A nurse is assessing a child who has heart failure. Which of the following findings is a clinical manifestation associated with this diagnosis?

A. Toddlers with phenylketonuria (PKU) need to limit their intake of phenylalanine, an amino acid found in protein. Therefore, the toddler's protein consumption should be carefully controlled and monitored.

B. Foods high in iron do not need to be specifically limited for a child with PKU. Iron-rich foods are important for overall health and should be included in the diet.

C. Aspartame contains phenylalanine and should be avoided by individuals with PKU. PKU is a metabolic disorder that impairs the body's ability to break down phenylalanine, so it is important to limit phenylalanine intake.

D. This is correct. Foods containing milk products should be avoided, as they are a source of phenylalanine and can contribute to an excessive intake of this amino acid in a child with PKU. Instead, specialized medical foods low in phenylalanine are recommended.

A. Changing positions frequently may be distracting and confusing for the child. It is important to find a comfortable and quiet environment for communication.

B. Exaggerating the pronunciation of words may distort the natural flow of speech and make it more difficult for the child to understand. It is best to speak clearly and at a normal pace.

C. Using light touch when initiating conversation is not effective for a child with hearing loss, as they rely primarily on visual and auditory cues for communication.

D. This is the correct action. Maintaining a neutral facial expression allows the child to observe facial cues and expressions that are important for understanding non-verbal communication. It also helps create a comfortable and natural environment for conversation.