Tatalaksana pasien tetralogi fallot Pada penderita yang mengalami serangan sianosis maka terapi ditujukan untuk memutus

patofisiologi serangan tersebut, antara lain dengan cara : 1. Posisi lutut ke dada agar aliran darah ke paru bertambah 2. Morphine sulfat 0,1-0,2 mg/kg SC, IM atau Iv untuk menekan pusat pernafasan dan mengatasi takipneu. 3. Bikarbonas natrikus 1 Meq/kg BB IV untuk mengatasi asidosis 4. Oksigen dapat diberikan, walaupun pemberian disini tidak begitu tepat karena permasalahan bukan karena kekuranganoksigen, tetapi karena aliran darah ke paru menurun. Dengan usaha diatas diharapkan anak tidak lagi takipnea, sianosis berkurang dan anak menjadi tenang. Bila hal ini tidak terjadi dapat dilanjutkan dengan pemberian :

Propanol 0,01-0,25 mg/kg IV perlahan-lahan untuk menurunkan denyut jantung sehingga seranga dapat diatasi. Dosis total dilarutkan dengan 10 ml cairan dalam spuit, dosis awal/bolus diberikan separohnya, bila serangan belum teratasi sisanya diberikan perlahan dalam 5-10 menit berikutnya. Ketamin 1-3 mg/kg (rata-rata 2,2 mg/kg) IV perlahan. Obat ini bekerja meningkatkan resistensi vaskuler sistemik dan juga sedatif Penambahan volume cairan tubuh dengan infus cairan dapat efektif dalam penganan serangan sianotik. Penambahan volume darah juga dapat meningkatkan curah jantung, sehingga aliran darah ke paru bertambah dan aliran darah sistemik membawa oksigen ke seluruh tubuh juga meningkat.

Lakukan selanjutnya 1. Propanolol oral 2-4 mg/kg/hari dapat digunakan untuk serangan sianotik 2. Bila ada defisiensi zat besi segera diatasi 3. Hindari dehidrasi

etralogy Of Fallot In Children

WHAT YOU SHOULD KNOW:
Tetralogy Of Fallot In Children (Aftercare Instructions) Care Guide

Tetralogy Of Fallot In Children Tetralogy Of Fallot In Children Aftercare Instructions

Tetralogy Of Fallot In Children Discharge Care Tetralogy Of Fallot In Children Inpatient Care En Espanol Tetralogy of Fallot, also called TOF, is a congenital heart disease that causes cyanosis (bluish color of the skin). A congenital heart disease is one that a person is born with. Cyanosis occurs when blood from right side of the heart goes directly to the left side. The blood does not pass through the lungs, and it will not carry enough oxygen to give to the body. With TOF, four different problems happen in your child's heart while inside the womb. The first problem is that the wall separating the two ventricles does not completely close, forming a hole. The second problem is that the blood vessel that connects the heart to the lungs is narrowed. The third problem is that the aorta (major artery) abnormally grows from both ventricles, rather than from the left ventricle only. The fourth problem is that the increased backflow of blood causes the muscles of the right ventricle to enlarge and thicken.

Problems in the development of your child's heart while inside the womb are thought to cause TOF. These problems may be as a result of infections or the use of certain medicines and alcohol during pregnancy. TOF is diagnosed by echocardiography, blood tests, heart catheterization, chest x-ray, electrocardiogram (ECG), or doppler test. Treatment may include oxygen, medicines, such as heart medicines or diuretics, and surgery. With treatment such as surgery, your child's quality of life may be improved.

INSTRUCTIONS: Medicines:

Keep a current list of your child's medicines: Include the amounts, and when, how, and why they are taken. Bring the list and the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency. Throw away old medicine lists. Give vitamins, herbs, or food supplements only as directed.

Give your child's medicine as directed: Call your child's primary healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Ask before you change or stop giving your child his medicines. Antibiotics: This medicine is given to fight an infection caused by bacteria. Give your child this medicine exactly as ordered by his primary healthcare provider. Do not stop giving your child the antibiotics unless directed by his primary healthcare provider. Never save antibiotics or give your child leftover antibiotics that were given to him for another illness. Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often. Heart medicine: This medicine may be given to make your child's heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your child's medicine is and why he is taking it.

Ask for more information about where and when to take your child for follow-up visits:
For continuing care, treatments, or home services for your child, ask for information.

Caring for your child:

Activity: Your child may feel like resting more. He should match his activity to the amount of energy he has. Your child should take naps (sleep) and rest as much as possible. Give him books or a drawing pad for quiet play. If he has shortness of breath or fatigue, he may not be able to do heavy exercise or sports. Ask your child's caregiver for more information on what activities your child is allowed to do. Diet: Give your child healthy food from all of the five food groups: fruits, vegetables, breads, dairy products, meats and fish. Eating healthy foods may help your child feel better and have more energy. It may also help your child get better faster. Ask your child's caregiver if your child should be on a special diet. Liquids: Give your child 8 to 10 (eight ounce) glasses of liquid to drink each day. Follow the advice of your child's caregiver if you must limit the amount of liquid your child drinks. Good liquids to drink are water, juices, and milk. Limit the amount of caffeine your child drinks. Caffeine may be found in coffee, tea, soda, and sports drinks. Oral hygiene: Keep your child's teeth and gums healthy. Ask your child's caregiver if antibiotics should be given when your child is having his teeth cleaned. Antibiotics may also be needed if your child has been exposed to someone with certain infections.

Second-hand smoke: Do not let anyone smoke around your child. Smoke can make your child cough or make it hard for him to breathe. Smoke can harm your child's heart, lungs, and blood. Your child is more likely to get lung disease and cancer if people smoke around your child. Vaccines: Have your child vaccinated (given a shot) to help protect him from infections caused by viruses or bacteria. Ask your child's caregiver for more information about vaccinations.

CONTACT A CAREGIVER IF:

Your child has a fever. Your child has chills, a cough, or feels weak and achy. Your child's skin is itchy, swollen, or has a rash. You have questions or concerns about your child's TOF, medicines, or his treatments.

SEEK CARE IMMEDIATELY IF:

Your child has trouble breathing all of a sudden. Your child has weakness or numbness in an arm, leg, or on his face. Your child's lips or fingernails are blue or white in color. Your child's signs and symptoms get worse

Feeding and Nutrition

Babies who have tetralogy of Fallot can tire while nursing or feeding. Small, frequent meals may be easier for your baby to handle. Your child also may need extra nutrition. A supplement or an extra feeding can give the baby more calories, vitamins, or iron. Your child's doctors will work with you to decide whether your baby needs extra nutrition.