The nurse is providing instructions about how to treat a sprained ankle. What statement by the mother does the nurse recognize as indicative of a need for additional teaching?

A. Wheezing. Cystic fibrosis can cause airway obstruction due to thickened mucus, leading to wheezing and difficulty breathing, especially during respiratory infections or exacerbations.

B. A barrel-shaped chest is often seen in advanced stages of cystic fibrosis. It results from hyperinflation of the lungs due to air trapping, chronic lung disease, and repeated respiratory infections. The chest appears rounded and enlarged, similar to the shape of a barrel.

D. Clubbing of fingers and toes is a common finding in cystic fibrosis. It is caused by chronic hypoxia and inadequate oxygenation of tissues, leading to changes in the nail beds and fingertips. Clubbing typically develops over time in individuals with chronic respiratory conditions, including cystic fibrosis.

C. Thin, watery mucous is not expected in cystic fibrosis. Instead, cystic fibrosis is characterized by thick, sticky mucus due to dysfunction of the exocrine glands, leading to blockages in the airways, pancreas, and other organs.

E. Rapid growth spurts are not typically associated with cystic fibrosis. In fact, children with cystic fibrosis may experience growth failure or delayed growth due to malabsorption of nutrients, chronic illness, and increased energy expenditure.

A. Decreased cardiac output in heart failure can lead to poor perfusion of the extremities, resulting in cool skin and decreased urine output due to reduced renal perfusion and impaired kidney function.

D. Poor feeding is often observed due to increased respiratory effort, tachypnea, and fatigue associated with heart failure. Additionally, infants may exhibit failure to thrive or inadequate weight gain despite increased caloric intake due to metabolic demands and inefficient utilization of nutrients.

E. Tachypnea and respiratory distress occur due to pulmonary congestion and increased respiratory effort in response to heart failure. Infants may exhibit signs such as nasal flaring, grunting, retractions, and cyanosis.

B. Bradycardia and hypotension are not typical manifestations of heart failure in infants. Instead, infants with heart failure often present with tachycardia (rapid heart rate) as a compensatory mechanism to maintain cardiac output. Hypotension may occur in severe cases but is not a common finding.

C. Increased appetite and excessive weight gain are not typical manifestations of heart failure in infants. Infants with heart failure often experience poor feeding and failure to thrive due to inadequate cardiac output and oxygen delivery to meet metabolic demands.