Nursing considerations when caring for clients with heart defects that decrease pulmonary blood flow include monitoring and managing tissue perfusion, maintaining adequate gas exchange, monitoring cardiac output, preventing infection, maintaining adequate nutrition, decreasing the client’s risk for injury and providing reassurance and education to the client and family.
Now, when monitoring and managing tissue perfusion, keep a close eye on the client’s hemoglobin and hematocrit levels.
Low H&H levels can indicate poor oxygenation. It’s also important to create a calm and soothing environment since causing the client to become upset or cry can result in a hypercyanotic spell.
Should that happen, place the client in a knee-to-chest position or if they are an older child, assist them to a squatting position.
Also, be sure to provide education and anticipatory guidance to the parents, guardians or caregivers about how to manage hypercyanotic spells.
Limiting activity and maintaining the client’s airway are helpful nursing interventions to promote adequate gas exchange.
And, thoughtful planning on carrying out your nursing care can help allow ample time for the client to rest.
Additionally, monitoring the client’s electrolyte levels closely will help you to determine if acidosis is present and needs to be corrected.
Decreased cardiac output is a potential complication for clients with heart defects that decrease pulmonary blood flow, so continuous monitoring of vital signs, like heart rate, blood pressure and respiratory rate, must be performed.
Also, assess for signs of heart failure, which may include peripheral edema and abdominal distention.