A nurse is reinforcing teaching to a newly hired nurse about anencephaly. Which of the following statements should the nurse make?

A. Weight gain. Corticosteroids cause fluid retention and increased appetite, leading to significant weight gain. In a 6-year-old, this can affect self-esteem and social interactions, potentially leading to body image concerns and difficulty fitting in with peers.

B. Irritability. Mood changes, including irritability, anxiety, and mood swings, are common side effects of corticosteroids. These emotional changes can impact relationships with family and friends, affecting the child's psychosocial well-being.

C. Osteoporosis. While long-term corticosteroid use can lead to osteoporosis, it is primarily a physical concern rather than a psychosocial one. Bone health issues typically become more evident later in life rather than in early childhood.

D. Hypertension. Elevated blood pressure is a physiological side effect of corticosteroids but does not directly impact the child’s psychosocial development. It is more of a medical concern requiring monitoring rather than a factor affecting social interactions.

E. Nausea. Although nausea can cause discomfort, it does not have a significant impact on the child's psychosocial development compared to mood changes and body image issues caused by corticosteroid therapy.

A. Cough, edema, and increased work of breathing. While these symptoms can indicate worsening heart failure, cough and edema are less prominent signs in infants compared to respiratory distress and feeding difficulties.

B. Tachypnea and diaphoresis with feeding, poor weight gain, and irritability. This is correct. Infants with worsening heart failure often struggle with feeding due to increased energy demands and difficulty breathing. Tachypnea (rapid breathing) and diaphoresis (excessive sweating) during feeding are classic early signs. Poor weight gain results from inadequate caloric intake, and irritability may be due to fatigue and hypoxia.

C. Abdominal pain, poor appetite, and cough. Abdominal pain is difficult to assess in infants, and poor appetite alone is not a definitive sign of heart failure. Cough may occur but is not a primary indicator of worsening heart failure in infants.

D. Bradycardia, rapid weight gain, and irritability. Bradycardia is not a common sign of worsening heart failure in infants; tachycardia (fast heart rate) is more typical. Rapid weight gain could suggest fluid retention but is not as reliable a sign as feeding difficulties and respiratory distress.