents of siblings have coarctation.\ Chromosomal abnormalities: deletion of chromosome 22q11.\ \ \ \ Disease Process:\ Narrowing of the aortic isthmus during fetal development.\ Obstruction of blood flow from the aorta to the lower body.\ Increased blood pressure above the coarctation.\ Decreased blood pressure below the coarctation.\ Potential for cardiac failure, hypertension, and stroke.\ \ \ Signs and Symptoms:\ Hypertension:\ Weak or delayed pulses: in lower extremities.\ Shortness of breath:\ Fatigue\ Headaches: due to hypertension.\ Dizziness: Lightheadedness.\ Cold extremities: decreased blood flow.\ \ \ \ Nursing Management:\ Blood pressure monitoring\ Cardiac monitoring\ Medication management: antihypertensive, beta-blockers.\ Fluid management\ Nutritional support\ Infection prevention\ Comfort measures\ \ \ Treatment:\ Surgical repair: Resection of coarctation with end-to-end anastomosis.\ Stent replacement: maintaining patency.\ Bypass grafting: Creating alternative blood flow pathway.\ \ \ Nursing Diagnoses:\ Decreased cardiac output: related to coarctation.\ Hypertension: related to increased blood pressure.\ Activity intolerance: related to fatigue\ Anxiety\ Risk for infection: related to compromised immune system.\ Deficient fluid volume: related to dehydration.\ \ \ \ Other Chromosomal Abnormalities:\ \ TURNER SYNDROME (TS): is genetic disorder affecting females, characterized by the absence or abnormality of one X chromosome (45, X or 45, X46, XX mosaicism).\ \ Etiology:\ Monosomy X: Loss of one X chromosome. (45, X).\ Mosaicism: Mix of 45, X and 46, XX cells.\ X chromosome deletion: Partial or complete deletion of X chromosome.\ Family history: Increased risk if family members have TS.\ Advanced Maternal age: Increased risk.\ \ Disease Process:\ Abnormal X chromosome formation during meiosis.\ Hormonal imbalances: Estrogen deficiency.\ Growth and development delays.\ Reproductive system abnormalities.\ \ Signs and Symptoms:\ Short stature: Growth hormone deficiency.\ Delayed puberty: Hormonal imbalances.\ Infertility: Ovarian dysgenesis.\ Heart defect: Coarctation of the aorta.\ Kidney abnormalities: Horseshoe kidney.\ Hearing and vision problems: Strabismus\ Cognitive impairment: Learning disabilities.\ \ \ Nursing Management:\ \ Growth hormone therapy monitoring.\ Hormone replacement therapy.\ Cardiac monitoring.\ Blood pressure monitoring\ Infection prevention.\ Nutritional support\ \ \ Treatment:\ Growth hormone therapy: stimulate growth.\ Hormone replacement therapy: Estrogen replacement.\ Surgery: correcting heart defects, reproductive system abnormalities.\ Speech and language therapy: communication skills development.\ Physical therapy: motor skills development.\ Psychological counseling; coping strategies.\ \ \ Nursing Diagnoses:\ Disturbed body image: related to physical characteristics.\ Delayed growth and development: related to hormonal imabalance.\ Anxiety\ Deficient knowledge: related to disease understanding.\ Impaired social interaction: related cognitive impairment.\ Risk for infection: related to compromised immune system.\ \ \ NEURAL TUBE DEFECTS (NTDs): are congenital anomalies resulting from incomplete closure of the neural tube during embryogenesis, leading to defects un the brain, spine, or spinal cord.\ \ Etiology:\ Genetic mutations: (ex. Trisomy 13).\ Environmental factors: maternal diabetes, rubella infection, exposure to toxins.\ Nutritional deficiencies: folic acid deficiency\ Family history: increased risk in family members have NTDs.\ Advance Maternal age: increased risk.\ \ \ Disease Process:\ Failure of neural tube closure during embryogenesis (22-28 days post conception).\ Abnormalities in brain, spine, or spinal cord development.\ Potential for hydrocephalus, and spinal cord damage.\ \ \ Types OF NTDs:\ \ Spina Bifida: incomplete closure of spinal cord and vertebrae.\ Meningocele: Protrusion of meninges through the spinal defect.\ Myelomeningoecele: Protrusion of spinal cord and meninges.\ Encephalocele: protrusion of brain tissue through skull defect.\ Anencephaly: absence of brain and skull development.\ \ \ Signs and Symptoms:\ Visible defects: Spinal or cranial abnormalities.\ Motor dysfunction: Weakness, paralysis.\ Sensory deficits: Numbness, loss of sensation.\ Bladder and bowel dysfunction: Incontinence.\ Hydrocephalus: Increased intracranial pressure.\ Seizures: due to brain abnormalities.\ Developmental delays: Cognitive and motor impairment.\ \ \ Nursing Management:\ Neurosurgical evaluation.\ Wound care: Protecting exposed neural tissue.\ Infection prevention: antibiotic prophylaxis.\ Pain management\ Bladder and bowel management: catheterization, bowel training.\ Physical therapy: Maintaining mobility.\ Occupational therapy: promoting independence.\ \ \ Treatment:\ \ Surgical repair: closure of defect.\ Rehabilitation therapy: Physical, occupational, speech.\ Medication management: Seizure control, pain management.\ \ \ Health Teaching:\ \ Disease explanation.\ Wound care\ Infection prevention.\ Bladder and bowel management\ Medication adherence.\ Follow-up care.\ \ \ Nursing Diagnoses:\ \ Impaired physical Mobility: related to motor dysfunction.\ Deficient knowledge: related to disease understanding.\ Anxiety\ Risk for infection: related to compromised immune system.\ Impaired urinary elimination: related to bladder dysfunction.\ Impaired skin integrity: related to wound complications.\ \ \ CLEFT LIP (CL) and CLEFT PALATE (CP): are congenital anomalies characterized by abnormal development of the upper lip and palate,\ \ \ \ \ \ Etiology:\ \ Genetic mutations: Chromosomal abnormalities.\ Environmental factors: Maternal smoking, alcohol consumption, and exposure to toxins,\ Nutritional deficiencies: Folic acid deficiency.\ Family history: Increased risk if family members have Cleft lip/cleft palate.\ Advance maternal age: increased risk.\ \ Disease Process:\ Abnormal fusion of facial structures during embryogenesis (6-12 weeks' gestation).\ Clefting of the lip, palate, or both.\ Potential for feeding difficulties, speech impairment, and hearing loss.\ \ Signs and Symptoms:\ \ Visible clefting\ Feeding difficulties\ Speech impairment\ Hearing loss\ Dental abnormalities\ Nasal regurgitation.\ \ \ Nursing Management:\ \ Initial assessment: evaluate airway, breathing, and feeding.\ Feeding support: specialized bottles, nipples, and feeding techniques.\ Infection prevention: antibiotic prophylaxis.\ Pain management\ Parental support: emotional and educational support.\ \ \ \ \ \ Treatment:\ \ Surgical repair: Cleft lip (3-6 months), palate (6-12 months).\ Orthodontic management: dental alignment.\ Speech therapy\ Hearing aids\ Dental restoration.\ \ Health Teaching:\ \ Disease explanation.\ Feeding techniques.\ Infection prevention.\ Follow-up care\ Speech and hearing development monitoring.\ \ \ Nursing Diagnoses:\ \ Impaired oral membranes: related to clefting.\ Deficient knowledge: related to disease understanding.\ Anxiety\ Impaired verbal communication: related to speech impairment.\ Risk for infection: related to compromised immune system.\ Imbalanced Nutrition: related to feeding difficulties.\ \ \ Problems in Reproduction and Sexuality of Male and Female Clients:\ \ Male Reproductive and Sexual Health Issues:\ \ ERECTILE DYSFUNCTION (ED): is the inability to achieve or maintain an erection sufficient for satisfactory sexual performance.\ \ \ \ \ Etiology:\ \ Vascular diseases: Atherosclerosis, hypertension, diabetes.\ Neurological disorders: Parkinson's disease, multiple sclerosis, spinal cord injury.\ Hormonal imbalances: Low testosterone, thyroid disorders.\ Psychological factors: Anxiety, depression, stress.\ Medications: Antidepressants, antihypertensive, sedatives.\ Lifestyle factors: smoking, alcohol consumption, obesity.\ \ Disease Process:\ \ Reduced blood flow to the penis.\ Smooth muscle relaxation.\ Decreased erectile tissue responsiveness.\ \ Signs and Symptoms:\ \ Inability to achieve erection:\ Reduced erectile rigidity: Soft or partial erection.\ Decreased libido: low sexual desire.\ Premature ejaculation: Uncontrolled ejaculation.\ Performance anxiety: fear of failure.\ \ \ Nursing Management:\ \ Assessment: Medical history, Physical examination, Laboratory test.\ Education: disease explanation, treatment options.\ Counseling: addressing psychological factor.\ Lifestyle modifications: quit smoking, exercise, weight management.\ Medication management. Phosphodiesterase inhibitors (ex. Sildenafil).\ \ Treatment:\ \ Phosphodiesterase inhibitors: Sildenafil, tadalafil, vardenafil.\ Vacuum erection devices: Mechanic