Which of the following is an early sign of congestive heart failure that the nurse should recognize?

A. Increased urine output is not typical in early congestive heart failure (CHF); in fact, decreased urine output can occur due to reduced kidney perfusion. B. Tachypnea (rapid breathing) is an early and key sign of CHF in children. It occurs due to pulmonary congestion and decreased cardiac output, leading to poor oxygenation and compensatory increased respiratory rate. C. Bradycardia is a late and often ominous sign of cardiac deterioration in children, not an early indicator. D. Inability to sweat is not a recognized clinical indicator of CHF. On the contrary, diaphoresis (especially during feeding in infants) can be an early sign.