Ventricular Septal Defect
Definition
Congenital defect when there's a hole in the ventricular septum and blood flow to lungs increases
Causes
Congenital heart defect from birth
Severe blunt trauma to the chest
Signs and Symptoms
Fatigue
Congested lungs
Difficulty in breathing
Excessive sweating
Nursing intervention
Measure apical pulse for full 1 minute
High caloric intake together with supplements
Monitor potassium level because if it is high digoxin toxicity increases
Monitor intake and output
Diagnostic Purposes
Chest X-ray: To see if heart is enlarged or if lungs have extra fluids
Pulse Oximetry: Help measure amount of oxygen in the blood
Echocardiogram: Determines size, location and severity of VSD
Phatophysiology
Cardiac catheterization and echocardiography will dertemine size of cardiac shunt
Flow through pulmonary vascular bed(QP) is compared to flow through systemic vascular bed, normal rati is 1. if QP/QS is greater than 2 then symptoms manifest
Systemic flow can be reduced if shunt is large resulting in congestive heart failure symptoms
Significant left to right shunting can occur resulting in high ventricular cardiac output
Treatment
Diuretics
ACE inhibitors
Digoxin
Lopressor
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