Cardiovascular Case Study: Atrial Septal Defect

atrial septate Defect(ASD) is a very wide-ranging problem concerning the fancy in its overall function. When the heart, world the core of the cardiovascular system, has issues it effects the rest of the personate as a result. The core of the problem resides in the atrial septum. Normally the heart is divided into quaternary separate chambers. But a person with atrial septal defect has an atrial septum that allows the blood from the go forth side of the heart back into the right side. This results in increased pulmonary blood flow and diastolic overload of the right ventricle.By having this constant left-to-right shunt, it can shift the pulmonary vascular resistance leading to hypertension or even the reversal of the shunt itself. on that point atomic number 18 three types of Atrial Septal Defects ostium secundum, ostium primum, and fistula venosus. The opening of the atrial septum may be small, on the count of the foramen ovale failing to close or large, when the septum is do itly absent from the heart itself. There is a very logical explanation between Ryans softness to gain weight, as well as not taking an interest in provender during meals.His carcass isnt able to grow normally because the exchange of nutrients and barbaric products in his body is completely deficient. He isnt absorb the adequate amount of nutrients that his body directs. Him being 11-months old, this causes a huge problem because nutrition is extremely important. His heart is working little efficiently, which makes the blood traveling end-to-end his body subsequently deficient as well. each of the systems in Ryans body are going to be affected by his diagnosis of Atrial Septal Defect. Ryans growth and development is not detach for his age.Ryan was natural weighing 7lbs, and now, 11 months later he is 15. 4 lbs. He is close to being a 1 year old, and his birth weight should be a little less that triple the amount that he was at birth. Ryan should be approximately 21 lb s at his period age, leaving about a 5-6 lb deficit. Ryans parents stated that he doesnt crawl or campaign to stand because of the fact that he gets out of snorkel breather easily. This is being caused by the Atrial Septal Defect. every(prenominal) he can do is sit unsupported, which he should have been able to do at 8 months.At 11 months old, Ryan should be able to stand honest holding onto an adults hand, as well as endure himself finger foods and drink from a sippy cup. He should be able to pull himself up to a rest position as well. Also, sleeping after take in is just an indication of how much energy it is for him to complete a meal, which is making him uninterested in food overall. Again, all of these factors seem to be affected by his current diagnosis. Ryan is currently on digoxin two hundred micrograms and furosemide 10 mg q day.He is prescribed Digoxin because this medication increases overall cardiac output as well as slowing the heart rate. This is unsloped for Ryan, because at this point he is not receiving the appropriate amount of output needed for his growth and development. Furosemide is a diuretic that treats roving retention as well as hypertension. This is important because when there is a defect with the heart, pulmonary issues may occur when fluid retention begins. Also, Ryan is currently predisposed to hypertension because of his condition. Ryans current Potassium level was at a 2. 9 mml/L.Adequate levels of Potassium compared to his age should be at 3. 3-4. 7 mmol/L. Too little Potassium affects the hearts oftenness as well as contractions. His Digoxin levels were tested to see if the medication was becoming toxic. He was at a 2. 6 ng/ml which is in the upper limits, but not enough to be considered toxic. Here are some examples of nursing diagnosis that patients uniform Ryan would have luck for deficient fluid record book think to pre operating(prenominal) diarrhea. Impaired nutrition less than body requirements. Decrease d cardiac output think to pre-existing compromise in cardiac function.Fatigue related to decreased cardiac output. Nursing Diagnosis for Ryan Post sherlock would be Risk for infection related to functional incision. Acute pain related to post operative surgery. Impaired verbal communication related to age. Risk for aspiration related to immobility. Teaching is such a vital component in ensuring that all patients are fully aware of their medical condition. Ryan, being an 11 month old, the teaching must go to his parents. They pass on need to be supplied information about Atrial Septal Defect, surgeries involved, and the prognosis when completed.They go forth need proper(postnominal) information about the medications that Ryan is going to be on. They will need to be aware of the medications actions, side effects, and realizable signs of toxicity/allergies. If Ryan were to have surgery, they would need to be taught how to sustainment for the incision properly to avoid infection . They will need to know the signs and symptoms of infection. Last, they will need to ensure that they are constantly promoting proper growth and development with Ryan, so a daily plan must be made. That includes activities, diet, etc.