The nurse is caring for a child experiencing multiple hypercyanotic episodes associated with tetralogy of Fallot. Which medication should the nurse anticipate from the primary healthcare provider (PHCP)?
The nurse is caring for a child experiencing multiple hypercyanotic episodes associated with tetralogy of Fallot. Which medication should the nurse anticipate from the primary healthcare provider (PHCP)?
A. Morphine
[45%]
B. Furosemide
[7%]
C. Enalapril
[20%]
D. Formoterol
[27%]
Statistics
Subject/Lesson
Subject
Child Health
Lesson
Cardiovascular
Client Need
Test Plan
Physiological Adaptation
Related Topic
Medical Emergencies
Item Type
Item Type
Application
Explanation
Choice A is correct. Morphine, for some unknown reason, is a medication utilized for refractory hypercyanotic episodes. It is theorized that this medication's sedative effect will calm the child and decrease the oxygen demand.
Choice B is incorrect. Furosemide would be contraindicated because this would decrease blood volume and could compromise perfusion.
Choice C is incorrect. Enalapril is an angiotensin-converting enzyme inhibitor (ACE inhibitor). ACE-Inhibitors would be contraindicated because of their ability to decrease systemic vascular resistance (SVR). Increasing SVR is crucial to forcing blood into its appropriate chambers.
Choice D is incorrect. Formoterol is a bronchodilator that could worsen the cyanotic spell because of the medication's ability to raise the heart rate. This increase in the heart rate would further demand more oxygen-rich blood flow.
Related Videos
2 Key Topics
Tetralogy of Fallot (TOF)
31.5 Cyanotic Congenital Heart Defects
Additional Info
✓ Calming the infant or child is an early intervention for hypercyanotic episodes.
✓ The nurse should increase systemic vascular resistance by placing the infant's knees to their chest or having the child squat.
- Other key interventions include the administration of prescribed oxygen, morphine, and isotonic saline.
✓ Be prepared for potential complications, and have emergency equipment and medications readily available. Ensure that the healthcare provider's orders include clear instructions for emergencies.
