A 4-Hour-Old Male Infant Is Being Assessed Because of Bluish

A 4-hour-old male infant is being assessed because of bluish discoloration of his lips and tongue. He was born at term and the antenatal period showed tetralogy of fallot. Initial Apgar scores are 5 and 7 at 1 and 5 minutes after birth, respectively. His temperature is 37.3°C (99.1°F) , pulse is 170/min, respirations are 65/min, and blood pressure is 70/46 mm Hg. Pulse oximetry on room air shows an oxygen saturation of 92%. A grade 3/6 holosystolic murmur is heard over the left upper sternal border. This patient should be immediately treated with a medication producing which of the following effects?

A) Decreased left ventricular end diastolic pressure
B) Increased pulmonary surfactant levels
C) Increased pulmonary vascular resistance
D) Maintenance of ductus arteriosus patency
E) Stimulation of fetal hemoglobin production

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