Lecture Notes: Patent Ductus Arteriosus (PDA)

Introduction

• Presenter: Sarah from RegisteredNurseRN.com
• Topic: Patent Ductus Arteriosus (PDA)
• Series: Part of the NCLEX review series on pediatric nursing
• Additional Resource: Free quiz available post-video

Overview of PDA

• Definition: A congenital heart defect where the ductus arteriosus fails to close post-birth
• Result: Increased pulmonary blood flow, leading to complications

Understanding PDA

• Terminology:
  • Patent: Indicates something has failed to close
  • Ductus Arteriosus: Vessel connecting the aorta to the pulmonary artery in a fetus
• Function in Fetus:
  • Carries blood from the right side of the heart to the body, bypassing non-functional fetal lungs
  • Essential for fetal circulation; unnecessary post-birth

Normal vs. PDA Circulation

• Normal Post-Birth Circulation:
  • Blood flows to the lungs for oxygenation
  • Oxygenated blood returns to the heart and is distributed to the body
• Circulation in PDA:
  • Open ductus arteriosus allows oxygenated blood to flow back into the lungs
  • Results in excessive pulmonary blood and lung stress

Complications of PDA

• Pulmonary Hypertension:
  • High pressure in lungs damaging arterial walls
  • Leads to respiratory issues, decreased oxygenation, and risk of lung infections
• Heart Strain:
  • Increased resistance due to narrowed arteries
  • Potential for heart failure
• Endocarditis Risk:
  • Bacterial infection risk due to damaged heart lining

Signs and Symptoms

• Variability: Depends on size of PDA
• Large PDA:
  • High blood flow from aorta to pulmonary artery
  • Cardiac complications
• Small PDA:
  • Possible asymptomatic cases
  • May self-resolve
• Common in: Premature infants

Mnemonic: CALL

• C for Cardiac:
  • Heart Murmur: Continuous, machinery-like, audible at left upper sternal border
  • Endocarditis & Increased Heart Rate: Due to low oxygen levels
  • Wide Pulse Pressure: High difference between systolic and diastolic pressure
  • Heart Failure: Uncommon in newborns, tied to lung congestion
• A for Activity Intolerance:
  • Fatigue during activities (e.g., eating, crying)
  • Sweating and diaphoresis
• L for Lung Issues:
  • Decreased lung function and increased infection risk
  • Feeding difficulties due to respiratory issues
• L for Loss of Weight:
  • Difficulty in feeding leads to caloric deficit and failure to thrive

Treatment Options

• Medication:
  • Endomethacin: Prostaglandin inhibitor for premature infants
• Invasive Procedures:
  • Heart Catheterization: Device to close the ductus arteriosus
  • Surgery: Physically tying off the vessel

Conclusion

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