A newborn child has been diagnosed with tetralogy of Fallot. What symptoms would the nurse expect to observe in this child?

Choice A rationale
While obesity can contribute to hypertension and other cardiovascular diseases, it is not a contraindication for the use of propranolol. Weight management would be part of the overall treatment plan for hypertension, but it would not prevent the use of this medication.
Choice B rationale
Age is not a contraindication for the use of propranolol. While older adults may be more susceptible to certain side effects of the medication, age alone would not prevent a patient from taking propranolol.
Choice C rationale
Diabetes is a contraindication for the use of propranolol. Propranolol is a non-selective beta- blocker, which can mask symptoms of hypoglycemia, a common condition in people with diabetes. Therefore, it’s generally not recommended for people with diabetes.
Choice D rationale
Race is not a contraindication for the use of propranolol. While there are some differences in how people of different races may respond to certain medications, race alone would not prevent a patient from taking propranolol.

Choice A rationale
Pulsus paradoxus, an exaggerated decrease in systolic blood pressure during inspiration, can be a sign of several conditions, including pericardial tamponade, constrictive pericarditis, and restrictive cardiomyopathy.
Choice B rationale
Exudate, a fluid with a high protein content that leaks out of blood vessels due to inflammation, is not typically associated with the symptoms described.
Choice C rationale
An aneurysm, a bulge or ballooning in a blood vessel, could potentially cause the symptoms described, but it is not the most concerning finding given the symptoms of edema, hepatomegaly, and muffled heart sounds.
Choice D rationale
Tamponade, a serious condition in which fluid or blood fills the pericardial sac, compressing the heart and preventing it from pumping effectively, could cause the symptoms described and would be the most concerning finding.