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 A: Avoiding use for more than 3 days.

Choice A rationale:

Recommending avoiding the use of decongestant nose drops for more than 3 days is crucial due to the risk of rebound congestion. Decongestant nose drops work by constricting blood vessels in the nasal passages to alleviate congestion. Prolonged use can lead to a phenomenon known as rebound congestion, where the nasal passages become more congested once the medication wears off, causing the person to use the drops more frequently. This can result in a cycle of worsening congestion and overuse of the medication, which can be counterproductive and harmful. Limiting the use of decongestant nose drops to 3 days helps prevent this rebound effect and encourages the use of alternative treatments if congestion persists.

Choice B rationale:

Administering drops until nasal congestion subsides is not the recommended approach. Prolonged use of decongestant nose drops can lead to rebound congestion, as mentioned earlier. Using the drops until congestion subsides might extend their use beyond the safe period and increase the risk of adverse effects.

Choice C rationale:

Keeping drops to use again for nasal congestion is not advised. While it's important to follow the medication's storage instructions, relying on decongestant nose drops for recurring nasal congestion can lead to overuse and rebound congestion. This choice does not address the potential risks associated with prolonged use.

Choice D rationale:

Administering drops after feedings and at bedtime is not a standard recommendation for decongestant nose drops. The timing of administration is not a primary concern in the context of decongestant use. Instead, the focus should be on the duration of use and the potential for rebound congestion.

The correct answer is choice C. Therapeutic management includes administration of gamma globulin and aspirin.

Choice A rationale:

The child's fever in Kawasaki disease is not usually responsive to antibiotics within 48 hours. Kawasaki disease is an inflammatory condition of blood vessels, and it doesn't typically respond to antibiotics. The fever associated with Kawasaki disease often persists even with appropriate treatment, and the management focuses on reducing inflammation and preventing complications.

Choice B rationale:

Aspirin is not contraindicated in Kawasaki disease. In fact, aspirin is a key component of the therapeutic management of Kawasaki disease. It is used to reduce inflammation and prevent the development of coronary artery aneurysms, a severe complication of the disease. However, the dosing of aspirin in Kawasaki disease is different from its use for pain relief, and it should be administered under medical supervision.

Choice C rationale:

Therapeutic management of Kawasaki disease does include administration of gamma globulin and aspirin. Gamma globulin is given to reduce the risk of coronary artery involvement and aneurysm formation. Aspirin, at a specific dose regimen, is used to decrease inflammation and platelet aggregation, thus preventing clot formation in the coronary arteries.

Choice D rationale:

The principal area of involvement in Kawasaki disease is not the joints. Kawasaki disease primarily affects the blood vessels, particularly the coronary arteries. The inflammation of these arteries can lead to the development of coronary artery aneurysms, which is a critical concern in Kawasaki disease. Joint involvement is not a prominent feature of this condition.