The nurse is caring for an infant diagnosed with "failure to thrive." The nurse observes the physician taking blood pressures in all four extremities, and recognizes that the congenital cardiac defect suspected is:
1. Tetralogy of Fallot.
2. Pulmonary atresia.
3. Coarctation of the aorta.
4. Ventricular septal defect.
3
Rationale:
1. There are minimal differences between upper and lower blood pressure readings in tetralogy of Fallot.
2. There are minimal differences between upper and lower blood pressure readings in pulmonary atresia.
3. Normally, blood pressures in the lower extremities are the same or higher than upper-extremity blood pressures. But in coarctation of the aorta, the narrowing of the aorta causes decreased blood flow to the lower extremities, and so lower extremity blood pressure readings are significantly lower than upper-extremity readings.
4. There are minimal differences between upper and lower blood pressure readings in ventricular septal defect.
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