A nurse is caring for a child who is postoperative following surgical correction of tetralogy of Fallot. Which of the following findings should the nurse identify as an indication of heart failure?

A. Weight loss: Heart failure in children is more commonly associated with poor weight gain or weight gain due to fluid retention rather than weight loss. Weight loss may reflect inadequate nutrition or increased metabolic demand but is not a primary indicator of heart failure. B. Decreased respirations: Children with heart failure typically exhibit tachypnea due to pulmonary congestion and decreased cardiac output. Decreased respiratory rate is not consistent with the compensatory mechanisms seen in heart failure. C. Exercise intolerance: Exercise intolerance is a classic manifestation of heart failure in children, reflecting reduced cardiac output and inadequate oxygen delivery during activity. Postoperative children may fatigue easily, have dyspnea with exertion, or show decreased ability to engage in normal play. D. Bradycardia: Heart failure is usually associated with tachycardia as a compensatory response to maintain cardiac output. Bradycardia is uncommon and may indicate conduction abnormalities or medication effects rather than heart failure.