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Ohio University, AthensNURSING NR 507Discussion Part Threeweek three nr 507 advanced pathophysiology

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Discussion Part Three (graded) A new patient is brought into the office for their annual evaluation. The child is a 6-year-old and appears a bit small for their age but not so small that any alarm b ... ells are set off. The vitals are: P = 116, R = 22, T = 98.6 F , BP = 110/50. (The normal vitals in a 6-year-old are P = 75 – 120, R = 16 – 22, T = 98.6 , BP = (85-115)/(48-64). Examination of the lungs is normal, HEENT is normal, as is the abdominal exam. The heart however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Because, you were trained at Chamberlain College of Nursing you immediately know that this is probably a patent ductus arteriosus. Explain the murmur from a mechanistic view of the hearts physiological functioning? What is the epidemiology of a patent ductus arteriosus? How is a patent ductus arteriosus treated? Topic responses  Discussion  Expand All More Sort By:        Janet Farrelly 9/14/2016 4:39:05 PM Patient: 6 year old with Patent Ductus Arteriosus Scenario:  6 year-old child brought into the office for their annual evaluation.  He appears a bit small for his age, but nothing to be overly worried about.  V/S: P 116, R22, T 98.6, B/P: 110/50  Examination of the lungs is normal, HEENT is normal, as is the abdominal exam.  The heart, however, seems laterally displaced and there appears to be only a continuous murmur which can be described as crescendo/decrescendo systolic murmur that extends into diastole. Normal Vital Signs in a 6 Year Old Child Pulse = 75-120 Respirations = 16-22 Temperature 98.6 Blood Pressure = 85/115 to 48/64 Prior to answering this question, first I will explain what Patent Ductus Arteriosus: According to Baffa, (2013), patent ductus arteriosus is described as the following:  Persistence of the fetal connection (ductus arteriosus) between the aorta and pulmonary artery after birth, resulting in a left-to-right shunt.  At birth, the rise in the partial pressure of oxygen and the decline in prostaglandin concentration cause closure of the ductus arteriosus, typically beginning within the first 10 to 15 hours of life.  If this normal process does not occur, patent ductus arteriosus results. Also, for a more detailed explanation, I turned to Schneider and Moore (2006) who write for Circulation and provide information for the adult cardiologist. According to Schneider and Moore (2006), patent ductus arteriosus can be described as the following:  This is a vascular structure that connects the proximal descending aorta to the roof of the main pulmonary artery near the origin of the left branch pulmonary artery.  This essential fetal structure normal closes spontaneously after birth.  After the first few weeks of life, persistence of the ductal patency is abnormal and the physiological impact, as well as the clinical significance of the PDA depends largely on its size and the underlying cardiovascular status of the patient. IN PDA [Show More]

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