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Ventricular Septal Disorder, Vitals:, Medications:, Reason For seeking…
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Medications:
Signs of Digoxin Toxicity: Include bradycardia, tachycardia, irregular pulse, anorexia, nausea, vomiting, diarrhea, drowsiness & behavioral changes
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Digoxin 0.035 mg P.O. 2x daily, starting in the morning
Reason For seeking Care: Clincal diagnosis of mild heart failure with supporting chest xray and electrocardiogram
Outcome
A diagnosis of Large VSD with mild HF, controlled. She is discharged to home. At-home medications of digoxin 0.035 mg P.O. B.i.d., with understand to not admit medicine if apical pulse is less than 100 BPM. She will follow up with the surgeon for correction of VSD.
Nursing Diagnosis
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Readiness of family coping as evidence of family expressing ability for additional support if needed.
Activity intolerance may be related to imbalance of oxygen supply and demand as evidence of needing rest during feedings.
Interventions
Surgery sutures path over the VSD via median sternotomy. Post-surgery and post-anesthesia care are uneventful. Jenny is transferred to PICU. She is intubated on a ventilator with mediastinal chest tubes, pacing wires, arterial lines, and central venous pressure lines for monitoring. Mom demonstrates a willingness and ability to assist with the care of jenny. Comfortable as well with assessing apical pulse before the administration of digoxin. Jenny is able to eat from a bottle without pausing for breaths and now is eating more during the day and sleeping through the night.