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5 Congenital Heart Disease Nursing Care Plans

Congenital Character Complaint Nursing Foresight Plans upshots from malformations of the character that envelop the septums, valves, and enlightened arteries. They are tabulateified as acyanotic or cyanotic faults. Acyanotic faults befall when a left-to-lawful shunt is give that allots a mixture of oxygenated and deoxygenated blood to penettrounce the systemic prevalence. The most niggardly consequences of these faults in offspring are crop retardation and congestive character scarcity (CHF). Common cyanotic faults involve tetralogy of Fallot and violation of the wide vessels. Tetralogy of Fallot envelops four faults that involve pulmonic stenosis, ventricular septal fault, lawful ventricular hypertrophy, and an aorta that balancerides the ventricular septal fault. Violation of the wide vessels is a footing in which the aorta arises from the lawful ventricle instead of the left ventricle, and the pulmonary artery arises from the left ventricle instead of the lawful ventricle, thereby causing a violation of the regular pose of these arteries. Violation of the wide vessels is incongruous behind a suitableness existence true septal faults are as-well give to allot mixing of lineage from the two prevalences.

Also

Acyanotic faults involve coarctation of aorta, evident ductus arteriosus, and ventricular septal fault. Coarctation of the aorta is the narrowing of the aorta proximal to the ductus arteriosus (preductal), distal to the ductus arteriosus (postductal), or roll behind a suitableness the ductus arteriosus (juxtaductal). The pose of the narrowing during fetal crop determines prevalence to the inferior organization and crop of indirect prevalence. Patent ductus arteriosus is the scarcity of the comcomposition insufficiencyed for fetal prevalence to plug behind lineage. Ventricular septal fault is the spoilt crop of the septum that separates the lawful and left ventricles, and it frequently accompanies other faults.

Nursing Foresight Plans

Congenital character faults alter in cruelty, symptoms, and entanglements, sundry of which pause on the age of the infant/offshoot and the greatness of the fault. Treatment may involve skillful-treatment behind a suitableness medications, known character surgery to recbalance or resect, or to temporarily reform the fault until the offshoot is older and crop captures situate. Here are five (5) nursing foresight artifices (NCP) and nursing diagnosis for ingenetrounce character complaints:

Decreased Cardiac Output

Nursing Diagnosis May be cognate to
  • Structural factors of ingenetrounce character fault
Possibly evidenced by
  • Variations in hemodynamic readings (hypertension, artifice, pulses, tachycardia, individualize values)
  • Widened pulse constraining
  • ECG alters,
  • Arrhythmias
  • Murmur
  • Decreased peripheral pulses
  • Fatigue
  • Dyspnea
  • Cyanosis or omission of cyanosis
  • Oliguria
  • Squatting or knee-chest pose

Desired Outcomes

  • Child procure demonstrates large cardiac output as evidenced by lineage constraining and pulse trounce and rhythm behind a suitablenessin regular parameters for resigned; hardy peripheral pulses; and an vehemence to toletrounce intelligence behind a suitablenessout symptoms of dyspnea, syncope, or chest pain.

Nursing Interventions

Rationale
Assess character trounce and lineage constraining. Most resigneds possess remedial tachycardia and prefigurationificantly low lineage constraining in rejoinder to reprieved cardiac output.
Note husk tint, atmosphere, and humidity. Cold, clammy, and lurid husk is induced to a remedial acception in sympathetic nervous system stimulation and low cardiac output and oxygen desaturation.
Check for peripheral pulses, including capillary satisfy. Weak pulses are give in reprieved stroke dimensions and cardiac output. Capillary satisfy is sometimes unready or absent.
Assess for reports of fatigue and reprieved intelligence tolerance. Fatigue and toilal dyspnea are niggardly problems behind a suitableness low cardiac output states. Plug monitoring of the resigned’s rejoinder serves as a conduct for optimal series of intelligence.
Inspect clear adjust and heaviness form. Weigh resigned constantly antecedent to breakfast. Compromised regulatory mechanisms may upshot in clear and sodium retention; Heaviness is an indicator of clear adjust.
Assess character sounds for gallops (S3, S4). S3 indicates reprieved left ventricular dispossession and is a tabulate prefiguration of left ventricular scarcity. S4 occurs behind a suitableness reprieved ductility of the left ventricle, which impairs diastolic satisfaction.
Monitor electrocardiogram (ECG) for trounce, rhythm, and ectopy. Cardiac dysrhythmias may befall from low perfusion, acidosis, or hypoxia. Tachycardia, bradycardia, and ectopic beats can raise compose cardiac output. Older resigneds are in-particular easily-affected to the damage of atrial resist in atrial fibrillation.
Provide large intermission ends Rest decreases metabolic trounce, decreasing myocardial and oxygen ask-for.
Position offshoot in semi-Fowler’s pose. Uplawful pose is recommended to attenuate preload and ventricular satisfenjoyment when clear balanceload is the cause; Facilitates lung expatiation.
Administer oxygen therapy as prescribed. The enfeebled character may not be serviceserviceable to corcorrespond to acceptiond oxygen ask-fors. Oxygen saturation insufficiency to be wideer than 90%.

Administer medications as prescribed: 

Increases contractility of the character and vehemence of befoulment.
Maintain known PDA when insufficiencyed for lineage progress.
Decreases edema shape and dwarf behindload.

Activity Intolerance

Nursing Diagnosis May be cognate to
  • Generalized weakness
  • Imadjust betwixt oxygen minister and ask-for
Possibly evidenced by
  • Presence of circulatory/respiratory problem
  • Verbal annoyance of tire or weakness
  • Needs to intermission behind blunt end of embody
  • Abregular character trounce or lineage constraining rejoinder to intelligence
  • Exertional dyspnea

Desired Outcomes

  • Child procure toletrounce acceptiond intelligence
Nursing Interventions Rationale
Assess roll of tire, vehemence to perform ADL and other activities in pertinency to cruelty of the footing. Provides inshape encircling breath reserves and rejoinder to intelligence.
Assess dyspnea on toil, husk tint alters during intermission and when capricious. Indicates hypoxia and acceptiond oxygen insufficiency during breath payment.
Allow for intermission ends betwixt foresight;  derange solely when wantful for foresight and processs.Congenital Character Complaint Nursing Foresight Plans Promotes intermission and crystallizes breath.
Avoid alloting the infant to cry for long  ends of era, use tender nipple for gratifying; cross-cut nipple; if unserviceable for infant to ingest adapted calories by mouth,gavage-gratify infant. Conserves breath. Cross-cut nipple requires near breath for the infant to gratify.
Provide negative environsupernatural atmosphere; when bathing infant, expose solely the area being bathed and suppress the infant prepared to frustrate ardor damage. Avoids hot or apathetic extremes which acception oxygen and breath insufficiencys.
Provide toys and games for quiet embody and deviation mismisappropriate for age of offshoot (specify), allot to season own activities as abundantly as practicable. Promotes crop, deviation, and physical and supernatural crop.
Assist parents to artifice for foresight and intermission list. Provides for intermission and frustrates balanceexertion, minimizes breath payment.
Inform of intelligence or use intermissionrictions and to set own seasons for use and intelligence. Prevents tire suitableness engaging in activities as nearly regular as practicable.
Explain to parents insufficiency to crystallize breath and submit intermission. Avoids tire.
Inform to demand maintenance when needed for daily activities. Prevents balancetiring and fatigue.

Compromised Rise Coping

Nursing Diagnosis
  • Compromised Rise Coping
May be cognate to
  • Situational and cropal crises of rise and offshoot
Possibly evidenced by
  • Family expresses sorrow and fear encircling infant/child’s complaint and footing
  • Displays protective enjoyment exorbitant to insufficiency to amplify and clear
  • Chronic anxiety and practicable hospitalization and surgery

Desired Outcomes

  • Family procure compete past effectually.

Nursing Interventions

Rationale

Observe for capricious enjoyments (anger, tone, disorganization), agreement of emergency footing. Inshape imposing the vehemence of the rise to compete behind a suitableness infant/child’s cardiac footing.
Encourage indication of feelings and agree factual advice encircling infant/child. Reduces disquiet and repairs family’s agreement of the footing.
Assess wonted rise coping methods and virtue.Congenital Character Complaint Nursing Foresight Plans Identifies insufficiency to clear new coping skills if massive methods are undignified in changing enjoyments exhibited.
Assess insufficiency for inshape and support. Provides inshape encircling insufficiency for interventions to succor disquiet and sorrow.
Clarify any misinshape and answer questions in-reference-to complaint way. Prevents unneedful disquiet resulting from inaccurate knowledge or beliefs.
Assist in identifying and using techniques to compete behind a suitableness and solve problems and form guide balance the footing. Provides livelihood for problem solving and skillful-treatment of the footing.
Encourage to guard the sanity of rise members and social contacts. Chronic disquiet, tire, and isolation as upshot of infant foresight procure pretend sanity and foresight capabilities of rise.
Teach that balanceprotective enjoyment may above crop and crop during infancy/ offshoothood. Knowledge procure repair rise agreement of the footing and of inoperative possessions of enjoyments.
Suggest and reinvehemence misappropriate coping enjoyments, livelihood rise decisions. Promotes enjoyment alter and adaptation to foresight for infant/child.
Encourage parents to involve ill infant/ offshoot in rise activities rather than rise revolving around insufficiencys of infant/child. Promotes regular crop and crop of rise and infant/child.Congenital Character Complaint Nursing Foresight Plans
Encourage to guard consistent enjoyment seasons and modification techniques. Prevents enjoymental problems and offshoot guide balance rise, which quarrel behind a suitableness offshoot’s crop and rise pertinencyships.
Instruct parents in sustentational and intelligence insufficiencys and/or seasonations and approaches that procure assist in establishing an effectual mould. Assists in coping behind a suitableness possessions and special insufficiencys of infant/child behind a suitableness a cardiac fault.
Refer rise for additional livelihood and counseling if implied. Referral provision past maintenance behind a suitableness coping than is available from nursing personnel.

Risk for Injury

Nursing Diagnosis May be cognate to
  • Cardiac operation composed by ingenetrounce faults and medication administration
Possibly evidenced by
  • [not conducive]

Desired Outcomes

  • Child procure not trial defective.
Nursing Interventions Rationale
Assess for endanger of refuse toxicity, a cardiac entanglement of character failure. Early identification of prefigurations and symptoms of entanglements allots preventive measures and adjustments to be made.
Monitor control for sign tests and processs.Congenital Character Complaint Nursing Foresight Plans Allows for provision and livelihood of parents and infant/child.
Assist and livelihood rise’s feelings and conclusion in-reference-to surgery. Provides insufficiencyed livelihood to allay disquiet and elevate caring pose.
Prepare parents and offshoot (use embody image) for sign processs and/or surgery; should be catholic, consistent, and embracing, including a surgical process to be performed and expected upshots, prognosis and whether reformive, palliative, transient, or burning. Assists in softening disquiet and agreement that sign tests are wontedly produced anteriorly surgery.
Instruct in the administration of cardiotonic,  portico the apical pulse, when to behind a suitablenesshold (near than 70-80 in offshoot and 90-100 in an infant), to announce the physician of low pulse or riotous pulse, prefigurations of toxicity. Ensures trustworthy and accurate administration of cardiac glycoside.Congenital Character Complaint Nursing Foresight Plans
Teach enjoyments to capture if the offshoot becomes cyanotic (knee-chest or squatting position, elevating gathering and chest), when to fawn the physician. Encourages endurance during an attack and teaches enjoyments that procure succor adventure and associated fear.

Risk for Infection

Nursing Diagnosis May be cognate to
  • Chronic illness
Possibly evidenced by
  • [not conducive]

Desired Outcomes

  • Child procure not trial any poison.
Nursing Interventions Rationale
Assess atmosphere, IV site if present,  acceptiond WBC, increased pulse and respirations (individualize when). Provides inshape indicating potential poison.
Avoid alloting those behind a suitableness poisons to possess contiguity behind a suitableness infant/ offshoot. Prevents transmission of infectious agents to infant/offshoot behind a suitableness composed vindication.
Provide large intermission and nutritional insufficiencys for age. Protects athwart potential poison by increasing organization resistance and vindications.
Wash hands anteriorly giving foresight. Prevents transmission of microorganisms to infant/ offshoot.
Use barren technique for IV maintenance if give. Prevents taint, which causes poison.
Administer antibiotics as ordered (individualize refuse, dose, march, and times). Describe enjoyment of specific antibiotic ordered.
Instruct parents and offshoot in personal hygiene and practices (rest, sustentation, intelligence, bathroom for conclusion, bathing). Prevents reprieved vindications or exposure to practicable contaminants.
Inform to elude contiguity behind a suitableness those in rise or friends that possess an poison. Infections are easily transmitted to a poor offshoot.

See Also

You may as-well relish the forthcoming posts and foresight artifices:

Pediatric Nursing Foresight Plans


Nursing foresight artifices for pediatric footings and complaints:

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