ACYANOTIC

Involves heart or circulatory

anomalies that involve either a
stricture to the flow of blood or a
shunt that moves blood from
arterial to venous system
(oxygenated to unoxygenated
blood or left to right shunts)
 Ventricular septal defect

Definition
Ventricular septal defect describes one
or more holes in the wall that separates
the right and left ventricles of the heart.
Ventricular septal defect is one of the
most common congenital (present from
birth) heart defects. It may occur by
itself or with other congenital diseases.
 Cause or Etiology

unknown.
 Risk Factors

Drinking alcohol and using the

antiseizure medicines depakote and
dilantin during pregnancy have been
associated with increased incidence
of VSDs.
 Signs and Symptoms
Shortness of breath
Fast breathing
Hard breathing
Paleness
Failure to gain weight
Fast heart rate
Pounding heart
Sweating while feeding
Frequent respiratory infections
 Diagnostic Test

Chest x ray
ECG
Echocardiogram
Cardiac Cathetherization
MRI
 Diagnostic test
Cardiac cathetherization
 Management
Medical management
Antibiotics for children

Surgical Management
Cardiac Cathetherization
 Nursing Diagnosis
Activity Intolerance
Decreased Cardiac Output
Ineffective Breathing Pattern

Nursing Outcome
Child’s pulse, blood pressure, and respiratory
rate are within acceptable parameters for
age group, abnormal heart sounds are
absent
 Nursing Intervention

Activity Therapy
Body Mechanics Promotion
Orginize all activities to provide maximum
rest periods
Promote Respiratory Status-Airway
Patency
Promote Cardiac Pump Effectively
Hemodynamic Regulation
Airway Management
Provide Oxygen as Necessary
Prognosis

Many small defects will close on their

own. For those defects that do not
spontaneously close, the outcome is
good with surgical repair.
Complications may result if a large
defect is not treated.
 Research
Sonja Rasmussen MD of the CDC’s National Center on Birth Defects and
Developmental Disabilities has reported her study findings online in the
American Journal of Obstetrics and Gynecology.

The data was gathered from the National Birth Defects Prevention Study
that involved over 12,000 infants born between 1997 and 2004, about half
of which were born with congenital heart defects. Women who were
classified as overweight at the beginning of pregnancy, defined as a BMI
of over 25 but less than 35, were found to have a 15% increased risk.
However, as weight increased, so do risks. For women classified as
obese, BMI over 35, the risk jumped to 30%.

The most serious of the 10 congenital heart defects related to obesity is

hypoplastic left heart syndrome. The left ventricle, the heart’s primary
pumping chamber, is underdeveloped. The defect is often fatal in the
first few weeks of life without treatment. Surgery is required soon after
birth to allow the larger right ventricle to pump the oxygenated blood
throughout the body. Some infants require a heart transplant. HLHS
occurs in about 4 of every 10,000 live births.

Mothers of infants with heart defects were found to have two primary risk
factors related to weight: gestational diabetes and hypertension during
pregnancy.
 Reference

http://www.healthsystem.virginia.edu/
uvahealth/peds_cardiac/asd.cfm

http://www.emaxhealth.com/1506/87/
33983/maternal-obesity-linked-child-
heart-defects.html
 Atrial Septal Defect

An atrial septal defect allows oxygen-

rich (red) blood to pass from the left
atrium, through the opening in the
septum, and then mix with oxygen-
poor (blue) blood in the right atrium.
 Cause

Gene defect
Environmental exposure
partitioning process does not occur
completely
 Risk Factors

routine dental check-up and teeth

cleaning.
Sex
Parity
Geography
 Signs and symptoms

child tires easily when playing

fatigue
sweating
rapid breathing
shortness of breath
Poor growth
 Diagnostic Test

Chest x ray
ECG
Echocardiogram
Cardiac Cathetherization
MRI
 Diagnostic test
Cardiac cathetherization
 Nursing Responsibilities

Post-Procedure Care
monitor the pulses and skin
temperature in the leg or arm that was
used for the procedure.
Several gauze pads and a large piece
of medical tape will be placed on the
site where the catheter was inserted
to prevent bleeding.
 Management
medical management
Digoxin and diuretics

Infection control
Antibiotics

surgical repair
device closure
 Nursing Diagnosis

Activity Intolerance
Decreased Cardiac Output
Ineffective Breathing Pattern
Fatigue
Nursing Outcome
Regain his baseline respiratory rate
and maintain stable respirations
 Nursing interventions

monitor VS before/after giving

medications frequently
client teaching:
adhere to the prescribed diet and
medications
to limit activities
to rest at regular period
 Expectations (prognosis)

With early diagnosis and repair of an

ASD, the outcome is generally
excellent, and minimal follow-up is
necessary. When an ASD is
diagnosed later in life, if complications
occur after surgical closure, or the
ASD is never repaired, the outlook is
generally poor
 Research
Source: NEWS RX
2009 AUG 24 -- According to a study from
Adelaide, Australia, "Information regarding
Left atrial (LA) substrate in conditions
predisposing to atrial fibrillation (AF) is
limited. This study sought to characterize
the Left atrial remodeling that results from
chronic atrial stretch caused by atrial septal
defect (ASD)."
 Reference

http://www.healthsystem.virginia.edu/
uvahealth/peds_cardiac/asd.cfm

http://www.newsrx.com/article.php?
articleID=1605670
 -end-

Prepared by:
PAGCALIWAGAN, HOLLY
ANN C.
BSN3-2