Congenital Heart Disease II
Complications: Hypoxia & CHF
Complications
CHF (Congestive Heart Failure)
Hypoxia (low O2)
PRIORITY
RIGHT to left blood flow: TOF, TGA
Memory Trick
0₂
T - Trouble!
T - Tetralogy of Fallot (TOF)
T - Transposition of the Great
Vessels (TGA)
T - Truncus Arteriosus
T - Tricuspid Atresia
0₂
0₂
0₂
If it starts with a
T think Trouble!
Always priority!
These defects take blood away from the lungs & push
blood from the RIGHT to the left side of the heart, resulting
in hypoxia (low oxygen making blue babies).
Signs & symptoms
Cyanosis (blue skin)
Poor feeding & weight gain
Clubbing fingers
Dyspnea & Tachypnea
Polycythemia
Blood clot risk!
Report Hemoglobin level
OVER 22 g/dL NCLEX TIP
Priority intervention = Hydration
LEFT to right: ASD, VSD, PDA, AVSD
Memory Trick
HF - Heart Failure
HF- Heavy Fluid
Signs & symptoms
Weight Gain = Water Gain NCLEX TIP
1. Pale, cool extremities
2. Puffiness around the eyes (periorbital edema)
3. Reduction in number of wet diapers
Diaphoresis & Grunting (during
feedings) NCLEX TIP
Dyspnea
Tachypnea & Tachycardia
Poor weight gain
Priority: Report Hemoglobin
level OVER 22 =
high risk for blood clots!
Polycythemia:
Increased production of red
blood cells due to hypoxia!
The body makes loads of new
red blood cells (RBCs) to
compensate for this low oxygen.
These defects are less deadly, as hypoxia is NOT a
primary problem.
Instead of perfusing the body
the extra RBCs cause a traffic
jam within the blood vessels
leading to deadly blood clots.
Blood is pushed from the LEFT side of the heart to
the right side & into the lungs. This OVERLOADS the
lungs with too much blood flow, making it difficult
to breathe during feedings!
3.2kg
CVA - Cerebral Vascular Accident
Saunders Question
KAPLAN Question
The nurse knows a
cyanotic congenital heart
defect is associated with
which symptom?
• Poor feeding with no or
very poor weight gain
.. infant with congenital
heart disease…. chronic
hypoxia:
• Clubbing of the fingers
… child with a diagnosis
of a right-to-left cardiac
shunt… which is the
most common
assessment finding?
• Bluish discoloration
of the skin
Kaplan Question
Cyanotic congenital heart defect.
The nurse understands that chronic
hypoxia from this disorder can result
in which finding?
● Polycythemia
HESI Questions
Q1: Polycythemia.. highest priority?
● Maintaining adequate hydration
Q2: … primary reason for a newborn
with congenital heart disease to
be kept well-hydrated?
● To reduce the risk of
cerebrovascular accidents (CVA)