Down Syndrome with Severe Pulmonary Stenosis
Vijayalakshmi1, Ambiga2
1Nursing Incharge, Kauvery Heartcity, Trichy, India
2Senior Staff Nurse, Kauvery Heartcity, Trichy, India
*Correspondence [email protected]
Abstract
An 8-year-old girl, with Down’s Syndrome, was diagnosed to have severe valvular pulmonic stenosis. She was advised Balloon Pulmonary Valvotomy and admitted for the same. The patient underwent successful Balloon pulmonary valvotomy on 30/11/2022. Her procedure and post procedure period were uneventful. She was treated with all possible supportive measures. Her condition improved and was discharged with stable vitals with the necessary advice.
Definition
Pulmonary valve stenosis is a type of heart valve disease that involves the narrowing of pulmonary valve, which controls the flow of blood from the heart’s right ventricle into the pulmonary artery to carry to the lungs.
Symptoms
Complaints of shortness of breath; baby had blue skin.
Vital Sign
BP: 90/60mmHg
HR: 84bpm
CVS: S1 – Normal S2 – Normal split, Pancystolic murmur in left parasternal border
RS: Clear
P/A: NAD
Investigation
- ECHO
- X – Ray
- Blood reports – Pre cath
ECHO:
Scan Report
Diagnosis
- Severe valvular pulmonic stenosis
- Down’s syndrome
This is a well known association
Procedure
Balloon pulmonary valvulotomy done
Nursing Care
- Baby was shifted to Critical Care Unit 1 with a duty doctor and continuous cardiac monitoring.
- Nurses skilled in IV infusion and blood sampling techniques (Phlebotomy) obtained the samples for blood investigations like (CBC, ESR, Sodium, Potassium, etc.,) with a sterile technique to prevent thrombophlebitis.
- Doctors explained the baby’s condition to the attenders. Nurses obtained consent for the clinical procedures after proper counseling.
- Nurses used AIDET technique (Acknowledge, Introduce, Duration, Explanation and Thank you) while communicating with patient and attenders to gain their confidence and improve the satisfaction level.
- Auscultate lung sounds to detect an increase or decrease in pulmonary crackles.
- Determine the degrees of jugular vein distension.
- Identify and evaluate the severity of edema.
- Monitor the baby’s pulse rate and BP and monitor for dysrhymia’s hypotension.
- Examine skin colour (pallor or cyanosis), skin turgor and mucous membranes for signs of dehydration.
- Assess for symptoms of fluid overload.
- Watch for bleeding or hematoma from the puncture site.
Discharge advice
- Advised to regular follow up
- Infective endocarditis prophylaxis (Whenever indicated for the next 6 months)
Ms. G. Vijayalakshmi
Nursing Incharge
Ms. Ambiga
Senior Staff Nurse
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