Nursing care of children with congenital heart disease

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Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) is a common congenital heart disease, previous t


Atrial septal defect (ASD), ventricular septal defect (VSD), patent ductus arteriosus (PDA) is a common congenital heart disease, previous thoracotomy under cardiopulmonary bypass repair is the only cure, transcatheter closure of ASD, with memory alloy VSD, PDA small trauma, quick recovery, small risk, do not leave the chest surgery scars, increasingly widespread clinical application.

Preoperative nursing

Psychological care: the patients under long-term illnesses, of this new technology has some doubts and fears, therefore, should be patiently introduced this new technology to the patient and family treatment principle, efficacy and advantages, briefly introduces the operation process and the matters needing attention and introduces the successful case of success or please advise, in order to eliminate the fear of psychological tension.

Preoperative preparation: according to the doctor's blood type, blood preparation, complete routine drug skin sensitivity test, complete ECG, clotting time and biochemical examination. Complete the color Doppler ultrasound to determine the size of the defect to select the size of the umbrella. 2 days before operation and training of patients relieving in bed; routine preoperative skin preparation, prevention of postoperative infection; preoperative fasting 6h, preoperative night according to the doctor's advice to tranquilizers, to ensure adequate sleep. And to be ready to rescue equipment and medicines, in order to cooperate with the doctor in a timely manner.

Intraoperative nursing

(1) the establishment of venous access and maintain patency, in order to facilitate the use of drugs. For anesthesia patients, assist the anesthesiologist to premedication.

(2) put the desired position and fixed, to ensure the smooth operation.

(3) prepare the necessary rescue drugs: Atropine 0.5mg, Ba 20mg pumped into the syringe.

(4) intraoperative monitoring of blood pressure, ECG monitoring and other dynamic state of the disease; intraoperative communication with patients often to understand the feelings of patients or other discomfort. In case of abnormal timely treatment.

Postoperative care

Postoperative medication: ASD, VSD patients with postoperative oral aspirin 5mg/kg, maximum dose of 300mg in June. The ECG and blood pressure fluctuation were observed within 24h after operation, and the blood pressure was recorded every hour.

Puncture body: extubation pressure 10 ~ 15min, bandaged with 1kg heavy bag vascular compression of the puncture vein compression artery of 4 ~ 6h, 8 ~ 12h, and ask the limbs after 24h encourage patients to get out of bed, in order to reduce the formation of venous thrombosis of lower extremity. In order to reduce the discomfort of the patient, the pillow can be intermittently placed on the side of the buttocks of the patient, and can be alternately carried out on both sides, and the patient can be massaged gently to the lower limbs or the movable ankle joints. At the same time to closely observe the puncture site without bleeding, hematoma, ecchymosis, a large area of abnormal fluctuations in temperature and humidity, tremor and skin changes, and observe whether the lower limb swelling, tenderness and body temperature.

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