CASE 3:

PEDIATRIC PX
WITH VSD

DE GUZMAN, Julianna
DE LEON, Cellina
2NUR3 RLE 3 Group 3
 Table of Contents

About the Patient FDAR # 2

01 Get to know baby Lani! 04 Risk for Infection

Post-Operative Care FDAR # 3

02 Caring for baby Lani who 05 Anxiety of Parents
underwent an operation

03 FDAR # 1
Risk for Injury
06 Discharge Plan
Health Teaching
01 Lani
Sta. Ana
● 7-month-old
● Down Syndrome &
VSD
Cardiac Catheterization

● A thin, flexible tube (a

catheter) is inserted into a
blood vessel in the leg that
leads to the heart.
 Cardiac Catheterization

● A special implant, shaped into

two disks formed of flexible
wire mesh, is positioned into
the hole in the septum.

● The device is designed to

flatten against the septum on
both sides to close and
permanently seal the VSD.
02 Post-operative
Care for a
Cardiac
Catheterization
 Caring for a Post-Op patient

● Monitor the puncture ● pic

site for possible
hematoma
○ Bleeding
○ Redness
○ Swelling
○ Pain (evidenced
by crying)
 Caring for a Post-Op patient

● Check the vital signs ● pic

○ Temperature
○ Heart rate
○ Respiratory rate
 Caring for a Post-Op patient

● Infant should be kept ● pic

lying flat on the bed for
several hours without
bending the leg
● Restriction of
movements
 Caring for a Post-Op patient

● Follow up ● pic
○ Electrocardiogram
- Information on
rhythm of the
heart
○ Echocardiogram
- Ultrasound of the
heart
03 FDAR # 1
“Risk for Injury”
 RISK FOR INJURY

DATA ACTIO RESPONSE

1.
N
monitor vital signs ● There’s no presence of
● previous catheterization
● 2. obtain lab results from pre- injury, and the heart rate
increased heart rate
catheterization of the infant will be in
● bruising
3. place pressure dressing on the site of normal value (110 bpm)
catheterization
4. assess for bleeding every 30 mins
5. maintain on bed rest
6. restrict activities as ordered by the
physician
7. Educate the family on the rationale
behind restricting the activities
8. Instruct family to monitor for signs of
bleeding
04 FDAR # 2
“Risk for Infection”
 RISK FOR INFECTION

DATA ACTIO RESPONSE

1.
N
Monitor white blood cell count ● There's no signs and
● previous catheterization
2. Monitor for signs and symptoms of symptoms of infection
for Ventricular Septal
infection in the newborn and she
Defect - possible
3. Monitor vital signs has normal vital signs
organism invasion ○
4. Educate the family on proper hygiene Temperature
of the infant and when handling her - 36.5 - 37.5
5. Educate the family to limit the visitors ○ Heart rate -
to avoid transmission of infection 110 bpm
6. Educate the family on the importance ○ Respiratory
of continuous taking of antibiotics as rate - 30
prescribed by the physician bpm
05 FDAR # 3
“Anxiety”
 ANXIETY

DATA ACTIO RESPONSE

1.
N
Establish a therapeutic relationship, ● The parent responded
● Mother expressed
conveying empathy and unconditional positively to the
“sobrang nag-aalala ako
positive regard. interventions and
para sa anak ko. Magiging
2. Assess the level of anxiety of teachings given by the
okay na ba siya
the parent. nurse as she seemed
pagkatapos ng ginawang
3. Be available to the parent for listening more relaxed.
operasyon?”
and talking.
● Distressed as shown in
4. Encourage the parent to express
her facial expressions
● feelings.
Quivering voice
5. Acknowledge the anxiety felt by the
● fidgeting and
parent and avoid false reassurance.
restlessness
6. Provide accurate information about
the child’s condition, specifically the
disease process, treatment regimen,
and health outcomes.
7. Provide comfort measures to limit the
degree of stress.
8. Counsel the parent, if needed.
06 DISCHARG
E
PLAN
 DISCHARGE PLAN

Exercise Hygiene

● Restriction of movements. ● Keep the puncture clean in

● Give appropriate toys, such order to prevent infection.
as squeeze toys, rattles,
and teething rings.
 DISCHARGE PLAN

Outpatient Diet

● Refer to Cardiologist in ● Complementary feeding of

order to assure the breastmilk and semi-solid
condition of the patient’s food.
heart.
 DISCHARGE PLAN

Spirituality Medications

● Attend to the needs of the

patient to ease her pain ● digoxin (Lanolin)
and fear. ● propranolol (Inderal)
 Thank
x You!
CREDITS: This presentation template was
created by Slidesgo, including icons by Flaticon,
and infographics & images by Freepik.

Please keep this slide for attribution.