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Nursing Care Plan for Patent Ductus Arteriosus

Assessment
  • Health history: a physiological response to the defect (cyanosis, limited activity).
  • Assess for signs of heart failure, rapid breathing, shortness of breath, retractions, extra heart sounds (machinery mur-mur), hepatomegaly.
  • Assess for chronic hypoxia: Clubbing finger
  • Assess for hyperemia at the fingertips
  • Assess diet, weight gain
  • Psychosocial Assessment include: age of the child, the task of child development, coping is used, the child's habits, family response to childhood diseases, family coping and family adaptation to stress.


Nursing Diagnosis for for Patent Ductus Arteriosus
  1. Decreased cardiac output r / t cardiac malformations.
  2. Impaired gas exchange r / t pulmonary congestion.
  3. Activity intolerance r / t imbalance between oxygen consumption by the body, and the supply of oxygen to the cells.
  4. Altered Growth and Development r / t inadequate supply of oxygen and nutrients to the tissues.
  5. Imbalanced Nutrition, Less Than Body Requirements r / t fatigue at mealtime and increased caloric needs.
  6. Risk for infection r / t decrease in health status.


Nursing Interventions for for Patent Ductus Arteriosus

1. Maintain adequate cardiac output:
  • Observation of the quality and strength of heart rate, peripheral pulses, skin color and warmth.
  • Enforce the degree of cyanosis (circumoral, mucous membranes, clubbing).
  • Monitor signs of CHF (restlessness, tachycardia, tachypnea, tightness, fatigue, periorbital edema, oliguria, and hepatomegaly).
  • Collaboration of digoxin appropriate order, using the toxicity hazard prevention techniques.
  • Give treatment to reduce afterload.
  • Give diuretics as indicated.
2. Reduce the increase in pulmonary vascular resistance:
  • Monitor the quality and respiratory rhythm.
  • Adjust the position of the child with Fowler position.
  • Avoid child of an infected person.
  • Give adequate rest.
  • Provide optimal nutrition.
  • Give oxygen if indicated.
3. Maintaining adequate levels of activity:
  • Allow the child to rest frequently, and avoid disturbances during sleep.
  • Encourage games and activities to do lightly.
  • Help the child to choose activities appropriate to the age, condition and ability of the child.
  • Avoid the ambient temperature is too hot or too cold.
  • Avoid the things that cause fear / anxiety in children.
4. Provide support for the growth and development
  • Assess the level of development of the child.
  • Give the stimulation of growth and development, play activities, gaming, watching TV, puzzles, drawing, and others according to the condition and age of the child.
  • Involve the family in order to keep providing stimulation for treatment.
5. Maintaining growth in weight and height appropriate
  • Provide a balanced diet, high nutrients to achieve adequate growth.
  • Monitor height and weight, documented in the form of graphs to identify trends in the growth of the child.
  • Measure body weight each day with the same weight and the same time.
  • Record intake and output correctly.
  • Give food with small portions but often to avoid fatigue at meals.
  • Children who receive diuretics are usually very thirsty, therefore not restricted fluid.
6. Children will not show signs of infection
  • Avoid contact with infected individuals.
  • Give adequate rest.
  • Give the optimal nutritional needs.

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