There are many ways that they can diagnose PPHN, but I want to start off by informing you about the laboratory testing that they use. Starting with Arterial blood gas levels also known as ABG. ABG tests are used to measure the levels of carbon dioxide and oxygen in the blood from an artery. The blood is always taken from an artery. It must be used from an artery due to the fact that in veins the oxygen has already been used up and carbon dioxide is present (Lung Disease & Respiratory Health center, 2012). Next diagnosis could possibly be done by blood count with differential. This test is done to test if an extreme infection or illness is the cause of the PPHN. Some of the infections and illnesses listed in the causes section can be determined by this test. Coagulation studies are also used to determine if there are dangerous infections present in the system that could potentially harm the fetus. Lastly, for laboratory tests is the serum electrolytes scan. This is to determine the levels of potassium and calcium that is released during the trigger event of PPHN. Since your carbon dioxide levels go up and oxygenation goes down you begin to release more potassium and calcium to trigger faster breathing and a quicker heart rate to disperse the CO2 and intake more oxygen (Ellis, 2014).
Next, I would like to discuss the imaging studies that can be done to help diagnose PPHN of the newborn starting with chest radiography. This is used to see if there are any lung diseases such as meconium aspiration syndrome or pneumonia. This scan also rules out potential congenital defects that could potentially be causing the same symptoms as the ones we were investigating. Next, I would like to explain echocardiography. There are used to map out ...
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“What is Cardiac Catherterization?”, Online, www.Nhlbi.nih.gov/health/health-topics/topics/cath/ , 27 March 2014
Glanville B. 2-11 “Normal Cardiac physiology – transition from fetal to neonatal,” online, learnpediatrics.com/body-systems/cardiology/normal-cardiac-physiology-transition-from-fetal-to-neonatal/, 27 march 2014
Dugdale D, Chen M. “Tricuspid regurgitation”. A.D.A.M Inc. 2014 www.nlm.nih.gov/medlineplus/ency/article/000169.htm
Walther FJ, Benders MJ, Leighton JO. “Persistent pulmonary hypertension in premature neonates with severe respiratory distress syndrome”. Pediatrics 90(6): Dec 1992. 899-904
Ellis, W.R. 2014. Personal Communication. Premier Women’s Health Specialists, Morristown, TN, 37814
Teitel DF, Iwamoto HS, Rudolph AM. “Changes in the pulmonary circulation during birth-related events. Pediatr Res 1990:27:372-8.
Additionally, some of the general diagnostic and pulmonary function tests are distinct in emphysema in comparison to chronic bronchitis. In the case of R.S. the arterial blood gas (ABG) values are the following: pH=7.32, PaCO2= 60mm Hg, PaO2= 50 mm Hg, HCO3- = 80mEq/L. R.S.’s laboratory findings are indicative of chronic bronchitis, where the pH and PaO2 are decreased, whereas PaCO2 and HCO3- are increased, when compare to normal indices. Based on the arterial blood gas evaluation, the physician can deduce that the increased carbon dioxide is due to the airway obstruction displayed by the hypoventilation. Furthermore the excessive mucus production in chronic bronchitis hinders proper oxygenation leading to the hypoxia. On the other hand, in emphysema the arterial blood gas values would include a low to normal PaCO2 and only a slight decrease in PaO2 which tend to occur in the later disease stages.
4. Right Ventricular hypertrophy (RVH) – In a normal heart, the left ventricle has a rather thicker wall than the right due to the fact that it has to pump oxygenated blood to the body as opposed to the right ventricle which only needs to pump deoxygenated blood to the lungs. However, Tetralogy of Fallot causes an enlargement of the right ventricular muscle due to the pulmonary stenosis in the pulmonary
Ascertaining the adequacy of gaseous exchange is the major purpose of the respiratory assessment. The components of respiratory assessment comprises of rate, rhythm, quality of breathing, degree of effort, cough, skin colour, deformities and mental status (Moore, 2007). RR is a primary indicator among other components that assists health professionals to record the baseline findings of current ventilatory functions and to identify physiological respiratory deterioration. For instance, increased RR (tachypnoea) and tidal volume indicate the body’s attempt to correct hypoxaemia and hypercapnia (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). The inclusive use of a respiratory assessment on a patient could lead to numerous potential benefits. Firstly, initial findings of respiratory assessment reveals baseline data of patient’s respiratory functions. Secondly, if the patient is on respiratory medication such as salbutamol and ipratropium bromide, the respiratory assessment enables nurses to measure the effectiveness of medications and patient’s compliance towards those medications (Cretikos, Bellomo, Hillman, Chen, Finfer, & Flabouris, 2008). Thirdly, it facilitates early identification of respiratory complications and it has the potential to reduce the risk of significant clinical
“Hypoplastic left heart syndrome accounts for 9% of all critically ill newborns with congenital cardiac disease, causing the largest number of cardiac deaths in the first year of life.(2) ” HLHS is a severe heart defect that is present at birth. HLHS combines different defects that result in an underdeveloped left side of the heart. This syndrome is one of the most challenging and difficult to manage of all of the congenital heart defects. Multiple portions on the left side of the heart are affected including the left ventricle, the mitral and aortic valve, and the ascending aorta. These structures are greatly reduced in size, or completely nonexistent causing the functionality of the left heart to be reduced, or non-functional all together.
An electrocardiogram (ECG) is one of the primary assessments concluded on patients who are believed to be suffering from cardiac complications. It involves a series of leads attached to the patient which measure the electrical activity of the heart and can be used to detect abnormalities in the heart function. The ECG is virtually always permanently abnormal after an acute myocardial infarction (Julian, Cowan & Mclenachan, 2005). Julies ECG showed an ST segment elevation which is the earliest indication that a myocardial infarction had in fact taken place. The Resuscitation Council (2006) recommends that clinical staff use a systematic approach when assessing and treating an acutely ill patient. Therefore the ABCDE framework would be used to assess Julie. This stands for airways, breathing, circulation, disability and elimination. On admission to A&E staff introduced themselves to Julie and asked her a series of questions about what had happened to which she responded. As she was able to communicate effectively this indicates that her airways are patent. Julie looked extremely pale and short of breath and frequently complained about a feeling of heaviness which radiated from her chest to her left arm. The nurses sat Julie in an upright in order to assess her breathing. The rate of respiration will vary with age and gender. For a healthy adult, respiratory rate of 12-18 breaths per minute is considered to be normal (Blows, 2001). High rates, and especially increasing rates, are markers of illness and a warning that the patient may suddenly deteriorate. Julie’s respiratory rates were recorded to be 21 breaths per minute and regular which can be described as tachypnoea. Julies chest wall appeared to expand equally and symmetrical on each side with each breath taken. Julies SP02 levels which are an estimation of oxygen
.... Tetralogy of Fallot occurs during fetal growth when the baby’s heart is developing. In most cases the cause of this disease is unknown.
Modercin-McCarthy M. A., McCue S., Walker J. Preterm infants and stress: A tool for the neonatal nurse. J Perinat Neonatal Nurs, 1997; 10, 62-71.
The typical defect that takes place with a human affected is heart problems. In early infancy surgery needs to be taken place to avoid serious issues in the future. Atypica...
The symptoms of a PPH include uncontrolled bleeding, hematoma or pain and swelling in the tissues around the vagina, decrease in hematocrit, decreased blood pressure and increased heart rate. The rapid loss of blood or loss of too much...
Parker, Steve. "Chronic Pulmonary Diseases." The Human Body Book. New ed. New York: DK Pub., 2007.
My case study encompasses pulmonary embolism and a saddle pulmonary embolism. The patient I chose was a female who had just given birth with no complications during labor, but developed a pulmonary embolism that later on was confirmed to be a saddle pulmonary embolism. Not known to me before this clinical study pulmonary embolism is a leading cause of death among pregnant women in the developed world. A pulmonary embolism is a sudden blockage in a lung artery. The blockage is usually by a blood clot that travels to the lung from the vein in the leg. A clot that forms in one part of the body and travels in the bloodstream to another part of the body is called and embolus (NAT13). Pulmonary embolism is a serious condition that can damage your lung due to lack of blood flow to your lung tissue, which can lead to pulmonary hypertension. Pulmonary hypertension is increased pressures in the pulmonary artery. PE can also cause low oxygen levels in your blood and damage other organs in your body because of a lack of oxygen. If a blood clot is very large it can cause death. A pulmonary embolism can also be called a venous thromboembolism.
Wisborg, K., Kesmodel, U., Tine, B. H., Sjurdur, F. O., & Secher, N. J. (2000). A prospective study of smoking during pregnancy and SIDS. Archives of Disease in Childhood, 83(3), 203-6. Retrieved from http://search.proquest.com/docview/196895386?accountid=41057
II. Imagine your little nephew or niece baby was born with a heart defect and required daily transfusions of blood in order to have a chance at survival.
Technology has had a very prominent influence on electronic fetal monitoring since its appearance in the 1960’s and 1970’s. For many years, fetal monitoring was simply done by listening to a fetal heartbeat through a stethoscope. Dramatic changes in the heartbeat, such as a long period or a drop in the rate or intensity, could be detected,. Now, not only is the electronic fetal monitor used on the outside of the womb by strapping electrodes to the mother’s abdomen but electrodes can also be inserted during the first stage of labor and placed directly on the baby’s head. With advanced technologies such as this the acidity of the infant’s blood as well as the heart rate can be measured.
There are 2 types of breathing, costal and diaphragmatic breathing (Berman, 2015). Costal refers to the intercostal and accessory muscles while diaphragmatic refers to breathing using your diaphragm (Berman, 2015).It is important to understand the two different types of breathing because it is vital in the assessment of the patient. For example, if a patient is suing their accessory muscles to aid in breathing then we can safely assume that they are having breathing problems and use a focused assessment of their respiration. Assessing respiration is fairly straightforward. The patient’s respiration rate can be affected by anxiety so a useful to avoid this is to check pulse first and after you have finished that, while still holding their pulse point, check their respiration rate. Inconspicuous assessment avoids the patient changing their breathing because they know they are being assessed which patients can sometimes do subconsciously. Through textbooks and practical classes I have learned what to be aware of while assessing a patient’s respiratory rate. For example; their normal breathing pattern, if and how their health problems are affecting their breathing, any medications that could affect their respiratory rate and also the rate, depth, rhythm and quality of their breathing (Berman, 2015). The only problem I found while assessing respiration rate was I thought it seemed a bit invasive looking at the