Tommy, a 3-year-old boy with tetralogy of Fallot, has just returned to his hospi
ID: 122224 • Letter: T
Question
Tommy, a 3-year-old boy with tetralogy of Fallot, has just returned to his hospital room from the cardiac catheterization recovery room. His mother calls you to the bedside to tell you that he is vomiting and bleeding. You arrive to find Tommy anxious, pale, crying, and sitting in a puddle of blood.
Questions
1. Evidence—Is there sufficient evidence to draw conclusions about Tommy’s situation?
2. Assumptions—Describe an underlying assumption about each of the following:
a. Risks of cardiac catheterization
b. Association between vomiting and bleeding after cardiac catheterization
c. Concerns related to acute blood loss
3. What priorities for nursing care should be established for Tommy?
4. Does the evidence support your nursing interventions?
Explanation / Answer
1. ANS: Tetralogy of Fallot
Tetralogy of Fallot is a congenital heart defect. This problem was mainly associated due the improper heart's structure which present at time of baby birth. This type of heart defect changes the normal flow of blood through the heart. It is a rare complex heart defect that occurs in about 5 out of every 10,000 babies.
Tetralogy of Fallot must be repaired with open-heart surgery, either soon after birth or later in infancy. Diagnostic tests and procedures can provide the information about the four heart defects. So the cardiac catheterization is administrated to tommy. Cardiac catheterization can helps doctor to estimate pressure and oxygen level inside the heart chambers and blood vessels and it also helps to determine whether blood is mixing between the two sides of the heart.
2a. ANS: Cardiac catheterization:
It is a medical procedure used to diagnose and treat some heart conditions. According to this a long flexible thin tube (catheter) was put into to your blood vessel through arm, groin (upper thigh), or neck and threaded to your heart. By using catheter the physician can diagnosis and treat your heart.
It rarely causes serious problems. But so many complications are included with this. They are…..
1. Bleeding, infection, and pain at the catheter insertion site.
2. Damage to blood vessels
3. Allergic reaction
4. Low blood pressure
5. Nausea and vomiting
6. Bleeding
2b. ANS: During the cardiac catheterization the patient can take prolonged time rest on bed. If any discomforts taken placed in the position can interrupt the physiological process. It later leads to back pain, urinary difficulty, hematoma, bruising, discomfort, bleeding, nausea and vomiting after catheterization.
2c. ANS: In cardiac catheterization a catheter was put into your body through a puncture site in your groin or arm. In some cases bleeding from this site leads to blood loss.
Concerns related to acute blood loss:
A. Lie on your back.
B. Place a clean cloth or gauze over the puncture site and do not press too hard in that place.
C. Hold pressure for at least 10 to 15 minutes without peeking or letting go. If it keeps bleeding after that, press on and off for 10 minutes at a time.
D. Once the bleeding has stopped, you can release the pressure. But stay lying on your back with your arm or leg straight for 60 minutes.
E. Call emergency services if bleeding is severe or does not stop within 60 minutes.
Please consider this: Answering too many questions are against to chegg rule.