Which medication should a nurse anticipate for a child experiencing hypercyanotic episodes related to tetralogy of Fallot?

In the context of managing hypercyanotic episodes associated with tetralogy of Fallot, administering morphine can be particularly beneficial. These hypercyanotic spells, often referred to as "tet spells," occur due to a sudden increase in right-to-left shunting of blood, leading to profound cyanosis and distress. Morphine is effective in this situation because it provides sedation and reduces the child's anxiety and stress, which can alleviate the respiratory effort and help decrease the metabolic demand during an episode.

Additionally, morphine can also lead to venodilation, which may promote increased blood flow to the pulmonary circulation, helping to improve oxygenation. By managing the symptoms and stabilizing the child, morphine aids in mitigating the acute crisis associated with these episodes, allowing for further medical intervention and monitoring.

Other medications listed, like furosemide and enalapril, primarily target fluid retention and blood pressure control, respectively, which are not directly beneficial in the urgent management of hypercyanotic spells. Formoterol is a bronchodilator typically reserved for asthma management and does not address the specific pathophysiology of tetralogy of Fallot. Thus, morphine is the most appropriate choice for managing hypercyanotic episodes due to its sedative