The home health nurse is visiting an infant who recently had surgery to repair tetralogy of Fallot. Which of the following signs of heart failure should the nurse teach the parents to report to the health care provider? Select all that apply.

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11ecbb05_ca97_5ad0_b433_ab46986a1c8d_MD0009_00 Following repair of tetralogy of Fallot, clients often develop chronic pulmonary regurgitation. Insufficient flow into the pulmonary vasculature causes the right ventricle to work harder, leading to right ventricular hypertrophy and a subsequent reduction in right ventricular function and cardiac output. The decrease in forward blood flow causes blood to back up into venous circulation, resulting in heart failure. Clinical manifestations of heart failure include: Pale, cool extremities due to reduced perfusion to the systemic circulation (Option A) Periorbital edema (puffiness around the eyes) and rapid weight gain due to systemic venous congestion and fluid retention (Options C and E) Reduction in the number of wet diapers due to reduced perfusion to the kidneys (Option D) (Option B) Infants with heart failure generally have decreased appetite and feeding due to dyspnea and fatigue. Educational objective: Following repair of tetralogy of Fallot, clients often develop chronic pulmonary regurgitation, leading to right ventricular hypertrophy, decreased cardiac output, and heart failure. Clinical manifestations of heart failure include signs of poor perfusion (eg, pale, cool extremities; reduced urinary output) and fluid overload (eg, periorbital edema, rapid weight gain).

The Home Health Nurse Is Visiting an Infant Who Recently