A 3-year-old patient is admitted to the Emergency Room

Vital signs

• Temperature-102.3
• Weight 16 kg
• Respiratory rate-44
• Blood pressure- 98/62
• Heart rate-122

History of present illness

Mom brought the child to the ER presenting with a fever for 6 days a strawberry tongue, cervical lymphadenopathy, and irritable

Complete the following sentence from the list of options

The patient is at the highest risk for developing.......

evidenced by the patient's diagnosis of …....

Hypoplastic Left Heart Syndrome is a complex congenital heart defect in which the left side of the heart (left ventricle and aorta) is underdeveloped, making it unable to pump oxygenated blood effectively to the body. The treatment of HLHS typically involves a series of surgical interventions because it cannot be cured with a single surgery. The ultimate goal of treatment is to provide palliative care, which means managing the condition to improve the child's quality of life while waiting for a heart transplant. The surgical procedures are typically performed in stages, with the first surgery usually performed shortly after birth, followed by additional surgeries as the child grows.

Option B is not accurate because HLHS cannot be cured with a single surgery, and creating an opening between the atria and ventricles (e.g., the Norwood procedure) is one step in the staged surgical treatment, but it doesn't completely "cure" the condition.
Option C is not accurate because HLHS is primarily characterized by an underdeveloped left ventricle and aorta, not the displacement of the pulmonary and aortic arteries.
Option D refers to the use of prostaglandin to maintain a patent ductus arteriosus (PDA) and improve blood flow to the lungs, which can be part of the initial management of HLHS but is not a definitive treatment. Prostaglandin is used to stabilize the infant before surgical interventions are performed.

Assessing pulses is a critical step immediately after a cardiac catheterization procedure because it helps determine the adequacy of blood flow to the extremities and any potential vascular complications. Cardiac catheterization involves the insertion of a catheter through blood vessels, which can temporarily affect blood flow. Checking pulses in the affected limb (e.g., the leg or arm where the catheter was inserted) is essential to detect any signs of vascular compromises, such as decreased or absent pulses, which could indicate complications like arterial thrombosis or embolism. Prompt recognition of such issues is crucial for timely intervention to prevent potential complications or limb damage.

The other options are also important but should be addressed after the initial assessment of pulses:
A. Pain: Assessing pain is important, but it should come after checking pulses. If the child reports pain, it could indicate discomfort or complications related to the procedure, which may require further evaluation and intervention.
C. Catheterization report: Reviewing the catheterization report is necessary for a comprehensive understanding of the procedure and its findings, but it is not the immediate priority when assessing the child's post-procedure condition.
D. Hemoglobin and hematocrit levels: Checking hemoglobin and hematocrit levels is important to monitor for potential bleeding complications that may occur during or after the procedure, but it is a secondary assessment compared to evaluating pulses. If there are significant changes in these levels, they may require further investigation and intervention.

In summary, assessing pulses is the initial priority after a cardiac catheterization procedure in order to promptly identify any vascular issues or complications that need immediate attention.