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General Objective: At the end of the case study, the level 3 nursing students will be able to expound and connect all ideas and knowledge gained to the nursing approach in doing valid and outmost care with the patient diagnosed of CHD D-TGA, PDA, PFO. PFO.
Specific Objectives: As supported by our main objective, the level 3 student nurses will be able to:
1. Familiarize with the background of what Congenital Heart Disease and Patent Ductus
Arteriosus is all about;
2. Recognize the predisposing and precipitating factors that may increase the development of
Patent Ductus Arteriosus; Arteriosus; 3. Review and understand the Anatomy and Physiology of the Cardiovascular System and each functions;
4. Explain and Illustrate the Pathophysiology of Patent Ductus Arteriosus; Arteriosus; 5. Determine what specific laboratory results that may lead to Patent Ductus Arteriosus; Arteriosus; 6. Describe the potential complications related to Patent Ductus Arteriosus. Arteriosus. 7. Develop a comprehensive nursing care plan, with a principle of SMART, that is applicable to
the client diagnosed with Patent Ductus Arteriosus; Arteriosus; 8. Provide a well-develop Health Teaching using the METHODS formula to promote positive continuity of care to the patient after discharge which would be in great help for his condition; and 9. Elaborate and appreciate the importance of the Cardiovascular System.
NAME: GENDER: AGE: ADDRESS: BIRTHDATE: BIRTHPLACE: RELIGION: CIVIL STATUS: NATIONALITY: ATTENDING PHYSICIAN: DATE AND TIME OF ADMISSION: CHIEF COMPLAINT: ADMITTING DIGNOSIS:
C.T.E Female 1 6/12 y.o 129 Anonas Ext. Sikatuna Village Quezon City January 04, 2008 Tagbilaran Bohol Roman Catholic Single Filipino Dr. J.D. July 16, 2009; 8:10 PM Cyanosis CHD D-TGA, PDA, PFO
INITIAL V/S (9:00AM) T 37.3 ̊C HR 165 RR 65
A. NURSING HISTORY (Gordon’s 11 FUNCTIONAL HEALTH PATTERNS) )
1. Health Perception According to the mother, being in the hospital makes C.J.E. cry a lot especially when inserted with IV needle/catheter. Also, during phlebotomy, she sees her daughter in so much suffering. However, when visited by nurses, C.J.E. doesn’t cry a lot and seems to understand that they are there just to take care of her. She doesn’t manifest any avoidance behavior 2. Nutritional-Metabolic Pattern C.J.E. is on DAT diet. Her mother reveals that she likes to brestfeed very often but can’t eat nor drink water that much. Because of her illness, she has minimal appetite for food. She can’t tolerate large amount of them because it will cause her dyspnea (shortness of breath). C.J.E. eats in very small, frequent feedings and her favorites are biscuits and fried chicken. On the other hand, C.J.E. drinks water with the use of a dropper containing just 2ml water. 3. Elimination Pattern C.J.E’s bowel movement is regular. She defecates semi-solid to solid, brownish to yellowish stool. She is not constipated at all. However, her voiding pattern is impaired. C.J.E. experiences extreme oliguria in the absence of Furosemide. She even cries so much if she can’t pass urine thus, making her diuretic-dependent. 4. Activity and Exercise C.J.E. learns to crawl at her 1st year of age, as well as grasping of objects, saying her first word, waving goodbye and rolling over the bed. She is fond of grasping any object within her reach and loves to play with them. Her mother shares, “Pag latag ko sa kanya sa kama, nagpapaikot-ikot na siya. Parang gumigiling siya tuwing naririnig yung kantang Igiling-giling”. However, upon admission to PCMC, C.J.E. becomes generally lethargic. 5. Sleep-Rest Pattern C.J.E.manifests sleep disturbances. She wakes up at night every now and then. Her sleeping pattern is interrupted and not comfortable. Her mother tells, “Hindi talaga tuloy-tuloy ang pagtulog niya. `Ni hindi nga siya nakakatulog ng matagal at mahimbing e. Kapag dumedede lang siya nakakatulog ng matiwasay”. 6. Cognitive-Perceptual Pattern At 1 year of age, C.J.E. utters the words “Ma” and “Pa”. She is very attracted to anything that’s color red and easily turns her head upon hearing her name. According to her mother, C.J.E. speaks words on her own, without having to teach them to her. 7. Self-Perception Pattern C.J.E.’s overall response to hospitalization is somewhat negative. Though she seems okay at times, her cries and grimaces show that she feels very ill and truly suffering. 8. Role-Relationship Pattern
C.J.E. is the 2nd and youngest child in the family. Her eldest brother is 5 years old. C.J.E. is closest to her mother. Her mother even shares, “Gustong-gusto niya lagi magpakarga sa akin. Paborito niya yung palagi ko siyang hinahalikan”. 9. Sexuality-Reproductive Pattern C.J.E. is a1 ½-year old, baby girl. 10. Values-Belief Pattern Her family is Roman Catholic. Her mother always brings her to the church when hearing mass every Sunday. They go to mass in their hometown in Bohol. But now, that C.J.E. is hospitalized, her mother can only pray, “Panginoon, sana naman po gumaling na ang anak ko”. 11. Coping-Stress Pattern C.J.E. can only stop crying upon breastfeeding. Also, she likes playing with her small toys. Divertional activities can be carrying her, showing her bright-colored stuff which she can touch and play with. C.J.E. smiles easily and is not hard to take care of. A. PHYSICAL ASSESSMENT
ASSESSMENT RESULT pale skin with 0/4 functional level General Health & Appearance (cannot move without assistance); There is presence of pale skin due weakness on both extremities; poor to poor peripheral circulation and weight gain; chest circumference of cardiac output gain; 44 cm Cyanosis Skin There is presence of cyanosis because of increased concentration of deomyhemoglobin. deomyhemoglobin. Head is larger than the body; Head Circumference of 44.5cm; absence of Head nodules; hair strands are thin and the scalp is not dry; color of the hair is black Pupils are symmetrical, round, and Eyes reactive to light and accommodation; (+) droopy eyelids Ears Symmetrical and with good hearing INTERPRETATION & ANALYSIS
No deviation, nasal mucosa appears Nose pink and without abnormal discharge, and no nasal polyps or other lesions are noted Present because of decrease in Mouth & Throat Circumoral cyanosis hemoglobin concentration; associated with nipple or breast feeding Symmetrical and palpations reveal no Neck nodules and masses; (+) distended neck vein Accumulation of blood in veins that are returning blood to the heart Inadequate systemic perfusion; Nails Poor capillary refill poor capillary perfusion and cardiac output Flat, NABS, soft; soft; Abdomen abdomen circumference of 39 cm There Respiratory No chest pain, no dyspnea and cough noted; (+) murmur is presence of murmur
because of valves does not close tightly and blood leaks backward; turbulent blood flow through the heart valves
Cardiovascular System Gastrointestinal Genitourinary Musculoskeletal
tightness; (+) anterior chest bulge; tightness; abnormal heart sounds With good bowel elimination Urine: amber, aromatic smell; regular frequency.
There is open valves resulting to presence of murmur
There is severe muscle weakness in Poor cardiac output both upper and lower extremities. No deformities or swelling on the joints
and bones Neurologic Awake and alert
B. MEDICAL HISTORY
A. History of present illness The mother of the patient was said to be working in the stock room in a mall in Bohol and for the whole 9 months of her pregnancy to the patient, she was exposed to insecticides esp. Baygon. The patient was healthy when she was born until she was 2 month old when her mother noticed a bluish-black discoloration of her nails and her heart beat was faster than usual. Her breast feeding was not regular too plus she doesn’t like bottlefeeding. The mother then brought her to Romero Hospital in Bohol and the patient was suspected to have CHD. Lanoxin, Furosemide and Aldactone were given for maintenance. Laboratory exams were done such as 2D echo, chest X-ray and ECG in Borja Hospital also in Bohol. On March 18, 2008, the patient was 2 month old and was diagnosed with CHD, PDA, TGA and PFO. She was advised for operation but due to financial constraints, the operation was not done. On October 2008, they were referred to Philippine Heart Center. One day prior to admission, the patient was screened, had checked-up, CBC was done and showed an elevated Hematocrit and a decrease in her Platelet count. Her operation was scheduled then but her HCT and Platelet count should be fixed first. They were then referred to Philippine Children’s Medical Center to fix the abnormality in her blood. And at 8:10 pm of July 16, 2009 the patient was admitted at 1B ward of PCMC. She was scheduled for platelet transfusion and phlebotomy. CBC was done and Fresh Frozen Platelet transfusion and phlebotomy followed. On the night of July 27, 2009, CBC was done again, additional platelets were given. After all the treatment done at PCMC, the patient went to PHC to have her operation done. B. History of Past illness The patient was the second child of her mother. The first child was healthy because she was not yet exposed to any chemicals during that time. When the patient was born, she took injectables because of her mother UTI during the pregnancy. The mother is said to be G2P2 and was on her 36th week of gestation. And on January 4, 2008 a healthy 7.5 lbs baby girl was born. The patient had regular pre-natal and after birth check ups and after being diagnosed with her disease, she had her check-ups every 2 months. The patient also experienced cough, colds and fever. She cannot able to stand or even sit alone. When she was 3 month old, she took her 3 medications namely, lanoxin, aldactone and furosemide.
C. Family history Mother: (+) UTI. She took amoxicillin on the first diagnosis and on the recurrence of the said disease during her pregnancy to the patient. Father: none. GROWTH and DEVELOPMENT GROSS MOTOR Head control Rolls over Sits alone Crawls Cruises Stands alone Walks alone Climbs up/down the stairs Catches ball ADAPTIVE Grasps objects Reach for objects Transfers objects Gives object/request Drinks from cup Writes alphabet LANGUAGE socialize Imitates sounds Understand gestures First word Indicates needs Follow directions Tell little stories Gives full name AGE Cannot do it When she was 1 year old Cannot do it When she was 1 year old Cannot do it Cannot do it Cannot do it Cannot do it She can things only, 9 months AGE When she was 1 year old When she was 1 year old When she was 1 year old can throw it too. Points to what she wants, 9 month old Cannot do it Cannot do it AGE When she was 1 year old When she was 7 month old When she was 8 month old When she was 1 year old (mama) Points out on what she wants. 9 month old Cannot do it Cannot do it Cannot do it
PERSONAL-SOCIAL Smiles Turns to sound
AGE When she was 4 month old When she was 6 month old
Peek- a- boo Close-open hands Wave bye-bye
When she was 10 month old When she was 9 month old When she was 1 year old.
ANATOMY AND PHYSIOLOGY Patent ductus arteriosus (PDA) is a heart problem that occurs soon after birth in some babies. In PDA, abnormal blood flow occurs between two of the major arteries connected to the heart. Before birth, the two major arteries—the aorta and the pulmonary artery—are connected by a blood vessel called the ductus arteriosus. This vessel is an essential part of fetal blood circulation. Within minutes or up to a few days after birth, the vessel is supposed to close as part of the normal changes occurring in the baby's circulation. In some babies, however, the ductus arteriosus remains open (patent). This opening allows oxygen-rich blood from the aorta to mix with oxygen-poor blood from the pulmonary artery. This can put strain on the heart and increase blood pressure in the lung arteries.
Normal Heart and Heart with Patent Ductus Arteriosus
Figure A shows the interior of a normal heart and normal blood flow. Figure B shows a heart with patent ductus arteriosus. The defect connects the aorta with the pulmonary artery. This allows oxygen-rich blood from the aorta to mix with oxygenpoor blood in the pulmonary artery. Reference: http://www.nhlbi.nih.gov/health/dci/Diseases/pda/pda_what.html
COURSE IN THE WARD
DOCTOR’S ORDER Labs: CBC • RATIONALE as a preoperative test to ensure both adequate oxygen carrying capacity and hemostasis to diagnose anemia to identify acute and chronic illness, bleeding tendencies, and white blood cell
DATE ORDERED 7/16/09 7:00PM
disorders leukemia Urinalysis
general health screening to detect renal and metabolic diseases diagnosis of diseases or disorders of the kidneys or urinary tract
While less sensitive than echocardiography , chest x ray can be used to check for disorders such as congestive heart failure or pulmonary edema. Manifestations phlebotomy after
WOF DOB, arrhythmia, decrease sensorium For phlebotomy
is performed to treat polycythemia vera, a condition that causes an elevated red blood cell volume (hematocrit). also prescribed for patients with disorders that increase the amount of iron in their blood to dangerous levels, such as hemochromatosis, hepatitis B, and hepatitis C. Patients with pulmonary edema may undergo phlebotomy procedures to decrease their total blood volume. is also used to remove
blood from the body during blood donation and for analysis of the substances contained within it.
Secure FFP, type specific • To check the labile as well as the stable components of the coagulation, fibrinolytic and complement systems; the proteins that maintain oncotic pressure and modulate immunity; and other proteins that have diverse activities. Also fats, carbohydrates and minerals that are present in concentrations similar to those in circulation. is used to give intravenous fluids to the patients suffering from salt and water deprivation.
Hydrate prior to phlebotomy with PNSS
If HCT >65, repeat phlebotomy
is performed to treat polycythemia vera, a condition that causes an elevated red blood cell volume (hematocrit). is also used to remove blood from the body during blood donation and for analysis of the substances contained
Platelet transfusion phlebotomy
used to prevent bleeding in patients with very low platelet counts, usually less than 20,000 cells per microlitre, and in those undergoing surgery or other invasive procedures whose counts are less than 50,000 cells per microlitre Furosemide - is a potent diuretic (water pill) that is used to eliminate water and salt from the body. In the kidneys, salt (composed of sodium and chloride), water, and other small molecules normally are filtered out of the blood and into the tubules of the kidney. The filtered fluid ultimately becomes urine. Most of the sodium, chloride and water
Continue furosemide, and aldactone
that is filtered out of the blood is reabsorbed into the blood before the filtered fluid becomes urine and is eliminated from the body. Furosemide works by blocking the absorption of sodium, chloride, and water from the filtered fluid in the kidney tubules, causing a profound increase in the output of urine (diuresis). Lanoxin - increases the strength and vigor of heart contractions, and is useful in the treatment of heart failure. It is extracted from the leaves of a plant called digitalis lanata. Digoxin increases the force of contraction of the muscle of the heart by inhibiting the activity of an enzyme (ATPase) that controls movement of calcium, sodium and potassium into heart muscle. Calcium controls the force of contraction.
Inhibiting ATPase increases calcium in heart muscle and therefore increases the force of heart contractions. Digoxin also slows electrical conduction between the atria and the ventricles of the heart and is useful in treating abnormally rapid atrial rhythms such as atrial fibrillation, atrial flutter, and atrial tachycardia. Aldactone In patients with heart failure and cirrhosis, increased levels of a hormone produced by the adrenal glands, called aldosterone, causes salt and fluid to be retained by the kidneys. (At the same time, it also causes the kidneys to eliminate potassium.) The body becomes overloaded with salt and water, and this worsens the heart failure. Spironolactone inhibits the action of aldosterone thereby causing the kidneys to excrete salt and fluid in the
urine while retaining potassium. Therefore, spironolactone is classified as a potassium-sparing diuretic, a drug that promotes the output of urine (diuretic) while allowing the kidneys to hold onto potassium.
A. LABORATORY EXAMS
NAME: Elicano, Chrishel Joy, Age: 1 year old Hospital No: 361936 Accession no: Sex: Female Specimen: Urine Ward # 1B 7/17/09 Requested by: Jarillas, MD 5:10 AM Microscopic/ Chemical examination Routine Physical Examination Color light yellow Turbidity (clarity) Clear Chemical Analysis: Glucose : Bilirubin: Ketone: Normal Specific gravity: negative Blood: • negative negative negative 1.010 moderate ph: protein: Urobilinogen: Nitrite: leukocytes: negative 7.0 negative
Lab Test required: 7/17/09 Sample submitted: Result Validated:
All laboratory results for Microscopic/ Chemical examination are normal.
Urine Sediment Analysis by Flowcytometry Result Interpretation Red blood cells NORMAL RANGE White Blood cells RANGE Epithelial Cells NORMAL RANGE Casts RANGE Bacteria 3 1 0 0 352 (M)0-3 (M)0-3 (F) 0-4 WITHIN WITHIN NORMAL WITHIN WITHIN NORMAL Reference Range
(F) 0-4 (F) 0-3
(M)0-750 (F) 0-850 WITHIN NORMAL RANGE
OTHERS: Crystals none found HEMATOLOGY SECTION PARAMETERS RESULTS NORMAL VALUES INTERPRETATION
Hemoglobin (HGB) Hematocrit (HCT)
215.1 RBC 0.67
116-140G/L 0.35-0.4 l
may be due to increased and CHD may reflect a condition called polycythemia vera may be due to CHD WITHIN NORMAL RANGE WITHIN NORMAL RANGE can occur as a result may be due to may be due to may be due to infections may be due to low
RBC 7.44 3.6-5.0 M/ul White cell count 9.2 5-10 x 10 9/L Differential Count Basophils 0.01 0-0.05 Eosinophils 0.01 0.02-0.07 of infection Segmenters 0.32 0.55-0.65 infections Lymphocytes 0.58 0.25-0.35 infections Monocytes 0.08 0.02-0.06 Platelet count 50 150-350 10 9/L oxygencarrying blood in the body and drug induced causes. MPV 7.68 5.83-8.46 Fl RDW 13.51 11.0-14.0 MCV 89.57 80-97 fL MCH 28.91 27-31 pg MCHC 32.27 32-36 %
WITHIN WITHIN WITHIN WITHIN WITHIN
NORMAL NORMAL NORMAL NORMAL NORMAL
RANGE RANGE RANGE RANGE RANGE
BLOOD TYPRE CROSS-MATCH RESULT Patient’s ABO GROUP: O Sourc e of blood FCMC Unit serial no. NVBSP 2009 .002 4499 Compon ent FFP (LR) ABO gro up 0 RH GROUP: POSITIVE Rh Grou p Positi ve Anti-body screening( unit) negative ANTI-BODY SCREENING(PATIENT) CROSS-MATCH IS(sali 37. AH Interpreta ne) 0 G tion 0 C Same ABO
VI. Nursing care plan A. Impaired gas exchange
Assessm ent O: >Irritabilit y >Cyanosi s >Nasal flaring RR 65 >Tachyca rdia HR 165 >Diaphor esis N.Diagn osis Impaired gas exchang e related to ventilatio n perfusion imbalanc e as in altered blood flow Inferenc e irregular transmiss ion of blood between two of the most important arteries in close proximity to the heart because of patency leading to impaired gas exchange Planning Short term goal: after 8hours of nursing interventio ns, the patient will verbalize understand ing of causative factors and appropriat e interventio ns. Long term goal: the patient will participate in treatment regimen within level of ability. Intervent ion >assess the condition of the patient >monitor v/s and cardiac rhythms >evaluate pulse oximetry to determine oxygenati on >elevate head of bed / position client appropriat ely >encoura ge adequate rest and limit activities to within Rationale >to obtain baseline data >indicatio n of proper ventilation or vice versa >to be able to give appropriat e interventi ons >to maintain airway Evaluatio n After 8 hours of nursing interventio ns, the goal was met as evidenced by the relative of the patient verbalized understand ing in giving appropriat e interventio ns and able to identify causative factors of dyspnea for example in simple body positioning.
>to promote calm / restful environm ent that helps limit
client tolerance >review risk factors particularl y environme nt to client and relative >emphasi ze the importanc e of nutrition to client and relative >review oxygen conservin g technique s like sitting instead of standing to perform tasks, etc to client and relative >refer to physician
oxygen consumpti on >to promote preventio n/ managem ent of risk
>it helps in improving stamina and reducing the work of breathing >to decrease dyspnea and improve quality of life
B. Ineffective tissue perfusion Assessment
Ineffective tissue perfusion
>to give appropriat e
After 8 hours of nursing
irregular Short >assess transmissi term goal: the on of after 8 condition
ess >Capillary refill >3sec >Altered respiratory rate outside of acceptable parameter s RR 65 >Skin discolorati ons [gums, conjunctiv a]
related to mismatch of ventilation with blood flow: exchange problems
blood between the most important arteries in close proximity to the heart causing ineffectiv e tissue perfusion
hours of nursing interventio ns, the patient will be able to verbalize understand ing of condition, therapy regimen and when to contact healthcare provider
of the patient >note customary baseline data (e.g. usual RR, HR, weight, etc) >Note presence of dyspnea and cyanosis >Measure capillary refill
managem ent >provides compariso n with current findings
Long term goal: the patient will demonstrat e increased perfusion as individually appropriate (e.g. v/s within client’s normal range, free of discomfort, etc)
>to assess and give appropriat e managem ent >result less than 0.9 indicates need for more aggressiv e preventive interventi ons >to lessen the burdens and anxiety level >to promote circulation
interventio ns, the goal was met as evidenced by the patient was able to comply with the therapeutic regimen and understand ing of the appropriate interventio ns regarding the patient’s condition.
>provide psychologi cal support
>elevate head of bed and maintain head / neck in midline or neutral position
>encourag e quiet, restful atmospher e >lowers tissue oxygen demand >to help the client in his condition
>administ er medication sa prescribed by the physician >refer to physician
C. Risk for delayed development Assessmen t
O: >Congeni tal disorder
Risk for delayed developm ent related to congenital disorder
Presence of congenital disorder may cause the person risk for delayed developm ent because it needs further screening, studies and surgical treatment that may
Short term goal: after 8 hours of nursing interventio ns, the patient will be able to verbalize understand ing of condition, therapy regimen and when to contact healthcare provider
>assess the condition of the patient >collaborate in multidiscipli nary evaluation to assess client’s developmen t in ff areas: gross motor, fine motor, cognitive, social / emotional, adaptive and
>to obtain baseline data
After 8 hours of nursing interventio ns, the goal was met as evidenced by the relative was able to identify and verbalize appropriate developme ntal expectation that the patient must have.
>to determine area(s) of need / possible interventio ns
affect / delay the normal activity of a person
communicati ve developmen t >ascertain nature of caregiverrequired activities and abilities to perform needed activities
>note chronologica l age and review expectations for “normal” >to help developmen determine t at this developme stage ntal expectation >provide s information regarding normal developmen t, as appropriate, including pertinent reference materials
>to be able to not develop too much dependenci es and promote independen ce
> to help determine developme ntal expectation s
HEALTH TEACHING Medication Doctors use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or indomethacin, to help close a patent ductus arteriosus in premature infants. NSAIDs block the hormone-like chemicals in the body that keep the PDA open.
Parents of children with congenital heart defects often worry about the risks of rough play and vigorous activity even after successful treatment. Although some children may need to limit the amount or type of exercise, many can lead normal or near-normal lives. Your doctor can advise you about which activities are safe for your child. • Treatment Surgery to repair a patent ductus arteriosus involves patching or sewing shut the abnormal opening. This can be done through an incision in the side of the chest or by catheterization. In cardiac catheterization, a thin tube (catheter) is inserted into a blood vessel in the groin and threaded up to the heart. Through the catheter, a plug or coil may be deployed to close the ductus arteriosus. In surgery, the ductus is closed with a metal clip. • Hygiene A child who has congenital heart disease may need to take preventive antibiotics before certain dental and surgical procedures. Your doctor will help you learn if this is necessary. But for most kids with a single heart defect, maintaining good oral hygiene and getting regular dental checkups is the best way to help prevent infection. • Out patient Neonates without adverse symptoms may simply be monitored • Diet Eat a well-balanced diet/ diet as tolerated. Include a vitamin supplement that contains folic acid.
✔ high-calorie formula or breast milk Special nutritional supplements may be
added to formula or pumped breast milk that increase the number of calories in each ounce, thereby allowing your baby to drink less and still consume enough calories to grow properly. ✔ supplemental tube feedings Feedings given through a small, flexible tube that passes through the nose, down the esophagus, and into the stomach, can either supplement or take the place of bottle-feedings. Infants who can drink part of their bottle, but not all, may be fed the remainder through the feeding tube. Infants who are too tired to bottle-feed may receive their formula or breast milk through the feeding tube alone. Spiritual Parents where able to ask God’s guidance and assistance in times of losing hope.
Towards the end of the case study or learning, the level 3 nursing students were able to, to, proposed the over all assessment findings with the patient with a Patent Ductus Arteriosus and expounded thoroughly and articulately the anatomy and physiology of the systems involved. They were able to illustration and explanation of the pathophysiology of the Patent Ductus Arteriosus with regards to the patient, devised a well planned, with the principle of SMART a comprehensive nursing care plan that is applicable to the patient with Patent Ductus Arteriosus, inculcated health teachings and elucidated and discuss the rationale of the Arteriosus, different nursing interventions to the patient and to the family as well. After proving the interventions, they evaluated the effectiveness and accuracy of the outcome.
Patent Ductus Arteriosus is a cardiovascular disorder found in patients of all ages and sizes, from tiny premature infants to older adults. The clinical implications vary depending on the anatomy of the ductus arteriosus and the underlying cardiovascular status of the patient. Concurrently, advances and widespread availability of technological diagnosis have resulted in improved detection and characterization of Patent Ductus Arteriosus in patients of all ages. In most cases, you can't do anything to prevent having a baby with a heart defect. However, it's important to do everything possible to have a healthy pregnancy. Getting early prenatal care, even before you're pregnant, quitting smoking, reducing stress, stopping birth control, eating a well-balanced diet including an intake of vitamin supplement that contains eating folic acid, limitation of caffeine, exercise regularly, avoiding risks and infections, and exercise keeping diabetes under control, if there is, are the basic guide to prevent baby having heart diseases. Having proper nursing management concerning the said heart disease would be helpful and essential. Indeed, complications of Patent Ductus Arteriosus can be avoided or ameliorated by appropriate diagnosis and management. All in all, While the majority of children do not have symptoms, the risks are nonetheless real. It is comforting for parents to know that no matter which technique is employed for treating this problem of their child's heart, after closure of the PDA, the circulation is normal, and the child will have a normal heart with no further risks for the remainder of a normal life. Indeed, meticulous attention to every aspect of care is absolutely essential to providing a positive outcome and quality of life to these infants. The health care team has a vital role in the recognition and management of infants that are diagnosed with congenital heart disease specifically Patent Ductus Arteriosus. Arteriosus.
ST. PAUL UNIVERSITY, QUEZON CITY NURSING DEPARTMENT
PATENT DUCTUS ARTERIOSUS [CASE STUDY]
SUBMITTED TO: MS. RHEA BIONAT
SUBMITTED BY: RAVELO, KIMBERLY RODIL, SHARLENE ROMULO, PEACHY SAKAMOTO, KAREN SANTIAGO, PATRICIA
JULY 28, 2009