Type of

Anomaly
Ventricular
Septal Defect
(VSD)
Increased
pulmonary
blood flow,
Acyanotic

Description

Atrial Septal
Defect (ASD)
Increased
pulmonary
blood flow,
Acyanotic

Opening in the
septum between
the right and left
atria

Heart failure,
ventricular
hypertrophy,
respiratory
problems, bacterial
endocarditis, failure
to thrive, growth
retardation
Dyspnea, tachypnea,
fatigue after
exertion, murmur,
clubbing,

Patent
Ductus
Arteriosus

Failure of fetal
ductus arteriosus
to close after

Atrial arrhythmias,
heart failure ,
respiratory
infections, mitral
valve prolapse,
growth retardation
Bounding pulses,
visible precordial
pulsations, machine-

Opening in the
septum between
the right and left
ventricles of the
heart

Signs & Symptoms

Complications
Dyspnea, tachypnea,
fatigue after
exertion, murmur,

Treatment

Nursing Interventions

Up to 85% of VDSs
close without
treatment. Treat with
dioxin and diuretics
if congestive heart
failure if present.
Surgical repair

Monitor VS,
Provide adequate
nutrition, Monitor G & D,
Provide for periods of
rest,
Prevent infections
(antibiotic prophylaxis)
Prepare child for
tests/surgery
Support and educate
family

ASDs may close

without treatment.
Treat congestive
heart failure with
medication. Surgical
repair may be
needed.

Monitor VS,
Provide adequate
nutrition, Monitor G & D,
Provide for periods of
rest,
Prevent infections
(antibiotic prophylaxis)
Prepare child for
tests/surgery
Support and educate
family
Monitor VS,
Provide adequate
nutrition, Monitor G & D,

Administration of
Indomethacin to
close the defect, if

(PDA)
Increased
pulmonary
blood flow,
Acyanotic

birth, resulting in
a blood vessel
connecting the
pulmonary artery
and the aorta

like murmur, wide

pulse pressure

Coarctation
of the Aorta
1:10,000 live
births
Obstruction of
blood flow
leaving the
heart,
Acyanotic

Narrowing of
the aorta at
the transverse
aortic arch or
in the area of
the ductus
arteriosus

Tetralogy of
Fallot (TOF)
Decreased
pulmonary
blood flow,
Cyanotic

Consists of four
defects:
1) Defect
(ventral
septal)VSD
2) Right
Ventricular
Hypertrophy
3)Overriding

Blood pressures and

O2 sats greater in
the arms than in the
legs,
Strong brachial
pulses, diminished
femoral pulses
Lower extremities
cooler than upper
extremities,
irritability, dizziness,
headache, fainting,
epistaxis (nose
bleeds from
hypertension), CVA
(stroke)
Cyanosis, tet
spells,
Low SaO2 levels,
clubbing,
polycythemia,
activity intolerance,
fatigue, poor
feeding, systolic
murmur, growth

Heart failure

unsuccessful surgical Provide for periods of

repair may be
rest,
needed
Prevent infections
(antibiotic prophylaxis)
Prepare child for
tests/surgery
Support and educate
family
Medical
Assess for heart failure,
management of
hypotension, murmur
congestive heart
Support and educate
failure; Digoxon &
family
Diuretics
Surgical repair (by
2yrs old)

Oxygen, MSo4,
Inderal,
Prostaglandin E1 to
maintain a patent
ductus arteriosus
until surgery,
Surgical repair (1-2
yrs old)

Prevention of tet spells,

emboli, and endocarditis,
Improve oxygenation
Support and educate
family

Transposition
of Great
Vessels
Mixed blood
flow, Cyanotic

Aorta
4)Pulmonary
stenosis

retardation

The positions of
the great arteries
are reversed
from the normal
position. Aorta
emerges from
the right
ventricle and the
pulmonary artery
emerges from
the left ventricle

Cyanosis from birth,

hypoxemia, dyspnea,
tachycardia,
cardiomegaly,
hepatomegaly, heart
failure, clubbing

This defect results in

a medical
emergency.
Stabilization treat
acidosis.
Administer
prostaglandin E1 to
maintain a patent
ductus arteriosus
until surgery is
performed.
Corrective surgery
involves switching
the position of the
major vessels (1 wk
3 months old)

Improve oxygenation,
Medications as ordered,
Supportive care until
surgery
Support and educate
family