CONGENITAL HEART DISORDER

Congenital heart disease is a general term for a range of birth defects that affect the normal way
the heart works. The term "congenital" means the condition is present from birth.

PATHOPHYSIOLOGY

Systemic Veins

Anastomotic Obstruction

Pulmonary Arteries
Branch PA

High PVR

Competitive arterial

Pulmonary Veins

Pulmonary vein obstruction

Atrium

AV valve stenosis/regurgitation

Loss of AV synchronous rhythm

Ventricular non-compliance

Ventricle
PRIORITIZED NURSING PROBLEM FOR CONGENITAL HEART DISORDER
Nursing Diagnosis Nursing Intervention
Decreased Cardiac Independent
Output
1. Assess heart rate and blood
pressure.
2. Note skin color,
temperature, and moisture.
3. Check for peripheral pulses,
including capillary refill.
4. Assess for reports of fatigue
and reduced activity
tolerance.
5. Inspect fluid balance and
weight gain. Weigh patients
regularly prior to breakfast.
6. Monitor electrocardiogram
(ECG) for rate, rhythm, and
ectopy.
Rationale
 Most patients have compensatory
tachycardia and significantly low
blood pressure in response to
reduced cardiac output.
 Cold, clammy, and pale skin is
secondary to a compensatory
increase in sympathetic nervous
system stimulation and low
cardiac output and oxygen
desaturation.
 Weak pulses are present in
reduced stroke volume and cardiac
output. Capillary refill is
sometimes slow or absent.
 Fatigue and exertional dyspnea are
common problems with low
cardiac output states. Close
monitoring of the patient’s
response serves as a guide for
optimal progression of activity.
 Compromised regulatory
mechanisms may result in fluid
and sodium retention; Weight is an
indicator of fluid balance.
 Cardiac dysrhythmias may occur
from low perfusion, acidosis, or
hypoxia. Tachycardia,
bradycardia, and ectopic beats can
further compromise cardiac
output. Older patients are
especially sensitive to the loss of
atrial kick in atrial fibrillation.
 Rest decreases metabolic rate,
7. Provide adequate rest decreasing myocardial and oxygen
periods demand.

 Upright position is recommended

8. Position child in semi- to reduce preload and ventricular
Fowler’s position. filling when fluid overload is the
cause; Facilitates lung expansion.

Dependent  The failing heart may not be able

to respond to increased oxygen
1. Administer oxygen therapy demands. Oxygen saturation needs
as prescribed to be greater than 90%.

 Increases contractility of the heart

and force of contraction. Maintain
2. Administer medications as open PDA when needed for blood
prescribed (Digoxin, flow.
Alprostadil)

Interdependent
Reference: https://nurseslabs.com/5-
congenital-heart-disease-nursing-care-
plans/