The nurse is caring for a newborn diagnosed with patent ductus arteriosus (PD

Choice A rationaleDecreased urine output is not typically associated with patent ductus arteriosus (PDA). PDA causes an abnormal connection between the aorta and pulmonary artery, leading to left-to-right shunting of blood, which predominantly affects the cardiovascular and pulmonary systems rather than renal output directly.Choice B rationaleBradycardia is not a hallmark sign of PDA. Instead, PDA commonly leads to increased cardiac workload and tachycardia. The persistent opening between the aorta and pulmonary artery creates volume overload in the heart, which does not slow heart rate but rather increases it to compensate for the extra demand.Choice C rationaleCyanosis of the extremities is more typical in conditions involving right-to-left shunting, which is not characteristic of PDA. In PDA, the blood flow is typically left-to-right, meaning oxygenated blood flows back into the pulmonary circulation, which may lead to pulmonary congestion but not peripheral cyanosis.Choice D rationaleA continuous "machinery-like" heart murmur is a classic sign of PDA due to the turbulent flow of blood between the high-pressure aorta and low-pressure pulmonary artery during both systole and diastole. This characteristic sound is often used diagnostically to identify PDA in newborns.