Nursing 209

N209: Reproductive Health Study Guide • If a large defect is noted, surgical correction is recommended to prevent complications as they reach adulthood Patent Ductus Arteriosus • In utero, the DA allows blood to bypass the lungs and oxygenation occurs via placenta and umbilical cord • Normally closes within a few days after birth • Affects girls more than boys • If it remains open, blood flows into the lungs and causes increased pressure and pulmonary hypertension • Can also cause heart failure and endocarditis • If multiple cardiac defects are present, meds may be given to keep PDA open for survival • Diagnosed when heart murmur is noted; confirmed on echocardiogram • Can be closed with meds in infants; older children and adults require surgery • In preterm infants, it often closes within the first two years of life • In full term infants, a PDA that remains open after the first weeks of life rarely closes on its own • Signs and symptoms: Tachypnea, tachycardia, poor feeding, SOB, easily fatigued, and poor growth Critical Congenital Heart Defects • Leads to hypoxia and requires surgery in first year of life; a life-threatening condition • Affects approximately 18:10,000 babies • Sometimes the infant is discharged to home before the defect is detected because they appear healthy at birth; they then quickly decompensate • Newborn Screening: Refer to chapter 5 o Now performed at 24 hours of age or as late as possible prior to discharge o Can pass screening but still have CCHD or another CHD o Seven CCHDs detected on screening:  Hypoplastic left heart  Pulmonary atresia  Tetralogy of fallot  Total anomalous pulmonary venous return  Transposition of great arteries  Tricuspid atresia  Truncus arteriosus

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