A nurse on a cardiac care unit is caring for a preschooler. Exhibits select words from the choices below to fill in each blank in the following sentence. The client is at risk for developing dropdown and dropdown.

Rationale for Correct Answers: Hypokalemia: The child is receiving frequent doses of IV furosemide, a loop diuretic that increases urinary potassium loss, putting them at high risk for hypokalemia which can worsen cardiac instability. Digitalis toxicity: The client is on a high-dose digoxin regimen. Hypokalemia potentiates digoxin's effects on the myocardium, increasing the risk for toxicity, especially in pediatric cardiac patients. Symptoms include nausea, dizziness, vomiting and arrhythmias. Rationale for Incorrect Answers: Hypertension: The child's blood pressure is 92/66 mm Hg, which is within the normal pediatric range and does not suggest elevated pressure. Instead, heart failure and diuretics may lead to hypotension. Murmur: While murmurs are associated with congenital mitral stenosis, it is a chronic finding, not a new or emergent risk in this acute scenario of worsening heart failure. Hypercyanotic spells: These are more common in conditions like Tetralogy of Fallot, not mitral stenosis. The child shows signs of respiratory distress but not cyanotic episodes. Fever: The client is afebrile across assessments (36.7°C to 36.9°C), and there are no indications of infection or inflammatory processes at this time. Dependent rubor: This is typically seen in peripheral arterial disease, more common in adults. The child’s symptoms are consistent with venous congestion from heart failure, not arterial insufficiency.