Pediatrics Question #4


Which instruction(s) will help reduce the number of hypercyanotic spells in an infant with
tetralogy of fallot? (Select all that apply.)


  1. Give a pacifier to the infant during crying spells.
    • Rationale:
  2. Provide several small, frequent feedings per day.
    • Rationale:
  3. Provide soothing environments upon awakening.
    • Rationale:
  4. Swaddling during stressful times such as invasive procedures.
    • Rationale:
  5. Turn the infant at least every two hours during sleep.
    • Rationale:



The correct answers are A, B, C, and D. Giving the infant a pacifier will help to soothe and decrease the incidence of crying which competes with oxygen supply and demand. The infant will not be able to eat large meals as this will raise the need for oxygen. Small, frequent feedings will help with oxygen demand. A soothing environment will help to decrease crying which will increase oxygen demand. Swaddling can comfort the infant and possibly decrease crying which increases oxygen demand. There is no indication to turn the infant every two hours during sleep and it will increase wakefulness.

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