Case Study

CARE OF CLIENTS WITH

TETRALOGY OF FALLOT
(ToF)

Presented by: Group 47

 GROUP
MEMBERS:

1 Lumasag, Olesaino P.

2 Mahaña, Joanna Jane

3 Montebon, Michelle Q.

4 Opella, Leana Celsa P.

5 Opon, Vanessa Grace R.

6 Pecolira, Lady Lee A.

7 Quijal, Pethuel Gwyn D.

8 Rafael, Ella B.
OBJECTIVES Specific
Objectives

A. Objectives
The care of a client with tetralogy of Fallot is focused on the development and maintenance of a
healthy individual. This includes providing traditional medical management as well as educational,
psychosocial, and other services to meet each child's needs.

The specific objectives for the care of a client with Tetralogy of Fallot (ToF) are as
follows:
➢ Maintain optimum cardiac, respiratory and hemodynamic status by adequate
oxygenation, maintenance of sinus rhythm.
➢ Maintain adequate tissue oxygenation.
➢ Collaborate with other members of the health care team to optimize quality of life
while protecting against complications.
➢ Continuously improve the quality of life through therapy planning and adaptation
to changes in patient status.
OBJECTIVES General
Objectives

The general objectives:

➢ Protect and promote their health, maximize quality of life and achieve the best
possible outcome regardless of pathophysiology or severity.
➢ To provide proper assessment and treatment for the client's present condition
and to prevent complications.
➢ Increase the quality of life and reduce the possibility of future complication.
➢ To maintain the life-preserving functions of heart and circulation.
➢ To make sure your child is getting enough nutrition, vitamins, minerals and
water to survive his/her illness.
 Introduction

Congenital heart defects result from abnormal changes in the structure of the heart that occurs early in pregnancy and are present at
birth. They are the most common birth defects, occurring in about 1 in 125 births. Tetralogy of Fallot (TOF) is one of the most common
cyanotic congenital heart malformations that is characterized by the presence of multilevel right ventricular outflow tract obstruction,
leading to right ventricular hypertrophy, and a malalignment ventricular septal defect with aortic override. The characteristic feature
of this condition is a strong dilation of the pulmonary artery and its branches, causing airway constriction. When this occurs, the flow
of blood from the heart to the lungs is obstructed causing low oxygen levels in the blood. According to Cleveland Clinic (2017), when the
blood has low levels of oxygen, it can't deliver enough oxygen to the organs and tissues that need it to keep working. if this persists
over time, it can damage the heart and brain along with other complications.

The primary goal of both Maternal and Child Health Nursing is the promotion and maintenance of optimal family health. Additionally,
Childbearing and childrearing are major focuses of nursing practice in promoting health for the next generation. The effects of
congenital heart diseases affect children not just during pregnancy but also later in life, increasing the likelihood that they will develop
a condition that may impair their normal functioning or that the following generation may inherit. And with the current statistics
showing the prevalence of babies having congenital heart diseases such as Tetralogy of Fallot, there is a compelling need to study the
case and continuous research is a must to advance our knowledge that could lead to new treatments that will improve the care of
children in the future.

Meanwhile, in the given case, our patient is Baby Pearl, a 9-month-old female who was presented to the Emergency department of the
hospital by his mother reporting episodes of tachypnea, cyanosis, and irritability during feeding.
PATIENT'S Biographic
PROFILE Data
PATIENT'S
Clinical Data
PROFILE
PATIENT'S Past Health
PROFILE History

Patient Baby Pearl was never hospitalized nor

undergone any surgical procedure, as reported by the
mother. Also, the patient has no known allergies to foods
and drugs.
 PATIENT'S Present Health
PROFILE History

The patient's mother had no prior pregnancies or abortions; also, the mother underwent prenatal genetic
tests for trisomy 21 and tested negative. She reported that her baby was small (born at the 10th percentile) but is
tracking along her length and weight growth curves. Her immunization is up to date. She denies smoking and
alcohol use during her pregnancy. Moreover, she refuses to attempt to terminate the pregnancy.

Furthermore, upon assessment, patient baby pearl's vital signs include the following:
● A pulse of 165 beats per minute.
● A respiration rate of 65 breaths per minute.
● An oxygen saturation level of 80%.

The patient's lung sounds are typical of auscultation; her heart auscultation is performed, and a systolic
murmur is noted at the left upper sternal border, most strongly in the pulmonic area (radiates to the axillae and
back).
PATIENT'S Family History
PROFILE

On the other hand, Patient baby Pearl’s family health history

revealed no heredo-familial diseases for both of her parents.
HEALTH ASSESSMENT
HEALTH ASSESSMENT
HEALTH ASSESSMENT
HEALTH ASSESSMENT
HEALTH ASSESSMENT
 REVIEW OF ANATOMY
AND PHYSIOLOGY

The Circulatory system (Cardiovascular system) pumps blood from the heart to the lungs to get oxygen.
The heart then sends oxygenated blood through arteries to the rest of the body. The veins carry oxygen-
poor blood back to the heart to start the circulation process over. The circulatory system is critical to
healthy organs, muscles, and tissues.
REVIEW OF ANATOMY
AND PHYSIOLOGY
PATHOPHYSIOLOGY Definition of
Diagnosis

Tetralogy of Fallot

This is a cardiac anomaly that refers to a combination of four related heart defects that commonly occur together. It affects normal
blood flow through the heart and it happens when a baby’s heart does not form correctly as the baby grows and develops in the
mother's womb during pregnancy.

Four related heart defects:

Ventricular septal defect (VSD) - The heart has an inner wall that separates the two chambers, called a septum which prevents the
oxygenated and poorly oxygenated blood from mixing. A ventricular septal defect is a hole in the septum that causes oxygen-rich
blood (left ventricle) and oxygen-poor blood (right ventricle) to mix.

Overriding aorta - the aortic valve is enlarged and appears to arise from both the left and right ventricles instead of the left ventricle
as in normal hearts

Pulmonary stenosis - narrowing of the pulmonary valve and outflow tract or area below the valve that creates an obstruction
(blockage) of blood flow from the right ventricle to the pulmonary artery

Right ventricular hypertrophy - thickening of the muscular walls of the right ventricle, which occurs because the right ventricle is
pumping at high-pressure
PATHOPHYSIOLOGY
Etiology

PATHOPHYSIOLOGY
Symptomatology

DISEASE PROCESS
PATHOPHYSIOLOGY
CONCEPT MAP
COURSE IN THE WARD/TREATMENT/
INTERVENTIONS
MEDICAL MANAGEMENT
Doctor's Progress Notes
MEDICAL MANAGEMENT
Doctor's Progress Notes
MEDICAL MANAGEMENT
Doctor's Progress Notes
MEDICAL MANAGEMENT
Doctor's Progress Notes
LABORATORY/DIAGNOSTIC EXAMINATIONS
MEDICAL MANAGEMENT
Laboratoy/Diagnostic
Examinations
MEDICAL MANAGEMENT
Laboratoy/Diagnostic
Examinations
MEDICAL MANAGEMENT
Laboratoy/Diagnostic
Examinations
MEDICAL MANAGEMENT
Laboratoy/Diagnostic
Examinations
MEDICAL MANAGEMENT
Laboratoy/Diagnostic
Examinations
CLINICAL REASONING QUESTIONS
NURSING MANAGEMENT Clinical Reasoning

Questions
NURSING MANAGEMENT Clinical Reasoning
Questions
NURSING MANAGEMENT Clinical Reasoning
Questions
NURSING MANAGEMENT Clinical Reasoning
Questions
NURSING MANAGEMENT
Discharge Plan
NURSING MANAGEMENT
ADDITIONAL
ACTIVITIES
NURSING MANAGEMENT
DESTINATION
CHECK
REFERENCES:

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