Atrial Septal Defect (ASD) Nursing | Congenital Heart Defects Pediatrics NCLEX

Atrial septal defect NCLEX review for pediatric nursing (congenital heart defects).

What is atrial septal defect (ASD)? It's a congenital heart defect characterized by a hole in the interatrial septum (atrial septum) that allows blood to mix in the right and left atria, which are the upper chambers of the heart. This allows for a connection of blood flow between the two atria that should not occur after birth.

According to the CDC.gov, 1 in every 770 babies born in the United States each year are born with an atrial septal defect

Why is an atrial septal defect a problem?
If the defect if larger enough (small ASDs usually don’t cause many issues), it creates a left to right shunt of blood that can lead to an INCREASE in LUNG BLOOD FLOW. This can cause:

Heart failure
Pulmonary hypertension… (if not treated this can lead to an irreversible condition can Eisenmenger Syndrome)
Stroke

Signs and symptoms of an atrial septal defect may not present at birth but later on in childhood or adulthood. A heart murmur may be noted. Atrial septal defect murmur includes a midsystolic murmur (systolic ejection murmur) that is heard at the 2nd intercostal space in the upper left sternal border. This is due to extra blood flow through the pulmonic valve. In addition, that may be a wide, fixed splitting of S2 due to the pulmonic valve closing slower than normal.

The patient may experience decrease growth rate, easily fatigued, edema, frequent lung infections, stroke etc.

Nursing inventions for an atrial septal defect: please see the video for these interventions

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