Nursing Care of Pediatric with Pulmonary Stenosis with Modified Blalock-Taussig Shunt: Two Case Comparative Studies

Abstract

The Pulmonary Stenosis (PS) was causes pediatric to become cyanotic and shortness of breath. It was a life-threatening condition. The pediatric must be treatment according to the situation. The palliative treatment was a Modified Blalock-Taussig shunt (MBT shunt) surgery to allow more mixed blood from the aorta to gas exchange in the lungs. The nurse must be able to care for pediatric all before and after surgery, correctly and efficiently. These to prevent complications from surgery.

Objective: To compare the result of two pediatric nursing care with pulmonary stenosis with Modified Blalock-Taussig shunt.

Methods: The methods were selecting case studies of the PS pediatric undergo MBT shunt who received treatment in the Pediatric Cardio Intensive Care unit, Sunpasitthiprasong Hospital. Data were collected from December 2022 to March 2023. The data analysis accordance with the concept of nursing process, nursing care for before and after surgery, holistic care and family centered care.

Result: Thai pediatric male patient, first case was admitted at the age of 2 years and 4 months, following an appointment to undergo MBT shunt surgery to palliative treatment of TOF with Severe PS. He on ET-Tube for 3 days After surgery, and on HHHFNC, postoperative complications such as thrombocytopenia and polycythemia, provided the correct treatment, clinical symptoms improve accordingly, could discharge and length of stay for 8 days. Second case was admitted at the age of 19 days with symptoms of cyanosis and shortness of breath, diagnosed with severe PS with Ebstein's anomaly, provided on ET-Tube for 3 days and provided PGE1 for 7 days, he had CHF, when the CHF condition improves, MBT shunt surgery was performed. He on ET-Tube for 1 days after surgery, and on HHHFNC, postoperative complications such as thrombocytopenia, anemia and sepsis with pneumonia, provided the correct treatment, clinical symptoms improve accordingly, could discharge and length of stay for 20 days.

Conclusion: Nursing care of a PS pediatric who has undergone MBT shunt surgery, the nurses must provide accurate and effective care in all the preoperative and operative periods, to prevent complications from all surgery and medical equipment that used for medical treatment and nursing, and discharge planning that emphasizes the importance of parents being able to properly provide continued care at home.