ACYANOTIC

Involves heart or circulatory anomalies that involve either a stricture to the flow of blood or a shunt that moves blood from arterial to venous system (oxygenated to unoxygenated blood or left to right shunts)

Ventricular septal defect

DefinitionVentricular septal defect describes one or more holes in the wall that separates the

right and left ventricles of the heart. Ventricular septal defect is one of the

most common congenital (present from birth) heart defects. It may occur by

itself or with other congenital diseases.

Cause or Etiology

unknown.

Risk Factors

Drinking alcohol and using the antiseizure medicines depakote and dilantin during pregnancy have been associated with increased incidence of VSDs.

Signs and Symptoms

Shortness of breathFast breathingHard breathingPalenessFailure to gain weightFast heart ratePounding heartSweating while feedingFrequent respiratory infections

Diagnostic Test

Chest x ray

ECG

Echocardiogram

Cardiac Cathetherization

MRI

Diagnostic test

Cardiac cathetherization

Management

Medical management

Antibiotics for children

Surgical Management

Cardiac Cathetherization

Nursing Diagnosis

Activity IntoleranceDecreased Cardiac OutputIneffective Breathing Pattern

Nursing OutcomeChild’s pulse, blood pressure, and respiratory

rate are within acceptable parameters for age group, abnormal heart sounds are absent

Nursing Intervention

Activity TherapyBody Mechanics PromotionOrginize all activities to provide maximum rest periodsPromote Respiratory Status-Airway PatencyPromote Cardiac Pump EffectivelyHemodynamic RegulationAirway ManagementProvide Oxygen as Necessary

Prognosis

Many small defects will close on their own. For those defects that do not spontaneously close, the outcome is good with surgical repair. Complications may result if a large defect is not treated.

ResearchSonja Rasmussen MD of the CDC’s National Center on Birth Defects and Developmental Disabilities has reported her study findings online in the American Journal of Obstetrics and Gynecology.

The data was gathered from the National Birth Defects Prevention Study that involved over 12,000 infants born between 1997 and 2004, about half of which were born with congenital heart defects. Women who were classified as overweight at the beginning of pregnancy, defined as a BMI of over 25 but less than 35, were found to have a 15% increased risk. However, as weight increased, so do risks. For women classified as obese, BMI over 35, the risk jumped to 30%.

The most serious of the 10 congenital heart defects related to obesity is hypoplastic left heart syndrome. The left ventricle, the heart’s primary pumping chamber, is underdeveloped. The defect is often fatal in the first few weeks of life without treatment. Surgery is required soon after birth to allow the larger right ventricle to pump the oxygenated blood throughout the body. Some infants require a heart transplant. HLHS occurs in about 4 of every 10,000 live births.

Mothers of infants with heart defects were found to have two primary risk factors related to weight: gestational diabetes and hypertension during pregnancy.

Reference

http://www.healthsystem.virginia.edu/uvahealth/peds_cardiac/asd.cfm

http://www.emaxhealth.com/1506/87/33983/maternal-obesity-linked-child-heart-defects.html

Atrial Septal Defect

An atrial septal defect allows oxygen-rich (red) blood to pass from the left atrium, through the opening in the septum, and then mix with oxygen-poor (blue) blood in the right atrium.

Cause

Gene defect

Environmental exposure

partitioning process does not occur completely

Risk Factors

routine dental check-up and teeth cleaning.

Sex

Parity

Geography

Signs and symptoms

child tires easily when playing

fatigue

sweating

rapid breathing

shortness of breath

Poor growth

Diagnostic Test

Chest x ray

ECG

Echocardiogram

Cardiac Cathetherization

MRI

Diagnostic test

Cardiac cathetherization

Nursing Responsibilities

Post-Procedure Care

monitor the pulses and skin temperature in the leg or arm that was used for the procedure.

Several gauze pads and a large piece of medical tape will be placed on the site where the catheter was inserted to prevent bleeding.

Management

medical management Digoxin and diuretics

Infection controlAntibiotics

surgical repair device closure

Nursing Diagnosis

Activity Intolerance

Decreased Cardiac Output

Ineffective Breathing Pattern

Fatigue

Nursing Outcome

Regain his baseline respiratory rate and maintain stable respirations

Nursing interventions

monitor VS before/after giving medications frequently

client teaching:

adhere to the prescribed diet and medications

to limit activities

to rest at regular period

Expectations (prognosis)

With early diagnosis and repair of an ASD, the outcome is generally excellent, and minimal follow-up is necessary. When an ASD is diagnosed later in life, if complications occur after surgical closure, or the ASD is never repaired, the outlook is generally poor

Research

Source: NEWS RX

2009 AUG 24 -- According to a study from Adelaide, Australia, "Information regarding Left atrial (LA) substrate in conditions predisposing to atrial fibrillation (AF) is limited. This study sought to characterize the Left atrial remodeling that results from chronic atrial stretch caused by atrial septal defect (ASD)."

Reference

http://www.healthsystem.virginia.edu/uvahealth/peds_cardiac/asd.cfm

http://www.newsrx.com/article.php?articleID=1605670

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Prepared by:

PAGCALIWAGAN, HOLLY ANN C.

BSN3-2