The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)

The correct answer is Choice B: Dry skin.

Choice A rationale:

Diarrhea is not a common clinical manifestation of juvenile hypothyroidism. Hypothyroidism is characterized by an underactive thyroid gland, leading to a decrease in metabolic activity. Symptoms of hypothyroidism include fatigue, weight gain, cold intolerance, constipation, and dry skin, but not diarrhea.

Choice B rationale:

Dry skin is a common clinical manifestation of juvenile hypothyroidism. The decreased thyroid function results in a slower metabolic rate, which can lead to dry and coarse skin due to reduced oil production. This symptom is often seen in hypothyroid patients.

Choice C rationale:

Insomnia is not a common clinical manifestation of juvenile hypothyroidism. Hypothyroidism usually leads to fatigue and excessive sleepiness rather than insomnia.

Choice D rationale:

Accelerated growth is not a common clinical manifestation of juvenile hypothyroidism. In fact, the opposite is true. Hypothyroidism in children can lead to growth retardation due to the decreased metabolic rate and altered hormonal balance.

The correct answer is choice C. Decreased oxygen-carrying capacity of blood.

Choice A rationale:

Anemia does not primarily result in a depressed hematopoietic system. In fact, anemia often occurs due to various factors that affect red blood cell production or lifespan. The hematopoietic system can be overactive in response to anemia, attempting to compensate for the reduced oxygen-carrying capacity of the blood.

Choice B rationale:

While some anemias may involve the presence of abnormal hemoglobin (e.g., sickle cell anemia), this is not the primary result of anemia. The primary consequence of anemia is a decreased ability of the blood to carry oxygen to the body's tissues.

Choice C rationale:

The correct choice. Anemia leads to a decreased oxygen-carrying capacity of the blood. Hemoglobin, the protein in red blood cells responsible for carrying oxygen, is reduced in quantity or function in various types of anemia. This results in inadequate oxygen delivery to tissues, potentially causing symptoms such as fatigue, weakness, pallor, and shortness of breath.

Choice D rationale:

Increased blood viscosity is not a primary result of anemia. Anemia tends to reduce blood viscosity because there are fewer red blood cells and less hemoglobin present, which makes the blood more fluid and less viscous. Increased blood viscosity is more commonly associated with conditions like polycythemia, where there is an excess of red blood cells.