Final answer:
Children with tetralogy of Fallot may experience hypoxic episodes, also known as "blue" spells, which require immediate nursing intervention, such as placing the child in a knee-chest position and providing supplemental oxygen.
Step-by-step explanation:
Children with tetralogy of Fallot may experience "blue" spells or hypoxic episodes, where there is a sudden onset of cyanosis and difficulty in breathing due to low oxygen levels in the blood. These episodes may be brought on by crying, feeding, or agitation and necessitate immediate nursing actions. The primary action is to place the child in a knee-chest position, which can help increase vascular resistance and reduce the right-to-left shunting of blood through the heart, improving oxygenation. Calming the child and providing supplemental oxygen may also be needed. If the situation does not improve rapidly, medical intervention should be sought immediately.