During a well baby examination of a 6-week-old infant, the primary care pediatric nurse practitioner notes poor weight gain, acrocyanosis of the hands and feet, and a respiratory rate of 60 breaths per minute. Oxygen saturation on room air is 93%. The remainder of the exam is unremarkable. Which action is correct?

Question

Quizplus · Accepted Answer

The findings of poor weight gain, acrocyanosis, tachypnea, and decreased oxygen saturation suggest the possibility of a congenital heart defect. Therefore, the infant should be referred to a pediatric cardiologist for further evaluation and management. A follow-up in 1 week or reassurance to parents is not appropriate in this case. Ordering a chest radiograph and an electrocardiogram may be helpful, but a referral to a specialist should be the first step.

During a Well Baby Examination of a 6-Week-Old Infant, the Primary