A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (Select all that apply.)

Increased urinary output

Nasal flaring

Peripheral edema

Bradycardia

Answer and Explanation

Correct Answer : B,C

Choice A reason: Increased urinary output is not typically associated with heart failure. In fact, reduced urinary output may be expected due to decreased kidney perfusion.

Choice B reason: Nasal flaring is a sign of respiratory distress and can be expected in infants with heart failure as they struggle to maintain oxygenation.

Choice C reason: Peripheral edema is a common finding in heart failure due to fluid retention and poor circulation.

Choice D reason: Bradycardia is not a typical sign of heart failure in infants; tachycardia is more common. However, bradycardia can occur in advanced stages due to poor cardiac output.

Choice E reason: Cool extremities are indicative of poor perfusion, which is a consequence of decreased cardiac output in heart failure.

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Correct Answer is C

Explanation

Choice A reason: Assessing the mouth with a tongue blade is not recommended postoperatively as it can cause discomfort and disrupt the surgical site.

Choice B reason: Removing the packing in the mouth is typically done by a healthcare provider, not immediately postoperatively, to avoid bleeding and protect the repair.

Choice C reason: Placing the infant in an upright position is recommended to facilitate breathing and reduce swelling⁷.

Choice D reason: Offering a pacifier with sucrose is not advisable as it can interfere with the healing of the cleft repair⁷.

A. "Digoxin may decrease your baby's heart rate." B. "If your baby vomits a dose, do not repeat the dose to ensure that the correct amount is received." C. "Give the correct dose of medication at regularly scheduled times." D. "Do not offer your baby fluids after giving the medication."

Correct Answer is C

Explanation

Choice A reason: Digoxin is used to treat heart conditions by slowing the heart rate and increasing its efficiency. It does not increase the heart rate. The normal heart rate for a 12-month-old infant ranges from 80 to 160 beats per minute.

Choice B reason: If an infant vomits after taking digoxin, repeating the dose could lead to toxicity. Instead, caregivers should wait until the next scheduled dose or contact a healthcare provider for guidance.

Choice C reason: Administering digoxin at regular intervals ensures consistent therapeutic levels in the bloodstream, which is crucial for the medication's efficacy and safety.

Choice D reason: Offering fluids after medication does not interfere with digoxin's absorption. However, caregivers should be aware of the signs of digoxin toxicity, which include vomiting, lethargy, and bradycardia.

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A nurse is assessing an infant who has heart failure. Which of the following findings should the nurse expect? (Select all that apply.)

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