SOLVED922

We have focused a great deal on those congenital heart problems that cause cyanosis. There is another group as well, illustrated in the following case: Baby Boy Z is a 3444-gram (AGA) product of an uncomplicated full-term pregnancy. His mother is a 28-year-old woman who had good prenatal care. She had two colds during her pregnancy but was otherwise well. Mother denies using drugs or alcohol and had a normal prenatal ultrasound at 20 weeks. This is her first baby. Delivery was a routine vaginal delivery. You examine the baby at 3 pm, an hour after birth. He is active and well-perfused. His skin color is pink, and he is breathing comfortably. He has clear breath sounds and a soft murmur over the pulmonary region. You congratulate parents on having a very healthy baby. The following morning, you recheck baby and find that he is still pink and comfortable but that he has a cardiac murmur that you did not hear previously. The murmur is loudest at the lower edge of the sternum and is very easily heard. Right after birth, the murmur was soft, with a blowing quality. Now it is very harsh. Heart rate is 120 beats per
SCIENCE
HEALTH SCIENCE
NURSING

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