What nursing action is appropriate to take when an infant with a congenital heart defect has an increased respiratory rate and sweating and is not feeding well?
a. Check the infant's temperature.
b. Alert the physician.
c. Withhold oral feeding.
d. Increase the oxygen rate.
B
An increased respiratory rate, sweating, and not feeling well are signs of early congestive heart failure and the physician should be notified; they do not suggest a febrile process. Withholding the infant's feeding is an incomplete response to the problem. Increasing oxygen may alleviate symptoms, but medications such as digoxin and furosemide are necessary to improve heart function and fluid retention.
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