This document provides information on acyanotic heart diseases, specifically coarctation of the aorta and patent ductus arteriosus. It defines these conditions, discusses their incidence, anatomy, pathophysiology, clinical manifestations, diagnostic testing, treatment options including surgery, complications, nursing management, and nursing diagnoses. Coarctation of the aorta involves narrowing of the aorta and increased pressure in the upper body and decreased pressure in the lower body. Patent ductus arteriosus is the failure of the ductus arteriosus to close after birth, allowing blood to flow from the aorta to the pulmonary artery.
Transcatheter closure of atrial septal defect in symptomatic childrenRamachandra Barik
Atrial septal defect (ASD) constitutes 8%–10% of the
congenital heart defects in children. The secundum
ASD accounts for nearly 75% of all ASDs. Since
the introduction of transcatheter device closure for
secundum ASDs in 1976 by King et al., there has been
a paradigm shift in their management. Over the years,
the procedure has evolved significantly to become a
treatment of choice in many institutions. The Amplatzer
septal occluder (ASO) is the most widely used device
owing to its user-friendliness and high success rate.
Various studies have reported transcatheter closure
to be as effective, and with lower complication rate, as
compared to surgical closure.[4,5] However, most of these
studies have included bigger children, adolescents, and
adults. Although a few studies have demonstrated
the feasibility and reasonable safety of transcatheter
ASD device closure in very young children,[7-10] none of
them have addressed important issues like how large
a defect is too large for device closure, how to select
the size of the device, does the length of the interatrial
septum (IAS) matter in the device selection, and is
there a need for using modified techniques to achieve
successful deployment of the device in this subset of
patients which is characterized by relatively large defects
in small hearts.
Transcatheter closure of atrial septal defect in symptomatic childrenRamachandra Barik
Atrial septal defect (ASD) constitutes 8%–10% of the
congenital heart defects in children. The secundum
ASD accounts for nearly 75% of all ASDs. Since
the introduction of transcatheter device closure for
secundum ASDs in 1976 by King et al., there has been
a paradigm shift in their management. Over the years,
the procedure has evolved significantly to become a
treatment of choice in many institutions. The Amplatzer
septal occluder (ASO) is the most widely used device
owing to its user-friendliness and high success rate.
Various studies have reported transcatheter closure
to be as effective, and with lower complication rate, as
compared to surgical closure.[4,5] However, most of these
studies have included bigger children, adolescents, and
adults. Although a few studies have demonstrated
the feasibility and reasonable safety of transcatheter
ASD device closure in very young children,[7-10] none of
them have addressed important issues like how large
a defect is too large for device closure, how to select
the size of the device, does the length of the interatrial
septum (IAS) matter in the device selection, and is
there a need for using modified techniques to achieve
successful deployment of the device in this subset of
patients which is characterized by relatively large defects
in small hearts.
Our concepts of heart disease are based on the enormous reservoir of physiologic and anatomic knowledge derived from the past 70 years' of experience in the cardiac catheterization laboratory.
As Andre Cournand remarked in his Nobel lecture of December 11, 1956, the cardiac catheter was the key in the lock.
By turning this key, Cournand and his colleagues led us into a new era in the understanding of normal and disordered cardiac function in huma
Anomalous left coronary artery from the pulmonary arteryManu Jacob
In a normal heart, both coronary arteries arise (branch) from the aorta.
In anomalous left coronary artery from the pulmonary artery (ALCAPA), something goes wrong while the heart is forming in the womb
The left coronary artery arises from the pulmonary artery instead of the aorta
bentall, and 'old' procedures that still valid until present. Bail out for valve sparring & the patology of indonesian most present were best in this procedures
Our concepts of heart disease are based on the enormous reservoir of physiologic and anatomic knowledge derived from the past 70 years' of experience in the cardiac catheterization laboratory.
As Andre Cournand remarked in his Nobel lecture of December 11, 1956, the cardiac catheter was the key in the lock.
By turning this key, Cournand and his colleagues led us into a new era in the understanding of normal and disordered cardiac function in huma
Anomalous left coronary artery from the pulmonary arteryManu Jacob
In a normal heart, both coronary arteries arise (branch) from the aorta.
In anomalous left coronary artery from the pulmonary artery (ALCAPA), something goes wrong while the heart is forming in the womb
The left coronary artery arises from the pulmonary artery instead of the aorta
bentall, and 'old' procedures that still valid until present. Bail out for valve sparring & the patology of indonesian most present were best in this procedures
This file was made while my course of studying pediatrics at college,intednded to make the cardiology lessons more organized and easier to study and memorize. And I do hope it will be useful to the other medical students who read it.
Heart failure, sometimes known as congestive heart failure, occurs when your heart muscle doesn't pump blood as well as it should. Certain conditions, such as narrowed arteries in your heart (coronary artery disease) or high blood pressure, gradually leave your heart too weak or stiff to fill and pump efficiently.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
Follow us on: Pinterest
Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
2. CONGENITAL HEART DISEASESCONGENITAL HEART DISEASES
DEFINITION:
• Congenital heart disease is defined as the structural, functional or
positional defect of the heart in isolation or in combination present at
birth but may manifest at anytime after birth.
3. INCIDENCE OF CONGENITAL HEARTINCIDENCE OF CONGENITAL HEART
DISEASEDISEASE
1. 6 -8 per 1000 live births.
2. 2% of total death is due to CHD
3. Acyanotic heart disorders are more common than
cyanotic ones.
4. For girls –PDA,ASD
5. For boys –PS,AS,transposition and coarctation are
more common.
4. Classification of CHDClassification of CHD
• 2 types of CHD.
Acyanotic heart diseases
(Pulmonary blood flow)
Normaldecreased PBF
1. Pulmonary stenosis
2.Aortic stenosis
3.Coarctation of aorta
Increased PBF
1.Arterial septal defect
2.Ventricular septaldefect
3.Patent ductus arteriosus
5. COARCTATION OF THE AORTACOARCTATION OF THE AORTA
Definition:
COA is a localized malformation caused by a deformity of the
Aorta that results in a narrowing of the lumen of that vessels.
Incidence:
1.Accounts about 5% of CHD
2.13 of it present after childhood.
3.Male>Females(2:1)
6. Anatomy:
On the basis of their anatomical presentation COA is
classified into 2 types:
1.INFANTILE PREDUCTAL TYPE:
There is a constriction between the subclavian artery &the
arteriosus.98% is more common. It located at near the region of the
aortic isthmus.
2. POSTUCTAL TYPE:
Constriction at on distal to the ductus arteriosus.
Description:
1.Narrowing near the insertion of the ductus arteriosus.
2.Increased pressure to the proximal area (Head& Upper
extremities
3. Decreased pressure to the distal part of the defect
(Body& Lower extremities)
7. Pathophysiology and Haemodynamics:
Congenital causes
Narrowing within Aorta
Decrease pressure to the distal part of the defect
Increase pressure to the proximal part of the defect
Increase left ventricular workload
The flow of blood to the trunk &extremities through collateral arteries.
Collateral arteries bypass the coarctation
8. It connect arteries the branches of the subclavian artery to the arteries
which arise from Aorta below coarcation
Suzman’s sign(Dilatation of collateral arteries are often
seen over the scapular regions of the back)
HAEMODYNAMICS:
Preductal type:
The lower half of the body supplied by
Right ventricle through the ductus arteriosus
Postductal:
RV cannot maintain blood flow to the decending Aorta
9. Collateral arteries develops
It maintain flow from ascending to the decending Aorta.
Clinical manifestation:
1. High BP (Upper part of the body)
2. Bounding pulses in arms, weak femoral pulse
3. cool lower extremities with lower BP
4. Signs of CHF
5. Increase pressure it resulting in headache.
6. Dizziness
7. Fainting
10. 8.Epistaxis
9.Cerebrovascular accidents.
10.Muscle cramps in the leg while exercise due to anoxia.
INVESTIGATION:
1.X- ray:
Shows Dock’s sign
2.Retrograde aortography:
It passes via brachial artery may demonstrate the
presence &extent of coarcted area & state of collateral circulation.
3.Angiography:It shows COA
4.Cineangiography:Shows extent of the COA
5.Cardiaccatheteriztion:Estimate the progression of COA.
6.Echocardiography:Shows @ anomalies.
7. In radiology (Barium swallowing): Shows ‘E’ signs
11. MANAGEMENT:
Medical management:
1.Administer prostaglandin E1 (Ductal patency)
2.Treatment of Hypertension
a) beta blockers
b) M dopa
c) Captopril.
Surgical management:
1.End To End Anastomosis
2. Grafting
3.Percutanious balloon angioplasty
Prognosis:
1. Mortality < 5%
2.Preductal is poor.Postductal is better.
3.Increase risk in infants with other complex cardiac defects
13. PATENT DUCTUS ARTERIOSUS.PATENT DUCTUS ARTERIOSUS.
PDA is the third most common CHD in children
Definition:
PDA is the continuing patency of the ductus arteriosus,a
communication between the PA & ascending aorta.
Incidence:
1. Most common in premature infants
2. Less often in preterm infants
3.Occurs with other cardiac lesions
4.Ocurs about 7 -10 %
5.Female : male (2: 1)
6.Most common in klinefelters syndrome.
14.
15. Description:
1. DA - Artery connecting the aorta & PA
2. PDA – Is the failure of the fetal ductus arteriosus to close
within the I st weeks of life.
3.Continued patency of this vessel allows blood flow from the
higher pressure aorta to lower pressure PA.
Types of PDA:
1.Small
2.Moderate
1. SMALL PDA:
a) The opening usually less than 4 mm size at aortic end
b)Usually asymptomatic
c)Nogrowth failure
d)CHF
e)No murmur
16. 2. Moderate:
a) It can be symptomatic
b) Mild growth failure
c) The defect size is more than 4mm
d) Cardiomagaly
e) Murmur.
17. Embryology:
5th
& 7th
wk of gestation the aortic arch is formed
It form from the apex of the truncus arteriosus
Pulmonary arch gives a branch to develop lung
Right side of the lung Left side of the lung
It becomes PA It disappears Left side PA DA
18. It serve as connection between PA & the aorta
As soon as the baby is born the ductus is functionally closed.
Anatomical closure occurs around 6th
month of life
If it is remain for some reasons cause
Patent ductus arteriosus
19. Pathophysiology &Haemodynamics:
During fetal life
DA connects PA to the aorta
Blood reaches the descending aorta from PA to DA
Respiration begins at birth
Decrease pulmonary vascular resistance
Pulmonary arterioles dilate when PBF is increase
O2 level is increase
20. It cause the ductus to contract during 1 st 24 hrs to 72 hrs
It forms fibrous becoming ligamentum arteriosum
If this obliteration is not occur
Left to Right shunt
Blood flow from aorta to PA through PDA
Recirculation of oxygenated blood
Increase burden on left side of the heart
21. Increase pulmonary congestion
Left arterial, ventricular enlargement
Left ventricular hypertrophy.
Clinical manifestation:
1. Signs of CHF
2. Machinery like murmur
3. Widen pulse &bounding pulse
4. Bacterial endocarditis
5. Pulmonary vascular obstructive disease.
6. Dyspnea
7. Physical underdevelopment
8. Increased respiratory infections
9. Heart rate 150 bmt
22. 10.Gallop Rhythm (Due to rapid filling of the ventricle)
11.Cough
12.Heptospleenomagaly
Investigation:
1.X-ray : Left & Right ventricular
enlargement
2.Electrocardigraph : Left ventricular hypertrophy.
3.Echocardiography : Size of PDA,
4.Cardiac catheterization : Reveals increase pressure in RV.
Management:
Medical:
1.Treatment for CHF
2.Inefective endocarditis
3.Iron supplementation
4.Indomethacin
23. Surgical management:
1.Ligation of the patent vessel via left thoracotomy
2.Visual assisted thoracoscopic surgery
3.Smaller ductus –Triple ligation
4.Larger PDA -Division &suture
5.Coil occlusion
6.Device closure-Amplatzer
7.Other modalities:
a) Video assisted thoracoscopic ligation
b) Video assisted thoracoscopic clipping
Preterm with PDA >10 days:
Indomethacin.-0.1 mg kg 12 hr *2 doses
Ibuprofen –syrup -10mgkg
24. Prognosis:
1.Average life expectancy 23-40 yrs.
2.Prognosis following surgery is excellent
Complication:
1. Sub acute bacterial endocarditis.
2.PH
3.CCF
4.Bronchitis
5.Aneurysm
6.Rarely rupture of the greatly
dilated ductus & PA
7.Reversal of shunt
25. NURSING MANAGEMENTNURSING MANAGEMENT
Nursing management of infant with acyanotic heart disease
includes helping family members to adjust to the child’s
care &both preoperative &post operative care.
1.General nursing care:
a) Helping family members to adjust
b) During episodes Dyspnoea
c) Need for comfort & rest
e) Nutrional needs
f) Psychosocial needs
g) Continuing care
h) Family relationship
i) Financial support
26. 2.Preoperative care:
It includes
a) Pre operative assessment
b) Pre operative teaching
A)PRE OPERATIVE ASSESSMENT:
1.Admission history &physical examination
2.Pre operative studies
3.Baselines vital status.
4.Anthropometric measurement
5.Additional nursing observation.
B)PRE OPERATIVE TEACHING:
1. Introduction to environment.
2. Introduction to equipment
3.Introduction to postoperative procedures
27. 3.Post operative care:
1. Transfer to ICU
2.Monitor vital signs.
3.Assist in restoring the optimal functioning of the
-Cardiopulmonary
-Gastro intestinal
-Renal
-CNS.
28. NURSING DIAGNOSISNURSING DIAGNOSIS
1.Ineffective breathing pattern related to decreased PBF
Nursing intervention:
1. Assess the general condition.
2. Check breathing pattern
3. Poisoning & Head elevation
4. Avoid any constructing clothing
5. Administer humidified O2
6. Assess the respiratory rate
7. Assess O2 saturation
8. Provide calm & warm place
9. Provide comfort bed.
29. 2.Decreased cardiac output related to structural defect.
Nursing intervention:
1. Assess cardiac function
2. Provide quite environment
3. Provide tender loving care
4. Provide appropriate play to reduce anxiety
5. Administer Digoxin as order
6. Observe signs of hypokalemia
7. Observe for signs of hypotension
8. Monitor electrolyte level
9. Observe cardiac monitoring carefully.
30. 3.Imbalance nutritional status less than body requirement
related to less food intake.
Nursing intervention:
1. Assess the child's nutrional status
2. Assess the child’s Nausea,vomiting,inability to eat
3. Check the weight daily
4. Provide small amount of formula &food frequently
5. Feed slowly &Buddle to prevent distention of stomach
6. Provide low fat diet
7. Provide fruits &fiber rich diet
31. 4.Activity intolerance related to imbalance between O2
supply & demand
Nursing intervention:
1. Assess the child’s response to activity
2. Maintain neutral thermal environment
3. Respond promptly ti crying
4. Provide calm &comfortable environment
5. Feed small volume at frequent intervals
6. Provide divertional activity
7. Change the position of the child every 2 hours
8. Teach the parents ,about child’s activity
32. 5.Risk for infection related to reduced body defences
Nursing intervention:
1. Assess the child for any changes
2. Maintain aseptic environment
3. Use sterile equipment
4. Maintain good hand washing
5. Isolate child if nosocomal infection
6. Provide nutritional diet according to child’s preference
7. Teach family about manifestation of illness
8. Maintain disposal method
9. Administer antibiotics
33. 6. Risk for complication related to improper care or no early treatment
Nursing intervention:
1. Assess the condition of the child
2. Monitor vital signs
3. Response immediately for cry
4. Maintain aseptic technique
5. Administer O2 to prevent brain damage
6. Take early intervention
7. Frequent observation
8. Explain complication
9. Explain about early treatment
34. 7.Altered family process related to illness or hospitalization
Nursing intervention:
1. Assess the current knowledge.
2. Assess the current scoping skills
3. Recognize parental concern
4. Explore family feelings &problems surrounding
5. Clarify the doubts
6. Provide support as needed
7. Provide information on resources available
35. 8.Altered growth & development related to impaired blood supply
to the brain
Nursing intervention:
1. Check development of the child
2. Check anthropometric maseaurement
3. Encourage learning of self care skills
4. Provide nutritional diet
5. Provide play therapy
36. 9.Fear & Anxiety related to difficult breathing ,unfamiliar procedures
Nursing intervention:
1. Establish rapport with child & parents
2. Explain about the disease condition
3. Provide calm &quite environment
4. Explain unfamiliar procedure
5. Provide frequent attendance
6. Provide comfort
7. Instill confidence
8. Provide divertional activities
37. 10.Knowledge deficit related to treatment and follow up care
Nursing intervention:
1. Assess the knowledge of mother
2. Allow the mother to ask doubts
3. Explain the procedures
4. Explain about medication
5. Explain about nutrition
6. Explain the importance of surgery & follow up care.