TETRALOGY OF FALLOT - ENGLISH

TETRALOGY OF FALLOT - ENGLISH

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TETRALOGY OF FALLOT -

              Tetralogy of Fallot is a combination of four congenital abnormalities. The four defects include a ventricular septal defect (VSD), pulmonary valve stenosis, a misplaced aorta and a thickened right ventricular wall (right ventricular hypertrophy).

            

           This heart defect  presents four problems.

           They are:

Ø  a hole between the lower chambers of the heart

Ø  an obstruction from the heart to the lungs

Ø  The aorta lies over the hole in the lower chambers

Ø  The muscle surrounding the lower right chamber becomes overly thickened

 

            

           Sign and symptoms  -

           Blue color of the skin (cyanosis)

           Murmur heart sound

           Clubbing of fingers

           Poor weight gain

           Labored Breathing

           Heart failure

            

           Diagnostic investigations include-

           Physical examination-auscultaion of chest.

           Electrocardiography.

           Chest X-ray.

           Cardiac catheterization.

            

           TREATMENT- 

           Medical management includes supportive treatment such as

           oxygen inhalation to treat cyanosis

           Antibiotics to treat infection

           Adequate Nutrition

           Activity restriction

           Surgical management-Tetralogy of Fallot is treated with two kinds of surgery. One provides temporary improvement by a shunt to give more blood flow to the lungs. The other is a complete repair of the two most important abnormalities that make up tetralogy of Fallot. Patients might have one or both surgeries in their lifetime, depending upon condition and need.

            

            

 

 

NURSING MANAGEMENT-

Ø  -Observation of newborn and be alert to detect signs and symptoms of tetralogy of fallot.

Ø  - If signs of tetralogy of fallot are noted, the pediatrician should be informed immediately.

Ø  - Assessment of respiratory and cardiac status should be continue in pre operative period.

Ø  - Intake output chart is maintained so that nutritional status and water balance is assessed.

Ø  - IV fluid may be started to correct electrolyte and water imbalance as per doctor’s order.

Ø  - Anxiety level of parents is assessed and psychological support is provided to alleviate anxiety.

Ø  - Small and frequent feeding should be continue to maintain adequate nutritional status.

Ø  - Oxygen inhalation may be needed,which shoud be provided as per recomendation.

Ø  - The child and parents should be prepared for surgery by providing answer of their questions.

Ø    After surgery vital signs are monitored such as heart rate , respiratory rate and temperature and recorded.

Ø   Surgical site care is provided with aseptic technique to prevent infection and promote healing.

Ø  Other Nursing interventions – includes all nursing care of hospitalized child that we have discussed in previous lecture under heading Nursing care of hospitalized child in the lecture “Child Health Nursing”.

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