Practice Question
A nurse is feeding a newborn with congenital heart disease (CHD). Which finding would the nurse interpret as indicating respiratory distress and to pause the feeding.
Answer Choices:
Correct Answer:
subcostal retractions during feeding.
Rationale:
🔷Subcostal retractions during feeding are a classic sign of increased work of breathing and respiratory distress, indicating the infant is struggling to coordinate suck–swallow–breathe.
🔷In infants with congenital heart disease, any rise in respiratory effort can rapidly lead to fatigue, hypoxemia, and aspiration risk, so the safest action is to pause the feeding immediately.
🔷Retractions reflect negative intrathoracic pressure generation to move air, which is unsustainable during oral feeds and can precipitate feeding intolerance and desaturation.
🔷Early pausing allows for rest, repositioning, and supportive measures (e.g., pacing, slower-flow nipple, or gavage consideration) to maintain adequate oxygenation.
🔷Recognizing objective distress signs (retractions, nasal flaring, head bobbing, tachypnea, color change) is critical to prevent aspiration and decompensation in CHD infants.
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This question is from NUR 227 DFB FALL 2025 EXAM 2 which contains 58 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: Examplify Exam(s)
- Domain: Pediatrics
- Answer Choices: 4