A nurse is assessing a toddler who has infective endocarditis. Which of the following findings should the nurse expect?

Choice A rationale Infective endocarditis is a bacterial or fungal infection of the inner lining of the heart, most commonly affecting the heart valves. The presence of vegetation on the heart valves can alter blood flow dynamics, leading to the development of a new or changing heart murmur. This is a classic and significant clinical finding associated with the disease and is a key diagnostic criterion. Choice B rationale Weight gain is not a typical finding in a child with infective endocarditis. The infection is a catabolic state that often leads to a poor appetite, lethargy, and a general state of illness, which usually results in weight loss or a failure to thrive. Weight gain, particularly in the context of heart failure, is more indicative of fluid retention, which can be a complication but is not an initial finding. Choice C rationale Bradycardia, a slow heart rate, is an unexpected finding in infective endocarditis. The systemic inflammatory response to the infection typically leads to an increase in metabolic demand and a compensatory response, causing tachycardia (a fast heart rate) to meet the body's needs. Bradycardia is more often associated with conditions such as heart block or certain medications. Choice D rationale A decreased body temperature is not expected. The systemic infection and inflammatory response characteristic of infective endocarditis almost always result in a fever, which is one of the most common and persistent signs of the disease. A normal body temperature in children is typically between 36.5° C and 37.5° C (97.7° F and 99.5° F).