If a nurse assesses a 3-day-old infant with absent femoral pulses, which congenital heart defect is suspected?

When assessing a 3-day-old infant with absent femoral pulses, the indication points towards coarctation of the aorta. This congenital heart defect is characterized by a narrowing of the aorta, which often leads to differential blood flow. In coarctation of the aorta, blood flow past the point of constriction is reduced, particularly to the lower parts of the body. This leads to weak or absent pulses in the lower extremities, including the femoral pulses.

Furthermore, the critical aspect of this defect is that it can cause significant issues with systemic circulation, especially soon after birth. In a newborn, blood flow is primarily dependent on the ductus arteriosus to supply blood to the lower body. If there is significant coarctation, the femoral pulses may be absent due to inadequate blood flow reaching the lower body.

In contrast, the other conditions listed present different clinical findings. Patent ductus arteriosus typically allows blood flow between the aorta and pulmonary artery, which may not necessarily lead to absent femoral pulses. Hypoplastic left heart syndrome would present with more profound cyanosis and compromised systemic blood flow, but often not with specifically absent femoral pulses. Transposition of the great arteries usually leads to