Congenital Heart Disease

Subject: Child Health Nursing

Overview

A abnormality with the heart's anatomy that exists from birth is referred to as a congenital heart defect (CHD), sometimes known as a congenital cardiac anomaly or congenital heart illness. The precise sort of issue will determine the signs and symptoms. Symptoms might range from nonexistent to potentially fatal. They might include fast breathing, blue skin, low weight growth, and feeling exhausted when they are present. Chest discomfort is not brought on by it. Congenital heart disease affects 5 to 8 children out of every 1000 live births. Genetic and environmental factors are the main causes of congenital heart disease, but the exact cause is still unknown. Most congenital heart problems do not co-occur with other diseases. Clubbing, cyanosis, tachycardia, irritability, and other symptoms are common. Give Morphine during Tet spells to reduce the associated infundibular spasm, Prophylactic: Propranolol/Inderall Prostaglandin E (to maintain the ductus arteriosus patent), and Prophylactic antibiotic to prevent endocarditis. Constant monitoring with pulse oximetry + oxygen therapy + rests in the right position + emotional support. Health maintenance and follow-up, promoting growth and development.

Congenital Heart Disease

A abnormality with the heart's anatomy that exists from birth is referred to as a congenital heart defect (CHD), sometimes known as a congenital cardiac anomaly or congenital heart illness. The precise sort of issue will determine the signs and symptoms. Symptoms might range from nonexistent to potentially fatal. They might include fast breathing, blue skin, low weight growth, and feeling exhausted when they are present. Chest discomfort is not brought on by it. Most congenital cardiac conditions are not accompanied by other illnesses. Cardiac failure is one of the complications that can arise from heart abnormalities.

Children with congenital cardiac disease are affected 5 to 8 times per 1000 live births.

Causes

  • Unknown
  • Genetic and environmental factors
  • Maternal factors: diabetes, alcohol consumption, infection during 1st trimester of pregnancy
  • Family history of cardiac defect
  • Congenital defects

Diagnosis

  • Fetal echocardiology
  • Abdominal USG
  • Transvaginal USG
  • Chest x-ray

Classification

  • Cyanotic congenital heart disease

When deoxygenated blood bypasses the lungs and enters the systemic circulation or when a combination of oxygenated and unoxygenated blood enters the systemic circulation, a congenital heart defect (CHD) known as a cyanotic heart defect (CHD) results. The heart's structural flaws, such as right-to-left shunting, bidirectional shunting, and great artery malposition, as well as any condition that raises pulmonary vascular resistance, are to blame. The growth of collateral circulation is the end result.

Signs and Symptoms

  • Clubbing
  • The patient assuming a crouching position
  • Cyanosis - facial discolouration (particularly the lips) and digit discolouration (fingers & toes).
  • Crying
  • Crabbiness/irritability
  • Tachycardia
  • Tachypnea
  • A history of inadequate feeding.
  • Unusually large toe & finger nails.
  • Delayed development (both biological & psychological).

Management

  • Morphine during Tet spells to decrease associated infundibular spasm.
  • Prophylactic: Propranolol/Inderall
  • Prostaglandin E (to keep the ductus arteriosus patent)
  • Prophylactic antibiotic to prevent endocarditis
  • Surgery: Glenn Shunt, Hemi-Fontan Procedure, Fontan Procedure. The purpose of these operations is to redirect the blood flow of the deoxygenated blood to the lungs by attaching the Superior Vena Cava directly to the Pulmonary Artery causing the blood that flows into the lungs to be oxygenated before entering the chambers on the right side of the heart. Mathematical models are used to address the issue of pressure level alterations of circulation after the procedures. The pulmonary pressure resistance in the cardiopulmonary connection is increased, and these models permit clear analyses of the pressure increase allowing doctors to avoid possible venous circulation congestion.

Nursing Management

  • Relieving respiratory distress.
  • Keep child in semi-upright position.
  • Cleaning oral and nasal secretions.
  • Oxygen therapy.
  • Continuous monitoring of respiratory pattern.
  • Improving cardiac output.
  • Provide rest and comfort.
  • Minimum exercise.
  • Maintaining normal body temperature.
  • Administering medication.
  • Improving adequate oxygenation.
  • Continuous monitoring by pulse oximetry + oxygen therapy + rests in proper position + emotional support.
  • Provide adequate nutrition.
  • Provide small frequent feeding.
  • Oral feeding should be limited to 15-20 minutes.
  • Nasogastric tube feeding if needed.
  • Daily weight and recording.
  • Maintain intake and output chart.
  • Preventing infections.
  • Avoid exposure to infections and infected person.
  • Adopt good hand washing practices.
  • Maintaining general cleanliness and hygienic measures.
  • Immunization.
  • Health maintenance and follow-up, promoting growth and development.
  • Care for child undergoing cardiac surgery.
  • Preoperative care.
  • Pre-op assessment.
  • Lab investigation.
  • Physical preparation.
  • Premedication.
  • Teaching.
  • Explanation on outcome of surgery.
  • Consent and psychological preparation to child and parent for surgery.
  • Post surgery care.
  • Monitor vital signs, skin color, capillary refill, CVP line, Spo2.
  • Maintaining respiratory status.
  • Provide maximum rest and comfort.
  • Maintain fluid and electrolytes.
  • Observation for complications.
  • Emotional support.
  • Plan for discharge and home care.
Things to remember
  • A abnormality with the heart's anatomy that exists from birth is referred to as a congenital heart defect (CHD), sometimes known as a congenital cardiac anomaly or congenital heart illness.
  • Children with congenital cardiac disease are affected 5 to 8 times per 1000 live births.
  • Congenital cardiac disease is mostly brought on by genetic and environmental factors, while the exact reason is yet unclear.
  • During Tet episodes, morphine is used to lessen the accompanying infundibular spasm.
  • a preventative antibiotic to ward against endocarditis
  • It is essential to continuously check the breathing rhythm.
  • Continuous pulse oximetry monitoring, oxygen treatment, correct positioning when resting, and emotional support
  • Maintaining and monitoring one's health while encouraging growth and development

 

Questions and Answers

A abnormality with the heart's anatomy that exists from birth is referred to as a congenital heart defect (CHD), sometimes known as a congenital cardiac anomaly or congenital heart illness. The precise sort of problem will determine the signs and symptoms.

  • Unknown
  • Environmental and genetic influences
  • Diabetes, drinking, and infections during the first trimester of pregnancy are Maternal risk factors.
  • Familial cardiac defect history
  • Inherited flaws

 

  • Cyanotic congenital heart disease: Deoxygenated blood bypassing the lungs and entering the systemic circulation, or a combination of oxygenated and unoxygenated blood entering the systemic circulation, are the two main causes of the congenital heart defect (CHD) known as cyanotic heart defect. The heart's structural flaws, such as right-to-left shunting, bidirectional shunting, and great artery malposition, as well as any condition that raises pulmonary vascular resistance, are to blame. The growth of collateral circulation is the end result.

 

  • Reducing respiratory discomfort:

    • Keep the youngster partially upright.
    • Removing nasal and oral snot
    • Oxygen treatment
    • Ongoing observation of breathing patterns

  • Improving cardiac output:

    • Offer solace and comfort
    • little exercise
    • keeping the body's temperature normal
    • medicine administration

  • Improving adequate oxygenation:

    • Continuous pulse oximetry monitoring, oxygen therapy, correct positioning While you rest, and emotional support.
    • Give enough nourishment
    • Offer small, regular meals.
    • 15-20 minutes should be the maximum time for oral feeding.
    • If necessary, nasogastric tube feeding
    • Daily weight and keeping track
    • Upkeep of the output and intake chart

  • Preventing infections:

    • Keeping diseases and sick people at bay
    • Use effective hand cleaning techniques.
    • preserving general hygienic standards and cleanliness
    • Immunization
    • Maintaining and monitoring one's health while encouraging growth and development

  • Care for child undergoing cardiac surgery:

    • Preoperative care
    • Pre-op evaluation
    • laboratory analysis
    • Physical acquiescence
    • Premedication
    • Teaching
    • An explanation of the surgery's results
    • Obtaining parental and kid consent and preparing them psychologically for surgery
    • after-surgery care
    • Check your vital signs, skin tone, capillary refill, CVP line, and Spo2 levels.
    • keeping respiratory status constant
    • give the most comfort and rest possible
    • Maintain electrolytes and fluids
    • Looking out for potential issues
    • emotional assistance
    • Prepare for your discharge and home care

 

  • Clubbing
  • Taking a crouched position, the patient
  • Cyanosis is a condition that causes digit and face discoloration, especially on the lips (fingers & toes).
  • Crying
  • Crabbiness/irritability
  • Tachycardia
  • Tachypnea
  • A pattern of malnutrition in feeding.
  • Unusually big fingernails and toes.
  • Delayed progress (both biological & psychological).
  • During Tet episodes, morphine is used to lessen the accompanying infundibular spasm.
  • Prophylactic: Propranolol/Inderall
  • Psoas toxin E (to keep the ductus arteriosus patent)
  • Using a preventative antibiotic to ward off endocarditis
  • Glenn Shunt, Hemi-Fontan, and Fontan procedures all need surgery. By connecting the Superior Vena Cava directly to the Pulmonary Artery, which causes the blood flowing into the lungs to be oxygenated before accessing the chambers on the right side of the heart, these surgeries have the goal of redirecting the blood flow of the deoxygenated blood to the lungs. To address the issue of circulatory pressure level changes following the procedures, mathematical models are applied. These models make it possible to clearly analyze the pressure increase and help doctors avoid potential venous circulation congestion. The pulmonary pressure resistance in the cavopulmonary link is raised.

 

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