Pediatric ATI Practice Exam

In a preoperative assessment for a child with tetralogy of Fallot, what hematocrit value should the nurse expect?

1. 38%

2. 48%

3. 58%

4. 65%

The correct answer is: 58%

In the context of a preoperative assessment for a child with tetralogy of Fallot, an elevated hematocrit value is often observed due to chronic hypoxia resulting from the condition. Tetralogy of Fallot includes a combination of four cardiac defects that lead to reduced blood flow to the lungs and consequently decreased oxygenation. As the body compensates for lower oxygen levels, it stimulates the production of red blood cells (RBCs) to improve oxygen carrying capacity, leading to higher hematocrit values. A hematocrit level of 58% is indicative of this compensatory mechanism, reflecting the body's response to persistent hypoxia. It is important to monitor these levels as elevated hematocrit can increase the risk of complications, such as thrombosis, during surgery. Normal hematocrit values typically range from about 35% to 45% in children; therefore, seeing a value of 58% aligns with what might be expected in a child with this condition. This understanding helps clinicians prepare for the surgical risks associated with elevated hematocrit, including potential implications for fluid management and oxygen delivery.