A nurse is collecting data from a 15-month-old toddler.
Which of the following findings should the nurse expect?

Choice A rationale

Bounding peripheral pulses are characteristic of conditions like patent ductus arteriosus or hyperdynamic circulation, not heart failure. Heart failure often causes reduced cardiac output, resulting in weaker pulses. Peripheral vasoconstriction may occur as a compensatory mechanism.

Choice B rationale

Increased blood pressure is not typical in infants with heart failure. Instead, reduced cardiac output usually leads to hypotension or low systolic pressure. Hypertension is more associated with renal disorders or endocrine dysfunctions.

Choice C rationale

Tachycardia is a common manifestation of heart failure as the heart attempts to compensate for diminished cardiac output. Increased heart rate aids in maintaining adequate systemic circulation despite impaired myocardial function.

Choice D rationale

Increased urinary output is inconsistent with heart failure. Reduced cardiac output causes diminished renal perfusion, leading to decreased urine production or potential fluid retention and edema.

Choice A rationale

Allowing the toddler to inspect the stethoscope fosters trust and decreases anxiety, enabling a smooth assessment. Toddlers are developmentally curious and seek control over unfamiliar environments. By inspecting equipment, the toddler perceives the visit as less threatening. Reducing anxiety before assessments enhances cooperation, which supports accurate data collection. This approach aligns with developmental expectations of autonomy and exploration during toddlerhood, improving the assessment's reliability.

Choice B rationale

Performing traumatic procedures first is incorrect as it may increase anxiety and mistrust, making subsequent evaluations challenging. Developmentally, toddlers require reassurance and gradual introduction to the unfamiliar setting. Sequential assessments beginning with non-invasive actions minimize distress. Starting with traumatic procedures can lead to behavioral resistance, disrupting the assessment and delaying accurate data gathering.

Choice C rationale

Removing the toddler’s outer clothing early may provoke fear and resistance, impeding successful data collection. Toddlers may view sudden disrobing as invasive, increasing anxiety. Clothing removal is best performed later, once trust and calmness are established. Prioritizing comfort before invasive actions aligns with the toddler's developmental needs for security during unfamiliar experiences.

Choice D rationale

Discouraging the toddler from sitting in the parent’s lap may intensify separation anxiety, especially during early years when parental proximity provides security. Maintaining closeness ensures emotional reassurance, fostering cooperation. For toddlers experiencing a medical setting, familiar physical comfort minimizes stress and enhances focus, enabling smoother assessments.