TETROLOGY OF FALLOT SCENARIO Joseph, a 3-week-old infant, was…TETROLOGY OF FALLOT SCENARIO Joseph, a 3-week-old infant, was…

Question Answered step-by-step TETROLOGY OF FALLOT SCENARIO Joseph, a 3-week-old infant, was… TETROLOGY OF FALLOTSCENARIOJoseph, a 3-week-old infant, was admitted to the cardiac PICU since birth d/t severe central cyanosis and respiratory distress, oxygen saturation of 70%. Resuscitation at delivery and given Prostin (Prostaglandin E2). Dusky undertones with cold, cyanosed peripheries. He was started on CPAP, after reaching 80% SaO2 at 5 days after birth, it was weaned off. Antenatal ultrasound scans found several congenital heart problems, pulmonary stenosis, ventricular septal defect (VSD) and overriding aorta. Postnatal cardiac catheterization confirmed the findings, and he was given a diagnosis of tetralogy of Fallot. Question 1: What 4 defects are present with diagnosing TOF? He tolerated feeding via TPN and was given 6ml expressed breast milk every 2 hours. Bottle feeding was attempted, and he tolerated the feedings well. Recently, the feedings increased to 44ml every 2 hours. Joseph passed urine normally and his stools were of normal consistency. Question 2: A typical comment made by parents that would alert the nurse about the presence of a congenital heart defect is:A)          “He is always hungry”B)           “He tires out during feedings.”C)           “He is fussy for several hours every day.”D)          “He sleeps all the time.”Family History: Joseph’s father was diagnosed with cardiac defects (ASD, pulmonary stenosis & right ventricular dysfunction). Joseph’s mother has asthma and had gestational diabetes during pregnancy. She is a non-smoker, abstained from alcohol during the pregnancy, and is prescribed Ventolin for her asthma. Baby Joseph is the 3rd child in the family, having 1 brother and 1 sister. His brother was also diagnosed with Tetralogy of FallotAssessment: You arrive on the unit for your scheduled day of work. You are assigned Joseph and receive report from Nancy at the bedside. After report, you perform an initial assessment:No distress or painAlert/non-lethargicApyrexial (temperature 98.7)Bluish discoloration of lips and tongueSa 83% on RAHR: 156 bpmRR: 48/minBP 78/45 mmHgAnterior fontanelle WDLNo radial-radial delay or radial-femoral delayCarotid pulses WDLHand/nails WDLFace WDL-no noted abnormalitiesNon-cyanotic fingersNo finger clubbing/splinter hemorrhagesNon-pallor palmar creasesNon-pallor conjunctivaMild central cyanosisQuestion: What forms of treatment do you expect to anticipate?Digoxin 50 mcg/mLSurgical options: intracardiac repair, temporary shunt IV fluids LR 20 ml/hrNone of the aboveQuestion: The doctor comes to the patient’s bedside to speak with the mother and tells her since her baby has several cardiac defects including TOF, surgery is needed. He discusses the surgery with the mother, and she said she has no questions for the doctor. Once the doctor leaves the room:Joseph’s mother asks, “What is tetralogy of Fallot (TOF)? Your best response to her is: A)          “Tetralogy of Fallot is a complex heart condition that involves several congenital heart defects.” B) “Don’t worry, we have it under control.” C) “It’s a heart defect probably caused from your uncontrolled diabetes.” D) “It’s a heart problem that he may die from.” Question: You receive orders that Joseph is scheduled for surgery to have a palliative shunt placed today at 5pm. You review the orders and begin implementation. Consents from his parents are obtained after they verbalize, they have no other questions.You are preparing the baby for surgery. What orders would you expect to findA)          Nothing by mouth (NPO)B)           Preoperative antibioticsC)            Electrocardiogram (ECG)D)           All of the above Question: What are your postoperative interventions and assessments for the infant?  Health Science Science Nursing NURSING 1524 Share QuestionEmailCopy link Comments (0)