The nurse is assessing an infant with aortic stenosis and identifies bilateral fine crackles in both lung fields. Which additional finding should the nurse expect to obtain?
A.
Hemiplegia.
B.
Fever.
C.
Vigorous feeding and satiation.
D.
Hypotension and tachycardia.
The Correct answer and Explanation is:
The correct answer is D. Hypotension and tachycardia.
Explanation:
Aortic stenosis in infants is a condition where the aortic valve is narrowed, restricting blood flow from the left ventricle to the aorta and subsequently to the rest of the body. This condition can significantly impact the infant’s cardiovascular and respiratory systems. When assessing an infant with aortic stenosis, the nurse may encounter various clinical signs, including the presence of bilateral fine crackles in the lung fields. These crackles are indicative of pulmonary congestion due to heart failure.
1. Hemiplegia (Option A): Hemiplegia, or paralysis on one side of the body, is not typically associated with aortic stenosis. This condition usually results from neurological issues or severe trauma, rather than from cardiac defects like aortic stenosis.
2. Fever (Option B): Fever is not a direct result of aortic stenosis. While infants with heart conditions can sometimes develop infections or inflammatory responses that might cause fever, it is not a primary symptom of aortic stenosis itself.
3. Vigorous feeding and satiation (Option C): Infants with aortic stenosis often have difficulty feeding. Due to the increased work of the heart and poor perfusion, they may tire easily, leading to poor feeding and less satiation. Vigorous feeding is unlikely and does not match the typical presentation.
4. Hypotension and tachycardia (Option D): This is the most likely finding. Aortic stenosis can lead to decreased cardiac output because the left ventricle has to work harder to overcome the narrowed valve. This increased workload can cause hypotension (low blood pressure) as the heart struggles to maintain adequate perfusion. Additionally, tachycardia (rapid heart rate) often compensates for reduced cardiac output to meet the body’s demands for oxygen and nutrients. The presence of hypotension and tachycardia aligns with the physiological response to the increased cardiac workload and compromised circulation seen in aortic stenosis.
In summary, infants with aortic stenosis commonly present with signs of heart failure, including hypotension and tachycardia. These findings correlate with the increased effort required by the heart to overcome the obstruction caused by the stenotic valve and maintain effective blood flow.