RN Nursing · Cardiovascular Disorders in Children · Practice question
A nurse is reviewing the cardiac defects included in tetralogy of Fallot to educate a group of nursing students. Which of the following defects should the nurse include as part of the tetralogy of Fallot? (Select all that apply)
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Atrial septal defect (ASD).
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Coarctation of the aorta.
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✓
Right ventricular hypertrophy.
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✓
Pulmonary stenosis.
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Patent ductus arteriosus (PDA).
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✓
Ventricular septal defect (VSD).
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✓
Overriding aorta.
Answer & explanation
Correct: Right ventricular hypertrophy. · Pulmonary stenosis. · Ventricular septal defect (VSD). · Overriding aorta.
Tetralogy of Fallot is defined by four specific cardiac defects that occur together as a result of abnormal development of the infundibular septum. The four components are: pulmonary stenosis (obstruction to right ventricular outflow, causing reduced pulmonary blood flow), ventricular septal defect (an opening between the right and left ventricles allowing shunting of blood), an overriding aorta (the aorta sits directly over the VSD, receiving blood from both ventricles), and right ventricular hypertrophy (the right ventricle enlarges in response to increased resistance caused by pulmonary stenosis). These four defects together produce the classic presentation of a cyanotic heart defect with hypoxic or tet spells. Atrial septal defect is not one of the four components of tetralogy of Fallot; it is a separate, distinct congenital defect. Coarctation of the aorta is also a separate lesion involving narrowing of the aorta and is not part of the tetralogy. Patent ductus arteriosus is a persistence of the fetal ductus arteriosus and is not included in the classic description of tetralogy of Fallot. Students must memorize the specific four defects to distinguish tetralogy of Fallot from other congenital cardiac conditions.
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