Pathophysiology
What is tetralogy of fallot
A congenital heart defect.
What is the most common symptom in infants with TOF?
Cyanosis especially during crying or feeding
What imaging is most definitive for diagnosing TOF?
Echocardiography
What is the definite treatment for TOF?
Surgical repair, typically in the first year of life.
Why does right ventricular hypertrophy occur in TOF?
Because of increased workload from pulmonary stenosis.
What are the four defects in TOF
Ventricular septal defect, pulmonary stenosis, right ventricular hypertrophy, overriding aorta
What are "TET" spells?
Episodes of sudden cyanosis and hypoxia, often triggered by crying or exertion.
What is the classic Xray finding in TOF?
"Boot shaped" heart.
What surgery is usually performed for TOF?
Closure of the VSD and relief of the pulmonary stenosis.
What are potential long term complications post-surgery?
Pulmonary regurgitation, arrythmias and right ventricular dysfunction.
Is TOF a cyanotic or acyanotic heart defect
Cyanotic
What posture may relieve a TET spell in toddlers?
Squatting, which increases systematic vascular resistance.
What does ECG typically show in TOF?
Right axis deviation and right ventricular hypertrophy.
How are TET spells managed acutely?
Knee chest position, oxygen, morphine, beta blockers and IV fluids.
How should nurse manage oxygen therapy in a child with TOF?
Administer humidified oxygen as ordered especially during cyanotic episodes to help relief hypoxia.
What causes cyanosis in TOF
Right to left shunting of blood due to obstruction of pulmonary outflow and VSD
What heart sound is commonly heard in TOF?
A harsh systolic murmur due to pulmonary stenosis.
Can prenatal diagnoses of TOF be made?
Yes, by fetal echocardiography.
What medications may help TOF before surgery?
Prostaglandin E1 to keep the ductus arteriosus open in neonates.
What are some important nursing considerations before surgical repair of TOF?
Monitor for signs of worsening cyanosis, ensure adequate nutrition and educate caregivers on recognizing TET spells and proper positioning.
What role does pulmonary stenosis play in TOF
Increases right ventricular pressure, promoting right to left shunting.
What is clubbing and is it seen in TOF?
Thickening of fingertips due to chronic hypoxia, yes commonly seen in TOF.
What type of VSD is seen in TOF?
Large nonrestrictive subaortic(membranous) VSD
How does the overriding aorta contribute to cyanosis?
It receives blood from both ventricles, mixing oxygenated and deoxygenated blood.
What nursing assessments are important post TOF surgery?
Monitor vital signs, oxygen saturation, respiratory status and signs of infection or complications such as arrhythmias.