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Precipitating Factors - Problems during pregnancy - Exposure to teratogens - Taking of teratogenic medications during pregnancy - 4 TOOs (too young, too old, too sick, and too many pregnancies/deliveries)
Congenital deformity of the leaflets of the pulmonic valve Echocardiography: size of pulmonary artery Pulmonary valvotomy and/or balloon valvuloplasty Beta-blocker (Propanolol) Chest pains Narrowing of the entrance of the pulmonary artery Pulmonay Stenosis afterload pressure in the right side of the heart
pressure in the right side of the heart pushes deoxygenated blood to other possible exits
amount of deoxygenated blood going to the pulmonary artery deoxygenated blood going to the lungs lung perfusion oxygenated blood from the lungs going to the left side of the heart
Deep-breathing exercises
Tachypnea
Dyspnea
workload/effort of the right ventricular muscles to Deep-breathing push deoxygenated blood exercises out to the stenosed Dysrhythmias pulmonary artery Echocardiograhy & ECG results: Right Ventricular enlarged chamber of the right Hypertrophy side of the heart
O2 saturation
Aortal opening in the left heart is faced slightly to the right Diaphoresis Promote rehydration Poor feeding Aorta is dextropositioned (positioned to the right side)
Overriding Aorta (aorta overriding both ventricles) Blablock-Taussig Operation Brock Procedure
Loud, harsh, widely transmitted murmur or a soft scratchy localized systolic murmur in left 2nd, 3rd, or 4th parasternal space
Deoxygenated blood from the right ventricle shunted to the left ventricle and aorta
Deoxygenated blood mixes with the oxygenated blood in the left ventricle and aorta
O2 administration Hypercyanotic attacks Knee-chest position (tet spells) Morphine Sulphate - General cyanosis - Hyperpnea Promote rehydration - Irritability Promote rest periods - Diaphoresis - Limpness Promote safety - Loss of consciousness Risk for Injury r/t sudden loss of consciousness and weakness
Syncope Hypoxemia
Failure to thrive
Lab. Results: polycythemia, Hgb., Hct., total polycythemia RBC count blood viscosity embolism thrombophlebitis Thrombolytic medications (Alteplase recombinant) Heart by-pass surgery
Activity Intolerance r/t decreased energy and oxygen supply to the body and fatigue Promote rest periods
Plan activities that limit exertion and promote energy conservation Antianginal medications (Ranolazine)
oxygenated blood supply in the cardiac circulation O2 supply to the cardiac muscles/tissues
hepatomegaly
Non-pharmacological pain relief (ex. Back rub, diversional activities like playing toys, etc.) Risk for Decreased Tissue Perfusion r/t decreased amount of oxygenated blood in the circulation
Hepatic dysfunction
Cardiovascular accident
Underlying Factors Pathophysiologic Changes Underlying Heart Defect Signs and Symptoms Nursing Diagnoses
Hepatic Failure
LEGEND:
Submitted by: Hannah Marga C. Dalman Geraldine A. Ferraren John Kevin C. Giangan A3 Submitted to: Asst. Prof. Freslyn Lim, NCM 104, Pediatric Rotation, SMC
DEATH