A client asks the nurse about the causes of congenital heart diseases. What should the nurse explain as the primary factor contributing to these conditions?

A) The answer is A. Before administering digoxin, the nurse should check the infant's apical heart rate for a full minute. Digoxin is a medication used to improve cardiac contractility, and knowing the heart rate helps ensure the medication is given safely and at the correct dose.

B) Incorrect. While measuring blood pressure is essential in some cases, it is not the priority action before administering digoxin.

C) Incorrect. Assessing capillary refill time is an important part of the overall assessment, but it is not the priority action before giving digoxin.

D) Incorrect. While observing for respiratory distress is crucial, it is not the priority action in this specific scenario of preparing to administer digoxin. Checking the heart rate takes precedence.

A) This option is incorrect. Frequent sweating during feedings is not a normal response to the increased workload of the baby's heart. It can indicate an underlying issue related to heart function.

B) This option is incorrect. While gastrointestinal discomfort may cause sweating during feedings, it is not the most likely explanation, especially in the context of congenital heart diseases.

C) This option is incorrect. Inability to regulate body temperature is not a common reason for sweating during feedings in infants with congenital heart diseases.

D) Correct answer. Excessive sweating during feedings can be a sign of increased cardiac effort and inadequate oxygen supply in some congenital heart diseases. This symptom may be present in babies with cyanotic heart defects, where oxygen-rich blood is not adequately circulated to the body, leading to compensatory mechanisms like sweating to maintain oxygen balance.