Tetra of Fallot? - page 2

by Stephalump

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My patient this week was a peds patient with pneumonia. He had a history of open heart surgery to correct a congenital defect called Tetra of Fallot. I looked up the defect in my med-surg book and on a couple Internet... Read More


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    Quote from Stephalump
    My patient this week was a peds patient with pneumonia. He had a history of open heart surgery to correct a congenital defect called Tetra of Fallot.

    I looked up the defect in my med-surg book and on a couple Internet resources, but I don't really understand what it is and why it has an impact on a patient with a respiratory disease years after correction. I (vaguely) get that the defect causes oxygenation problems, so anything that impairs gas exchange would be a problem, but even after surgery?

    Anyone care to help me out?
    As far as his PNA, tell us your assessment? How was his breathing? Did he have a history of needed supplemental oxygen support? Was he vibrant or frail? How long ago was the surgery? Did he have a murmur? How did his lungs sound?

    Was his pna lobar or interstitial?
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    the defect made the pneumonia more urgent. His murmur was really pronounced (supposedly moreso than usually, according to his pediatrician) and his chest x-ray showed his heart was enlarged.
    This child has an enlarged heart and a murmur placing him at greater risk for comlications.....and more vulneralbe to infections
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    I had an exam today so I had to put my care plan on the back burner for a few days, but I wanted to be sure to that you all for your help!

    I have had zero pediatrics so far (someone had to volunteer to go into the rotation early, and that someone ended up being me) so I felt extremely lost and lacking in knowledge while I was there. Y'all definitely helped a lot!
  4. 1
    Quote from Stephalump
    I had an exam today so I had to put my care plan on the back burner for a few days, but I wanted to be sure to that you all for your help!

    I have had zero pediatrics so far (someone had to volunteer to go into the rotation early, and that someone ended up being me) so I felt extremely lost and lacking in knowledge while I was there. Y'all definitely helped a lot!
    If you are working with a population of chronically ill kids, odds are the parents will know far more about the kid's illness than you. So I will let you in on a huge insider secret tip...

    Ask the parents "tell me what you understand about your child's illness (or the history of)". It allows you to assess their insight and it fills in gaps for you. Plus, as nurses, we care about more than just the disease, we care about the individual's experience of the disease.
    GrnTea likes this.


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