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 C. Asthma.

Choice A rationale:

A foreign body in the trachea can cause acute respiratory distress and a sudden cough, but it is unlikely to cause chronic nonproductive cough and diffuse wheezing during the expiratory phase of respiration. The symptoms in the scenario are more suggestive of a chronic condition.

Choice B rationale:

Bronchiolitis primarily affects infants and young children, causing symptoms such as fever, rhinorrhea, and wheezing. While wheezing can be present, the diffuse wheezing during the expiratory phase described in the scenario is more characteristic of asthma.

Choice C rationale:

Asthma is characterized by chronic inflammation of the airways, leading to episodes of bronchoconstriction and increased airway reactivity. The chronic, nonproductive cough and diffuse wheezing during the expiratory phase are classic signs of asthma. Expiratory phase wheezing occurs due to the narrowing of the smaller airways during expiration.

Choice D rationale:

Pneumonia is an infection of the lung tissue and can cause productive cough, fever, and crackles on auscultation. While wheezing might occur in pneumonia due to inflammation and narrowing of the airways, it's not the most likely cause of the symptoms described in the scenario.

Choice A rationale:

Calcium carbonate is often given with meals to individuals with chronic renal disease, especially those on dialysis. One of the primary purposes is to bind dietary phosphorus in the gastrointestinal tract. In chronic renal disease, the kidneys are less effective at filtering out excess phosphorus from the blood, leading to elevated phosphorus levels (hyperphosphatemia). Elevated phosphorus levels can contribute to bone and mineral disorders in these patients. Calcium carbonate forms insoluble calcium phosphate complexes with dietary phosphorus, preventing its absorption and facilitating its elimination from the body through the feces.

Choice B rationale:

While calcium carbonate can interact with fat-soluble vitamins like vitamin D, the primary reason for administering it to individuals with chronic renal disease is to manage phosphorus levels. Calcium carbonate can bind phosphorus and prevent its absorption, which is particularly important for patients with compromised kidney function.

Choice C rationale:

Stimulating appetite is not a primary purpose of administering calcium carbonate to children with chronic renal disease. The main focus is on managing phosphorus levels and preventing complications associated with hyperphosphatemia.

Choice D rationale:

Preventing vomiting is not a primary purpose of giving calcium carbonate to children with chronic renal disease. Calcium carbonate is typically used to manage phosphorus levels and complications related to hyperphosphatemia in this population.