Nursing Care for a Child with Congenital Pulmonary Airway Malformation (CPAM) Undergoing General Anesthesia: A case study

Abstract

Abstract:Congenital Pulmonary Airway Malformation (CPAM) is a rare congenital respiratory anomaly occurring in infants and young children. Advances in modern medical technology have enabled prenatal diagnosis, allowing for timely treatment planning and optimization of preoperative preparation. Surgical management of CPAM in this population is highly challenging due to significant risks, including air trapping, tension pneumothorax, and potential hemodynamic complications. To support the development of appropriate nursing guidelines for future care, this case study aimed to examine optimal nursing management for pediatric patients with CPAM and to enhance the competencies of nurse anesthetists across all dimensions. The goal is to ensure safe and effective care through application of Gordon’s Eleven Functional Health Patterns as a framework for identifying patient problems and care needs. The case involved a 6-month-old infant undergoing right thoracoscopic right lower lobectomy under general anesthesia, during which oliguria occurred intraoperatively. Nursing care and assessment were performed according to Gordon’s functional patterns, enabling identification of the following nursing diagnoses: the caregiver has insufficient knowledge regarding (1) the surgical procedure, anesthesia, and pediatric care, (2) the risk for hypoxia related to difficult intubation, (3) the risk for cardiovascular dysfunction, (4) the risk for hypothermia, (5) the risk for shock due to dehydration and blood loss, (6) the risk for impaired gas exchange leading to oxygen deficiency, (7) the risk for infection, (8) acute postoperative pain, and (9) the risk for falls.