Nurse Ashley is caring for a 6-year-old female patient in an outpatient doctor's office

Patient Results

Leukocytes:

Nitrates

Urobil

Protein

PH 6.5

Blood

Spec Gravity 1.020

Ketones

Bilirubin

Glucose

Based on the patient's presentation, what would the nurse anticipate her diagnosis to be?

PDA is a congenital heart defect where a blood vessel called the ductus arteriosus, which is supposed to close shortly after birth, remains open. This allows oxygenated blood from the aorta to flow back into the pulmonary artery, leading to increased pulmonary blood flow and congestion. Over time, this can lead to increased pulmonary vascular congestion and potentially cause complications such as pulmonary hypertension and heart failure.

Surgical repair of PDA, often through a procedure known as ligation or closure of the ductus arteriosus, is performed to stop this abnormal blood flow and prevent the associated complications, particularly the increase in pulmonary vascular congestion.

The other options (B, C, and D) are not the primary complications associated with PDA and surgical repair is not performed primarily to address these issues:

B. Decreased workload on the left side of the heart is not a primary reason for surgical repair of PDA, although it can be a potential benefit of closing the ductus arteriosus.

C. Pulmonary infection is not a direct complication of PDA, but the increased pulmonary blood flow associated with a large PDA can make the lungs more susceptible to respiratory infections.

D. Right-to-left shunt of blood is not a typical complication of PDA. PDA typically involves left-to-right shunting of blood, with oxygenated blood flowing back into the pulmonary circulation, leading to complications related to increased pulmonary blood flow.

B. Cardiac Catheterization.
Cardiac Catheterization (B): Cardiac catheterization is an invasive procedure that involves threading a catheter into the heart's chambers and major blood vessels. It allows direct visualization of the coronary arteries, measurement of blood pressure within the heart, assessment of blood flow, and the ability to perform interventions such as angioplasty or stent placement. Cardiac catheterization is considered the gold standard for diagnosing coronary artery disease, evaluating heart valve function, and detecting congenital heart abnormalities.

Explanation:
A. Echocardiogram (A): An echocardiogram is a non-invasive imaging test that uses sound waves to create images of the heart. It is excellent for assessing the structure and function of the heart, including heart valve function and blood flow patterns. While it is a valuable tool for cardiac assessment, it may not provide the level of detail and direct visualization that cardiac catheterization offers.
C. Chest X-Ray (CXR) (C): A chest X-ray can provide information about the size and shape of the heart and detect certain abnormalities such as an enlarged heart or fluid in the lungs. However, it may not offer the level of detail required to diagnose specific cardiac issues accurately.
D. Electrocardiogram (ECG) (D): An ECG records the electrical activity of the heart and is useful for diagnosing arrhythmias and certain conduction abnormalities. While it provides essential information about cardiac rhythm, it does not directly visualize the structural aspects of the heart or blood flow.

In summary, while each of these diagnostic tools plays a crucial role in assessing cardiac issues, cardiac catheterization is the most accurate and comprehensive option for diagnosing a wide range of cardiac conditions due to its direct visualization and intervention capabilities. However, the choice of diagnostic test should always be made based on the patient's specific clinical presentation and the suspected cardiac problem.