Medical Management

SURGICAL MANAGEMENT
-PALLIATIVE SURGERY-
1. BLALOCK TAUSSIG SHUNT
-shunt is a surgical procedure used to increase pulmo
nary blood flow for palliation in duct dependent cyan
otic heart defects like pulmonary atresia, which are c
ommon causes of blue baby syndrome.
2.WATERSTON'S SHUNT
-is a form of palliative surgery performed in patients
with tetralogy of Fallot prior to the ability to repair th
e defect. It consists of a shunt formed between the a
scending aorta and the right pulmonary artery.

3. POTT'S SHUNT
-It is a surgical technique in which a side-to-side anas
tomosis is created from the left pulmonary artery to t
he descending aorta, resulting in a right-to-left shunt.
-CORRECTIVE SURGERY-
1. VSD CLOSURE
- involves closure of Ventricular Septal Defect with a s
ynthetic Dacron Patch so that the blood can flow nor
mally from the left ventricle to the aorta.
NURSING MANAGEMENT
Nursing Diagnosis
1. Risk for Decreased cardiac output related to structural abnor
malities of the heart.
-Assess and record the vital sign.
-Administer cardiac drugs as ordered.
- Assess dypsnea,exertion skin color during rest and when activ
e.
-Avoid allowing the infant to cry for a long period of time,use s
oft nipple when feeding.
2. Impaired gas exchange related to altered oxygen su
pply as evidenced by dyspnea, tachypnea, tachycardia
and fatigue.
- Establish good relationship with the patient and sign
ificant other.
- Monitor respiratory rate/depth, use of accessory mu
scles, areas of cyanosis.
- Auscultate breath sounds, noting presence or absenc
e of adventitious sounds.
- Help with breathing exercises. Pursed lip breathing.
- Elevate head of bed to moderate or high back rest.