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?

A. Partially correct but not specific. While poor appetite can be a symptom of worsening heart failure, abdominal pain is not a common early sign in infants, and cough may occur but is less specific compared to other hallmark symptoms. B. These are classic early signs of worsening heart failure in infants. Tachypnea occurs because the heart is unable to meet the body’s oxygen demands, leading to respiratory compensation. Diaphoresis with feeding indicates increased cardiac workload during exertion, even during minimal activity such as feeding. Poor weight gain reflects inadequate growth due to increased metabolic demands and poor intake. Irritability can result from fatigue, hypoxia, and discomfort due to fluid retention. Early recognition of these signs allows caregivers to seek prompt medical attention before the condition progresses. C. These are also signs of heart failure but are more pronounced in older children or in later stages. Infants may first show subtle signs like feeding difficulties, tachypnea, and irritability before more obvious edema develops. D. Bradycardia is not an early sign of heart failure; in fact, infants often have tachycardia as compensation. Rapid weight gain can indicate fluid overload but is less sensitive than gradual poor weight gain and feeding intolerance in early detection.