with diminished awareness of pain ,foods that are high in potassium is very important after surgery , following diuretics and coronary dilators because potassium level will drop and patient will suffer from the following: fatigue, weakness, severe thirst, excessive urination, changes heart beat ,also improve the abdominal and bladder binder and is very effective for the children with urinary incontinent as well as practicing bladder training exercise program(47), and the present illustrated an improvement after 6 months after following the nutritional program and practicing the bladder training program also families were cooperative during program .

Conclusion and Recommendation

1 - The provision of adequate, effective observation for the child with Down syndrome immediately after congenital heart defects surgery prevent the possibilities of immediate and late post-operative complications and improve the child condition.

2 - The cooperation between the health team and parents for follow-up care at home is very important stage of the rehabilitation program after congenital heart defects surgeries.

3 - The provision of adequate rehabilitative, social, and environmental support wills ultimately improves functional outcomes and ease burden of care.