A nurse is providing care for an infant who has heart failure and is being discharged from the hospital. When providing discharge education, which of the following clinical manifestations should the nurse ensure caregivers are able to identify as signs of worsening heart failure?

Rationale: A. Stridor, diuresis, and increased work of feeding is incorrect because stridor is a sign of airway obstruction rather than heart failure, and diuresis (increased urine output) is generally a desired effect of medications used to manage heart failure, not a sign of worsening condition. B. Bradycardia, rapid weight gain, and irritability is incorrect because bradycardia is less commonly an early sign of heart failure in infants. Heart failure more typically causes tachycardia as a compensatory response. While rapid weight gain can indicate fluid retention, the combination with bradycardia does not match typical heart failure presentations in infants. C. Tachypnea and diaphoresis with feeding, poor weight gain, and irritability is correct because these are classic signs of worsening heart failure in infants. Tachypnea occurs due to pulmonary congestion, diaphoresis with feeding results from increased work of the heart during exertion, poor weight gain occurs from inadequate caloric intake due to fatigue, and irritability reflects decreased perfusion and overall distress. Caregivers should be educated to recognize these signs early to prevent decompensation. D. Abdominal pain, poor appetite, and cough is incorrect because abdominal pain is nonspecific, poor appetite can occur with many conditions, and cough is less specific in infants. While these may occur with some forms of heart failure, they are not the hallmark early warning signs caregivers should monitor for at home.