Professional Documents
Culture Documents
of
fallot
INTRODUCTION
qOne of the first types of congenital heart
defects
Occurs 400/million
live births
Etiology
Chromosome 22
deletions
ANATOMY
and
PHYSIOLOGY
Fetal Circulation
The circulatory system of a
human fetus works differently
from that of born humans,
mainly because the lungs are
not in use:
the fetus obtains oxygen and
nutrients from the mother
through the placenta and
the umbilical cord.
Blood from the placenta is
carried to the fetus by
the umbilical vein.
About half of this enters the
fetal ductus venosus and is
carried to the inferior vena
cava, while the other half
enters the liver proper from
The ductus venosus then
merges to the inferior vena
cava, mixes with the
deoxygenated blood, and
travels to the right atrium.
In the fetus, there is an opening
between the right and left
atrium (the foramen ovale),
and most of the blood flows
through this hole directly into
the left atrium from the right
The continuation of this blood
flow is into the left ventricle,
and from there it
is pumped through
the aorta into the body.
Some of the blood moves from
the aorta through the internal
iliac arteries to the umbilical
arteries, and re-enters the
placenta, where carbon
dioxide and other waste
Some of the blood entering the
right atrium does not pass directly
to the left atrium through
the foramen ovale, but enters
the right ventricle and is pumped
into the pulmonary artery.
In the fetus, there is a special
connection between the pulmonary
artery and the aorta, called
the ductus arteriosus, which directs
most of this blood away from the
lungs (which aren't being used
PATHOPHYSIOLO
GY
FORAMEN OVALE
SURGICAL
MANAGEMENT
Corrective Surgery-Closing
the VSD
Opening and enlarging the
area that blood flows through
as it leaves the lower right
side of the heart
Opening or widening the
pulmonary valve
Temporary or Palliative Surgery -
As small opening can be made
between the ribs.
Place a tube/shunt between a
large artery branching off the
aorta and the pulmonary artery
The shunt is removed when the
baby’s heart defects are repaired
during the corrective surgery
NURSING
CARE
PLAN
CUES: CR –more than 160 bpm
DIAGNOSIS: Decreased cardiac output r/t ineffective
circulation
BACKGROUND
KNOWLEDGE
OBJECTIV INTERVENTION RATIONAL EVALUATION
E E
Tetralogy of The patient Assess and
If the
Fallot will have record the patient
results in adequate vital signs experiences
low cardiac decreased
oxygenation output as cardiac
of blood due evidenced output, the
to mixing of by cardiac cardiac
oxygenated rate within rate,
and normal respiratory
deoxygenated range rate will
blood in the increase
left and the bp
ventricle
through the will
VSD decrease.
BACKGROUND
KNOWLEDGE
OBJECTIV INTERVENTION RATIONAL EVALUATION
E E
and Administer Cardiac
preferential cardiac drugs are
flow of both drugs as given to
oxygenated ordered increase
and the
deoxygenated strength of
blood from cardiac
the contraction
ventricles s and/or
through the increase
aorta return of
because of blood flow
obstruction
to flow to the
through the heart,
pulmonary thereby
valve. increasing
CO.
BACKGROUND
KNOWLEDGE
OBJECTIV INTERVENTION RATIONAL EVALUATION
E E
Monitor and Digoxin is
record a potent
digoxin medication
levels. that needs
Notify careful
physician monitoring.
if levels If digoxin
are out of levels are
acceptable high, the
range. patient
will
experience
s/s of
toxicity
such as
vomiting.
BACKGROUND
KNOWLEDGE
OBJECTIV INTERVENTION RATIONAL EVALUATION
E E
Keep Decreased The
Provide Avoid
neutral extremes
environmental heat and
temperature; cold that
when bathing increases
exposed only oxygen and
area being energy
bathed and needs.
keep the
infant
covered to
prevent heat
loss.
BACKGROUND
KNOWLEDGE
OBJECTIVE INTERVENTION RATIONAL EVALUATIO N
E
Explain to Avoids The
patient ’ s
parents need
to conserve fatigue activity
level is
energy and optimal
encourage rest. within
the
Assist Provides limitatio
parents to rest and ns of the
avoids over disease .
plan for exertion,
care and minimizes
rest periods. energy
expenditure.