Soo I am preparing a care plan for a 2 month old who is found to have patent ductus ateriosus. In our pediatric nursing book all that it has on this defects is a small box so i have resorted to googleing.. and searching frantically in our online university library. There seems to be little.. my two diagnoses are decreased cardiac output r/t altered contractility (unsure if thats correct) and ineffective tissue perfusion r/t congential cardiac anomalies (i like this best). I have identified outcomes.. and some nursing interventions yet am STILL stumped on the assessments prior to the diagnoses. I understand there is a "machinery-like" murmur.. but is that it? I dont believe it can be. Also our professor added a new step into our care plan which is "implementation" right after nursing interventions.. im confused. Any help would be greatly appreciated!!