Nursing Care in Complex Congenital Heart Disease and Respiratory Distress Syndrome for Baby in NICU

Maulida Dwi Yani, Nova Fajri, Nenty Septiana
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Abstract

Background: Neonates are at high risk for health problems. Without proper treatment, those problems might lead to either disability or death. Congenital heart disease causes respiratory distress syndrome (breathing distress syndrome), with symptoms of dyspnea, cyanosis, and respiratory arrest due to pathological changes in the heart that disrupt the blood flow cycle throughout the body. This study aimed to discover nursing care for Baby MH with complex congenital heart disease and respiratory distress syndrome. Methods:  This research used a case study design—data collection from assessment to evaluation in the NICU in December 2022. The patient was observed for 4 days. Data collection techniques were carried out through interviews, observation, and documentation. Data analysis was carried out using narrative analysis. Results: Baby MH looks dyspnea with minimal epigastria retraction and hypersecretion in the mouth with CPAP installed. The nursing diagnoses in the case of Baby MH are ineffective breathing patterns, decreased cardiac output, activity intolerance, risk of shock, risk of hypothermia, risk of developmental disorder, and risk of attachment disorders. The interventions provided are based on the Indonesian Nursing Intervention Standards, consisting of observational, therapeutic, and collaborative interventions.  Conclusion: Nursing problems in baby MH after the treatment showed that the problem of ineffective breathing patterns had not been resolved, but the decreased cardiac output was partially handled while the activity intolerance had not been resolved. However, no shock occurred, and the risk of hypothermia was partially resolved.
新生儿重症监护病房复杂先天性心脏病及呼吸窘迫综合征患儿的护理
背景:新生儿是健康问题的高危人群。如果没有适当的治疗,这些问题可能会导致残疾或死亡。先天性心脏病引起呼吸窘迫综合征(呼吸窘迫综合征),其症状为呼吸困难、发绀和呼吸停止,这是由于心脏的病理变化扰乱了全身的血液循环。本研究旨在探讨复杂先天性心脏病及呼吸窘迫综合征患儿的护理方法。方法:本研究采用案例研究设计-从评估到评估的数据收集于2022年12月在NICU进行。观察4 d。数据收集技术是通过访谈、观察和记录进行的。数据分析采用叙事分析法。结果:婴儿MH在安装CPAP后出现呼吸困难,伴有轻微的上腹肌收缩和口腔分泌亢进。婴儿MH病例的护理诊断为呼吸模式无效、心排血量减少、活动不耐受、休克风险、体温过低风险、发育障碍风险和依恋障碍风险。所提供的干预措施基于印度尼西亚护理干预标准,包括观察性、治疗性和协作性干预。结论:治疗后MH患儿的护理问题表现为呼吸方式无效问题未得到解决,心排血量减少得到部分处理,活动不耐受问题未得到解决。然而,没有发生休克,体温过低的风险得到了部分解决。
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