Question

The nurse is conducting a physical examination of a child with a suspected cardiovascular disorder. Which of the following findings would be most suspicious of transposition of the great vessels?

A) Significant cyanosis without a murmur
B) Abrupt cessation of chest output with increased heart rate/filling pressure
C) Soft systolic ejection
D) Holosystolic murmur

Answer 1

The finding most indicative of transposition of the great vessels is significant cyanosis without a murmur. This congenital heart defect leads to inadequate oxygenation of the body's blood supply, resulting in cyanosis, but does not necessarily create a murmur that can be detected by auscultation.

Step-by-step explanation:

The most suspicious finding of transposition of the great vessels in a child during a physical examination would be A) Significant cyanosis without a murmur. Transposition of the great vessels is a congenital heart defect where the two main arteries leaving the heart are reversed. This condition results in an inadequate amount of oxygenated blood reaching the body, leading to cyanosis, but may not always produce a distinctive murmur during auscultation.

Murmurs are typically associated with turbulent blood flow, such as in septal defects or valve abnormalities. However, transposition of the great vessels might not initially present with a murmur if the condition is not associated with other defects that cause turbulent blood flow.

Congenital heart defects like patent ductus arteriosus and tetralogy of Fallot can also lead to abnormal heart sounds and signs of cyanosis. Therefore, while a murmur may indicate a cardiac issue, the absence of a murmur coupled with significant cyanosis is particularly suspicious of transposition of the great vessels.