Ventricular septal defect (VSD) – Health of the children has been considered as the vital importance to all societies because children are the basic resource for the future of humankind. Nursing care of children is concerned for both the health of the children and for the illnesses that affect their growth and development. The increasing complexity of medical and nursing science has created a need for special area of child care, i.e. pediatric nursing.
Pediatric nursing is the specialized area of nursing practice concerning the care of children during wellness and illness. It includes preventive, promotive, curative and rehabilitative care of children. It emphasizes on all round development of body, mind and spirit of the growing individual. Thus, pediatric nursing involves in giving assistance, care and support to the growing and developing children to achieve their individual potential for functioning with fullest capacity.
Ventricular septal defect (VSD)
Definition of VSD (Ventricular Septal Defect)
A ventricular septal defect (VSD) is an abnormal opening in the septum between right and left ventricles. It is the most common acyanotic congenital heart disease with left to right shunt. It is found approximately 25 percent of all CHD.
Causes of VSD (Ventricular Septal Defect)
- Congenital
- Acquired: Rupture of the intraventricular septum after acute Mid
Clinical Feature
A. Symptoms
a) Small defects
- Asymptomatic.
b) Large defect but pulmonary vascular resistance is not high: (Large left to right shunt)
- Congestive heart failure.
- Growth failure.
- Repeated lower respiratory infection. yd guilin
- c) Defect is large & high pulmonary vascular resistance: (Eisenmenger syndrome)Easy fatigue.
- Shortness of breath.
- Dyspnea onexertionate
- syanosis.
B. Sign’s
a) Small defect
- Loud pansystolic murmur (maladie de Roger).
b) Large defect but pulmonary vascular resistance is not high
- Apex beat thrusting in nature.
- Left parasternal lift.
- Pansystolic murmur in the left parasternal are in 4th/5th intercostal space.
c) Large defect (Pulmonary HTN)
- Clubbing.M
- Cyanosis
- JVP-normal but ‘a’ wave is prominent if pulmonary hypertension is present.
- Epigastric pulsation.
- Left parasternal lift.
- Thrill present in the left parasternal are in 4th/5th intercostal space.
- Soft early diastolic murmur in the left parasternal are in 4th/5th intercostal space.
Investigation
A. X-ray chest:
- Cardiomegaly.
- Lung field – plethoric
B. ECG:
- Evidence of RVH
C. Echocardigraphy- diagnostic
D. Cardiac catheterization
Management/Treatment
1. Small defects
- No Rx.
- Prophylactic antibiotic for infective endocarditis
- Good dental hygiene
- Adequate nutrition.
2. Large defect but pulmonary vascular resistance is not high: (Large left to right shunt) Medical
- Rx of congestive heart failure by digoxin & diuretics.
- Rx of respiratory infection.len
Surgical:
- Surgical repair of defect
3. Defect is large & high pulmonary vascular resistance: (Eisenmenger syndrome)
- No surgical Rx.
- Rx of congestive heart failure by digoxin & diuretics.
- Venesection.
- Heart-lung transplantation.
Complications
- CCF
- Complications
- Recurrent respiratory tract infections
- Infective endocarditis
- Eisenmengbr’s syndrome
- Pulmonary stenosis
- Pulmonary hypertension
- Failure to thrive
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