The mother of a 10-month-old infant tells the nurse that she has noticed that her son becomes blue when he is crying and that the frequency of this is increasing.He is also not crawling yet.During the examination, the nurse palpates a vibration that feels like a purring cat at the left lower sternal border and auscultates a loud systolic murmur in the same area.What would be the most likely cause of these findings?

Question

Quizplus · Accepted Answer

The cause of these findings is tetralogy of Fallot.Subjective findings include (1) severe cyanosis, not in the first months of life but developing as the infant grows, and right ventricle outflow (i.e., pulmonic) stenosis that gets worse; (2) cyanosis with crying and exertion at first and then at rest; and (3) slowed development.Objective findings include (1) thrill (feels like a purring cat) palpable at the left lower sternal border; (2) S₁ is normal, S₂ has a loud A₂, and P₂ is diminished or absent; and (3) the murmur is systolic, loud, and crescendo-decrescendo.

The Mother of a 10-Month-Old Infant Tells the Nurse That