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Nurs 6541 Assignment 1: Application – Protocol for Diagnosis, Tetralogy of Fallot

Essay Instructions:

Nurs 6541
Assignment 1: Application – Protocol for Diagnosis, Management, and Follow-Up Care of Disorders, week 7
As pediatric patients grow from infancy to adolescence, there are many common body system disorders that may potentially present. As an advanced practice nurse caring for these patients, you must understand the pathophysiology and epidemiology of these disorders as this will help you to recognize symptoms and select appropriate assessment and treatment options. In this Assignment, you prepare for your role in clinical settings as you design a protocol for the diagnosis, management, and follow-up care for a common body system disorder.
My choice of Topic (Tetralogy of Fallot)

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Tetralogy of Fallot
Name
Institution
Tetralogy of Fallot
Tetralogy of Fallot, a common body system disorder that is present at birth. It occurs to about one in about 2,000 new-borns. The disease has four related heart defects, which include ventricular septal defect, overriding aorta, pulmonary stenosis and right ventricular hypertrophy. Children with the tetralogy of Fallot may also have other ventricular septal flaws, an atrial defect or irregularities in the branching form of their coronary arteries. Some patients have a complete hindrance to the flow of blood from the right ventricle. The disease may also be related to chromosomal abnormalities. In the early detection of tetralogy of Fallot, physicians frequently treat the disease by open-heart surgery. The baby’s signs and size determine the timing of surgery. The paper focuses on the defects, protocol for the diagnosis, management, and follow-up care for tetralogy of Fallot.
The disorder has a combination of four defects that occur together. To start with is Ventricular septal defect, which is a hole between the two ventricles. In major aorta defect, the aortic valve is engorged and seems to arise from the ventricles rather than the left ventricle. Pulmonary stenosis involves contraction of the pulmonary valve and outflow area underneath the valve that blocks the flow of blood from the right ventricle to the pulmonary artery (O'Brien& Marshall, 2014). Lastly, the right ventricular hypertrophy defect causes thickening of the muscular walls of the right ventricle. Pulmonary stenosis and right ventricular outflow tract obstacle in tetralogy of Fallot limits the flow of blood to the lungs. When there is minimal blood flow to the lungs, both the ventricular septal defect and overriding aorta permits blood with deficiency of oxygen to return to the right atrium and right ventricle. The movement of blood with low oxygen level from the right ventricle to the body leads to a decrease in the arterial oxygen saturation and as a result, young ones appear blue.
Diagnosis
Diagnosis of congenital heart defects is echocardiography, which is fast and does not involve radiation. The diagnosis is also accurate and can be completed prenatally. In the past, doctors used chest x-ray for their diagnosis since the abnormal boot-like form of a heart with tetralogy of Fallot is typically visible (Fernandez &Kuczkowski, 2004). Lack of interstitial lung patterns secondary to pulmonary oligemia is alternative definitive finding in tetralogy of Fallot.
When significant cyanosis is detected in an infant, he or she is often placed in supplemental oxygen. The increased quantity of oxygen in the baby improves the child's oxygen levels in situations of lung disease, but inhalation of extra oxygen will have minimal effect on the oxygen standards of an infant with tetralogy of Fallot. Physicians use hyperoxia test to detect a cyanotic cardiac defect, where failure to react to the trial gives the first clue to suspect the fault. Children with this disorder may have normal oxygen levels only if the pulmonary stenosis is mild. For these children, the evidence to imply a cardiac defect is the discovery of a loud murmur when testing the infant.
After an echocardiography suspects the presence of a congenital heart disease, he or she can rapidly and accurately validate the four correlated defects representatives of tetralogy of Fallot. At most cases, Cardiac catheterization is necessary to assess the size and distribution of the pulmonary arteries and to make clear the branching forms of the coronary arteries. Catheterization also helps in demonstrating if patients have pulmonary blood flow provided by an unusual blood vessel from the aorta.
Management
After a diagnosis of a tetralogy, immediate management is vital since it determines whether a child’s oxygen levels are safe. When oxygen levels are low immediately after birth, a prostaglandin infusion is introduced to keep the ductus arteriosus open to offer extra pulmonary blood flow and heighten the infant’s oxygen level (Shakya, Sharma, & Shrestha, 2015). These children will require surgical intervention during the neonatal period. Children with normal oxygen levels are released to go home in the first days of their lives. When an infant is six months, complete repair is selectively done, where oxygen levels remain adequate. Surgical alteration of the deficiency is always essential. Sometimes, patients will need a surgical palliative technique earlier to the final adjustment.
The management aims at lessening pulmonary vascular resistance and heightening systemic vascular resistance. The management is divided into three; prehospital management, emergency department management, and postoperative Management. In prehospital mana...
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