Which parameter should be monitored in the infant with a large VSD to assess for heart failure?

• A. Caloric intake and weight
• B. Blood pressure and cholesterol
• C. Respiratory rate and oxygen saturation
• D. Urine output and electrolyte balance

Answer: (A)

Monitoring growth and energy intake is essential when an infant has a large VSD because this condition often leads to congestive heart failure from increased pulmonary blood flow. The heart struggles to meet the body’s needs, so the baby may tire easily during feeds, sweat, and take in fewer calories, resulting in poor weight gain. Tracking caloric intake and weight over time provides a clear, practical picture of how well the infant is coping with the increased workload on the heart and helps guide interventions such as adjusting feeding strategies or therapies. While respiratory rate and oxygen saturation can indicate lung involvement or acute distress, they’re not as direct a measure of heart-failure impact on nutrition and growth. Urine output and electrolyte balance reflect overall perfusion and renal status but aren’t as sensitive to early heart-failure progression in infants.