A nurse is reinforcing teaching to the parents of a school-age child about palliative care. Which of the following statements should the nurse make?

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.

A. Delayed motor development. Children with muscular dystrophy often experience delayed milestones, such as difficulty walking, running, or climbing stairs. This is due to progressive muscle weakness, which affects motor skill acquisition.

B. Lung defects. While respiratory muscle weakness can occur in later stages of muscular dystrophy, congenital lung defects are not a primary characteristic of the condition. Respiratory complications typically arise due to muscle deterioration rather than structural lung defects.

C. Scoliosis. Progressive muscle weakness leads to postural instability, increasing the risk of scoliosis (abnormal spinal curvature). This is particularly common in Duchenne muscular dystrophy (DMD) as the muscles supporting the spine weaken.

D. Insomnia. Sleep disturbances are not a primary symptom of muscular dystrophy. However, respiratory complications or discomfort in later stages may contribute to sleep issues, but insomnia is not a defining feature.

E. Muscle weakness. Progressive muscle weakness is the hallmark of muscular dystrophy. It typically starts in the proximal muscles (hips, thighs, shoulders) and worsens over time, leading to mobility challenges and loss of independence.