The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)

The correct answer is choice D. Epiglottitis.

Choice A rationale:

Laryngotracheobronchitis (LTB) is a viral infection commonly known as "croup." While it can cause airway inflammation and respiratory distress, it is usually not considered a medical emergency. LTB is characterized by barking cough, stridor, and hoarseness. It typically responds well to supportive care, humidity, and sometimes oral corticosteroids.

Choice B rationale:

Spasmodic croup is another type of viral croup, often triggered by allergies or irritants. It is characterized by sudden onset of symptoms, usually at night, including stridor and a barking cough. While it can be distressing, it is generally not considered a medical emergency. It usually responds to humidity and sometimes oral corticosteroids.

Choice C rationale:

Laryngitis involves inflammation of the larynx and is often caused by viral infections or excessive voice use. While it can lead to hoarseness and voice changes, it does not typically cause severe respiratory distress and is not considered a medical emergency. Resting the voice and staying hydrated are common interventions.

Choice D rationale:

Epiglottitis is a potentially life-threatening condition that causes inflammation of the epiglottis, a flap of tissue that prevents food from entering the windpipe during swallowing. It can rapidly progress to airway obstruction and respiratory failure. Children with epiglottitis often assume a "tripod" position, leaning forward to maintain an open airway. Immediate medical intervention, including securing the airway and administering antibiotics, is crucial.

The correct answer is choice A. Infection or inflammation close to the site.

Choice A rationale:

Tender, enlarged, and warm lymph nodes are indicative of infection or inflammation in the nearby area. Lymph nodes are part of the immune system and can become enlarged and tender when fighting off infections in their drainage area.

Choice B rationale:

While cancer can cause lymph node enlargement, it is less likely in children, and the question doesn't provide any other context to suggest cancer as the primary explanation.

Choice C rationale:

Local scalp infection might cause enlargement of the lymph nodes in the neck, but it would not be the best explanation for tender, enlarged, and warm cervical lymph nodes. Infections or inflammation close to the site of lymph node involvement are more likely.

Choice D rationale:

Infection or inflammation distal to the site wouldn't directly explain the tenderness, warmth, and enlargement of the cervical lymph nodes. Lymph nodes generally react to infections or inflammation in their drainage area.