TX: cath repairs, surgical repair with bypass, highest risk w/ early surgical repair AV Canal : ASD, VSD, 1 common valve, (no mitral/tricuspid), most common in kids with downs, extra blood circulates in the lungs Assess: dyspnea, lack of apetite, poor wt gain, cyanosis, fatigue, edema Care: feeding, growth, S&S of CHF TX: surgery by 6 mo, prophylactic tx for ineffective endocarditis PDA : patent ductus arteriosus, normal component of fetal circulation, bypasses lungs with placenta, most ductus arteriosis close within 48 hrs in full term infants, severity depends on size, gestation, degree of pulmonary vascular resistance Risk: resp inf & pneumonia, no long term effects with early tx Assess: woosh, murmur, tachypnea, poor feeding & wt gain, fatigue Care: strict I&O, freq rest periods, daily wt TX: dopamine, digoxin, surgical ligation, cardiac cath coil, ibuprofen & indomethacin to close Coarctation of the aorta : narrowing of descending aorta, near ductus arteriosus or left subclavian artery Assess: Ha, asymptomatic, upper pulses> lower, systolic ejection murmur, htn, SOB, poor feeding & growth, S&S of CHF Care: monitor perfusion, obtain 4 extremity BP, pre & post ductal O2 readings (pre R arm open PDA = no reading, post lower O2 reading anywerhe else) TX: cardiac cath, balloon dilation, stent, complications r/t decreased circulation in lower extremities Aortic Stenosis : obstruction of blood flow from LV to aorta, aortic regurgitation, valve stenosis or narrowing Assess: asymptomatic- fatal in newborn, chest pain, fatigue, syncope, murmur, SOB, hypotention, weak pulses, tachycardia, poor feeding Care: S&S of CHF, pain management TX: if severe in newborns, prostaglandin E to keep PDA open, balloon valuloplasty, surgical repair Pulmonic Stenosis: narrowing of pulmonic valve or area near valve, obstructs blood flow into pulmonary artery, leads to right ventricular hypertrophy Assessment: increased work of R vent, BP/HR, CHF, hepatomegaly, murmur, SOB Care: calm environment to reduce O2 requirements TX: prophylactic for endocarditis, balloon dilation of valve or surgical resection
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- Spring '17
- pulmonary blood flow