During the preoperative assessment of an adult with a previously corrected congenital heart defect,the perioperative nurse should be aware of anatomic anomalies associated with the original defect,or its subsequent repair,that may alter the current surgical plan for a patient who had prior pediatric cardiac surgery.What is an appropriate nursing response when the assessment reveals the adult patient has undergone prior pediatric cardiac surgery?

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Consultation with the surgeon can alert the staff to anticipate different anatomy (and surgical landmarks),special supplies and prosthetic materials,and potential complications.In addition to age-specific changes,there are a growing number of adults with acquired heart disease who underwent surgery in childhood for repair of congenital cardiac lesions.For example,patients with a previous Blalock-Taussig shunt for tetralogy of Fallot may have altered pulmonary and subclavian artery anatomy; patients with a mechanical closure device inserted for an atrial septal defect may be at risk for endocardial injury if the heart is retracted or otherwise manipulated too forcefully.The nurse should be aware that anatomic anomalies associated with the original congenital defect,or its subsequent repair,may alter the current surgical plan.

During the Preoperative Assessment of an Adult with a Previously