CCRN Critical Care Nursing

Category - Pediatrics

An infant with heart failure was fed and burped, after burping; he was repositioned in semi-fowler then had a bowel movement. Afterwards, the infant became diaphoretic and cyanotic. The nurse is aware that these were most likely caused by:
  1. feeding
  2. burping
  3. changing of position
  4. defecating
Explanation
Answer: D - This is caused by defecating and the valsalva maneuver during bowel movement. The maneuver occasionally causes tet spell or blue spell that results in increased intrathoracic pressure, decreased blood return to the heart, increased venous pressure, and decreased pulse rate.
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