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Child Care

Congenital
Heart Defects
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I . ATRIAL SEPTAL DEFECT (ASD):
Abnormal opening between the atria allowing the blood to flow from the left atri
um to right atrium, according to pressure differences. Then a mixing between oxy
genated and nonoxygenated blood happened.
Clinical manifestations : • Murmur during auscultation • Cardiac arrhythmias • Risk of
emboli formation • Atrial enlargement • Difficulty in breathing • CHF (congestive hea
rt failure )
II . VENTRICULAR SEPTAL DEFECT (VSD):
Abnormal opening between the ventricles allowing the blood to flow from left ven
tricle to right ventricle, according to pressure differences. Then a mixing betw
een oxygenated and nonoxygenated blood happened.
Clinical manifestations : • Murmur during auscultation • Risk of respiratory infecti
ons • Cardiomegaly • Difficulty in breathing • CHF (congestive heart failure )
III . PATENT DUCTUS ARTERIOSUS (PDA) :
Ductus arteriosus is an artery connecting the aorta and the pulmonary artery. An
d this defect results from failure of this duct to close after delivery, causing
the blood to flow from aorta to pulmonary artery according to pressure.
Clinical manifestations : • Hypoxemia • Wide pulse pressure • Risk of respiratory infe
ctions • Difficulty in breathing • Paleness of the skin • CHF (congestive heart failur
e )
IV . AORTIC STENOSIS ( AS ) : Narrowing of the aortic valve, causing resistance
to blood flow in the left ventricle and decrease cardiac output.
Clinical manifestations: • Hypotension • Tachycardia • Chest pain • Dizziness when stand
ing • Murmur
TREATMENT : They are treated by surgical repair of the opening before school age
.
ALL THESE DEFECTS MAY LEAD TO
CONGESTIVE HEART FAILURE
(CHF).
V . CONGESTIVE HEART FAILURE (CHF):
Inability of the heart to pump an adequate amount of blood to the systemic circu
lation to meet the demands of the body.
Clinical manifestations :
• • • • • • • • • • • • • Tachycardia Sweating Decreased urine output Fatigue Weakness Anor
Weak pulses Cardiomegaly Edema in lower limps Weight gain Tachypnea Hypotension
TREATMENT AND NURSING CARE Improve cardiac function by medications as digitalis
Remove accumulated fluids by diuretics Decrease cardiac demand by bed rest Impro
ve tissue oxygenated by O2 therapy Decrease pain by analgesics
VI . HYPERTENSION ( HTN ) :
It is the elevation of blood pressure due to increase cardiac output or increase
resistance in the peripheral arteries or gland disorders.
Clinical manifestations: • Headache • Dizziness • Sweating • Drowsiness of eyes
TREATMENT AND NURSING CARE:
Bed rest Monitoring of blood pressure B.P Medications - antihypertensive drugs S
uitable diet ( low salt diet )

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