When a newborn has a transposition of the great arteries (TGA), the only chance for survival is:
a. administration of continuous oxygen
b. serial blood transfusions to exchange the blood and increase the amount of oxygen in the newborn's blood
c. administration of sufficient potassium
d. an intra-atrial connection such as a patent ductus arteriosus that allows mixing of oxygenated and deoxygenated blood
D
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A Incorrect. In TGA, unoxygenated blood enters the right atrium to the right ventricle, then flows out the aorta into the body. Oxygenated blood from the lungs enters the left atrium to the left ventricle and then flows out the pulmonary artery back to the lungs. Thus, there is parallel circulation with no oxygenated blood getting to the systemic circulation. Administration of continuous oxygen will not benefit the newborn.
B Incorrect. Serial blood transfusions to exchange the blood and increase the amount of oxygen in the newborn's blood will not help because the mixing of oxygenated and unoxygenated blood needs to occur via an intra-atrial connection.
C Incorrect. Administration of sufficient potassium will have no impact on the newborn's chance of survival.
D Correct. When a newborn has a transposition of the great arteries (TGA), the only chance for survival is an intra-atrial connection such as a patent ductus arteriosus that allows mixing of oxygenated and deoxygenated blood.
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