Physiology Assignment Sample

Question and Answers: Physiology

Ans 1-

Ans 2- a. The role of ibuprofen in patent ductus arteriosus is to inhibit the synthesis of prostaglandins. These prostaglandins are the most potent vasodilators of the duct. This drug thus, helps in promoting ductal patency. Thus, it is an effective drug that can be used to manage to closure of ducts in PDA in pre-term infants, especially who are born with less body weight (El-Mashad, 2017). It is also helpful in reducing the risk of necrotizing enterocolitis and renal insufficiency in neonates.

b. The nursing evaluations for an infant undergoing pharmacological management for PDA can be inclusive of:

• Ensuring the delivery of accurate information to the mother or the care giver. This will help in reducing their anxiety, by having a good understanding of the clinical status of the neonates.
• Ensuring constant monitoring of the IV fluids given to the patient. Dully noting for any presence of fluid overload and thus, reducing the burden on the circulatory system.
• Safe administration of the medications required for medical management.
• Monitoring the weight of the infant for any signs of presence of edema. Rapid weight gain can be indicative of fluid retention and can thus, lead to cardiac failure.
• Monitoring oxygenation status to note for the presence of pulmonary edema.
• Encouraging the infant to take breast milk.
• Indomethacin can cause renal insufficiency in the neonates, thus, urine output should be closely monitored.

Post-surgical interventions can be inclusive of the following:

• Trying to keep the neonate as calm as possible in order to avert for any complication to develop from rigorous movements post-surgery.
• Trying to maintain a temperature homeostasis post-surgery.

Ans 3- Pulse oximetery is the most easy and non-invasive method to note for the oxygen saturation in neonates (Thangaratinam, 2017). The method of pulse oximetery can reflect upon desaturation of the blood objectively and thus, can be very helpful in detecting congenital defects in neonates, at an early stage without opting for any invasive diagnostic technique. This test can be combined with the other diagnostic test to monitor for the sensitivity in establishing the presence of any congenital defect in the neonates (Gupta, 2017). It is also helpful in noting early signs of hypoxia in neonates

Ans 4 a.

b. Tetralogy of fallot is mainly present in neonates due to structural abnormalities. There is an obstruction in the outflow of right ventricular tract. There is a hypoplasia observed in the right ventricular outflow tract, stenosis of the pulmonary wall as well pulmonary annulus and trunk. This restrict the normal blood flow through proper shunting and dispersion of the blood in the body of the infant. The severe cases are bound to have a higher anticipated rate of mortality in the individuals. It is also marked with pulmonary stenosis which leads to cyanosis in the infant. This is also largely responsible for limiting the blood flow in the body of the infant.

Outcomes- Improved outcomes have been observed in the cases where early intervention with surgical correction for PDA closure was done. The individuals with tetralogy of fallot also have an incremental hazard related to their condition. There are improved outcomes in terms of quality of life of neonates, who had received the required management in their initial four years of life. The surgical management of PDA closure in early stages of life has also shown positive results in terms of improved healthcare outcomes (Bokma, 2018).

References for Physiology Assignment

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Bokma, J. P., Geva, T., Sleeper, L. A., Narayan, S. V. B., Wald, R., Hickey, K., ... & Mulder, B. J. (2018). A propensity score-adjusted analysis of clinical outcomes after pulmonary valve replacement in tetralogy of Fallot. Heart, 104(9), 738-744.

Dowd, L. A., Wheeler, B. J., Al-Sallami, H. S., Broadbent, R. S., Edmonds, L. K., & Medlicott, N. J. (2019). Ibuprofen treatment for patent ductus arteriosus: practice and attitudes in Australia and New Zealand. The Journal of Maternal-Fetal & Neonatal Medicine, 32(18), 3039-3044.

El-Mashad, A. E. R., El-Mahdy, H., El Amrousy, D., & Elgendy, M. (2017). Comparative study of the efficacy and safety of paracetamol, ibuprofen, and indomethacin in closure of patent ductus arteriosus in preterm neonates. European journal of pediatrics, 176(2), 233-240.

Gupta, H., Anand, S., Grover, N., & Negi, P. C. (2017). Role of Pulse Oximetry For the Early Detection of Congenital Heart Diseases: A Prospective Observational Study. Heart, 134, 3-9.

http://www.uct.ac.za/sites/default/files/image_tool/images/198/PDF/CareProtocol_josephine.pdf

Peelukhana, S. V., Wang, Y., Berwick, Z., Kratzberg, J., Krieger, J., Roeder, B., ... & Kassab, G. S. (2017). Role of pulse pressure and geometry of primary entry tear in acute type B dissection propagation. Annals of biomedical engineering, 45(3), 592-603.

Sorelli, M., Perrella, A., & Bocchi, L. (2018). Detecting vascular age using the analysis of peripheral pulse. IEEE Transactions on Biomedical Engineering, 65(12), 2742-2750.

Thangaratinam, S., Daniels, J., Ewer, A. K., Zamora, J., & Khan, K. S. (2007). Accuracy of pulse oximetry in screening for congenital heart disease in asymptomatic newborns: a systematic review. Archives of Disease in Childhood-Fetal and Neonatal Edition, 92(3), 176-180.

Wani, G. R., Parray, N. A., Lone, M. R., Ganie, N. A., Hussain, A., Islam, J. U., & Mohammad, S. M. (2019). Association of patent ductus arteriosus (PDA) with prematurity and low birth weight neonates. International Journal of Contemporary Pediatrics, 6(2), 781.

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