Nursing Care Plan for Congenital Heart Defects

Pathophysiology

A congenital heart defect is a structural problem with the heart that is present at birth, but may not be detected until later in childhood or adulthood. Congenital heart defects are often divided into two main categories: cyanotic and acyanotic. Cyanotic heart defects are those that result in low blood oxygen level and create a bluish color of the skin. Some cyanotic heart defects include heart valve defects, Tetralogy of Fallot, and defects of the pulmonary vein. Acyanotic heart defects are characterized by defects of the atrial septum or ventricular septum that may change the flow of blood, but does not affect the oxygen level in the blood.

Etiology

The heart begins developing and taking its shape during the sixth week of pregnancy. While it is still unclear why many of these defects develop, it is believed that genetics, maternal medications and environmental factors (such as smoking during pregnancy) may be involved. In cyanotic defects, the blood flows from the right side to the left side of the heart through defects in the valves or abnormal openings. This causes the oxygenated blood to mix with deoxygenated blood so that there is less oxygen being pumped to the body. In acyanotic defects, the blood flows from the left side to the right side of the heart, usually due to an abnormal opening in the septum that divides the atrium or ventricles or may be caused by an opening between the pulmonary artery and the aorta. Narrowing of the pulmonary or aortic valves can also cause acyanotic defects.

Desired Outcome

Patient will have adequate cardiac output with blood pressure and heart rate within normal limits; patient will have optimal activity tolerance; patient will have adequate oxygenation and tissue perfusion

Congenital Heart Defects Nursing Care Plan

Nursing Interventions and Rationales

• Assess and monitor vital signs

• Auscultate heart and lungs for abnormal sounds

• Assess skin for cyanosis or pale color

• Obtain 12 lead ECG per facility protocol

• Assess peripheral pulses and capillary refill

• Obtain daily weights

• Position patient for comfort in upright or semi-Fowler’s position

• Administer supplemental oxygen via mask or hood as required

• Administer medications appropriately

• Cluster care and provide rest periods

• Prepare patient for and assist with catheterization or surgery as appropriate

• Provide patient and parent education regarding lifestyle restrictions and prevention of complications

References

• https://www.mayoclinic.org/diseases-conditions/congenital-heart-defects-children/diagnosis-treatment/drc-20350080
• http://www.heart.org/HEARTORG/Conditions/CongenitalHeartDefects/Congenital-Heart-Defects_UCM_001090_SubHomePage.jsp