Ventricular Septal Defect Nursing | NCLEX Pediatric Congenital Heart Defects

Ventricular septal defect (VSD) nursing NCLEX review over the pathophysiology, signs and symptoms, complications, nursing interventions, and treatments.

What is a ventricular septal defect (VSD)? It’s a congenital heart defect that occurs when a “hole” forms in the ventricular septum. This causes an increase in blood flow to the lungs.

There are four types of ventricular septal defects:

-Membranous: a hole is found at the upper section of the ventricular septum and is very close to the tricuspid and aortic valves (Notes: if the hole is found too close to the valves, the valves can become damaged and lead to regurgitation…example aortic valve etc.)
-Muscular: found at the lower part of the septum in the muscle layer. Small muscular VSDs have a high chance of closing on their own.
-Outlet (conal or subarterial): found at structures where blood is leaving the heart around the pulmonic and aortic valve location...hence the name “outlet” (not as common)
-Inlet (atrioventricular canal): found at structures where blood is entering the heart around the tricuspid and bicuspid valve (mitral)

Pathophysiology of a ventricular septal defect includes heart failure and pulmonary hypertension due to a left to right shunt of blood. Please watch the video for an in-depth review of this.

If a VSD is left untreated, it can lead to Eisenmenger Syndrome, which is the reversal of blood shunting in the heart right to left. This will lead to cyanosis and clubbing of the nails.

Signs and symptoms of a VSD include heart murmur (pansystolic/holosystolic), decrease in weight or growth, swelling in the extremities, difficulty breathing, and frequent lungs infections etc.

Nursing intervention for a VSD include monitoring heart rate, rhythm, and sounds, administering medications (digoxin, diuretics, ACE inhibitors), monitoring for infection, nutrition etc.

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