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Hypertension: This is not typical of decreased cardiac output. Reduced cardiac output more commonly leads to hypotension, not elevated blood pressure.

Increased urine output: Adequate or increased urine output indicates good renal perfusion, which suggests adequate cardiac output, not decreased output.

Capillary refill less than 2 seconds: A refill time under 2 seconds indicates normal peripheral perfusion. Decreased cardiac output is associated with delayed capillary refill (>2–3 seconds).

Hypertension: Cardiac tamponade leads to decreased cardiac output, which typically causes hypotension, not hypertension.

Widened pulse pressures: Tamponade causes a narrowed pulse pressure due to reduced stroke volume. Widened pulse pressure is more consistent with conditions like patent ductus arteriosus.

Increased chest tube drainage: Tamponade is more likely when chest tube drainage decreases or suddenly stops, allowing fluid to accumulate in the pericardial space. Increased drainage is generally a protective sign, indicating fluid is being removed.

Lotions and powders can trap moisture and bacteria, increasing the risk of infection. Incisions should be kept clean and dry unless otherwise prescribed.

Full immersion (baths, swimming) is usually restricted until the incision is well healed. Sponge baths are typically recommended initially to avoid soaking the incision.

Sterile adhesive strips (Steri-Strips®) are designed to fall off on their own as healing occurs. Parents should be taught not to pull them off, but falling off naturally does not require notifying the provider.

There are no exercise limitations: This is unsafe and incorrect. Children typically have temporary activity restrictions following cardiac surgery to protect the sternum, incision, and heart. Overexertion can increase the risk of complications.

The child may resume school in 3 days: Return to school is not standardized and depends on the child’s recovery, endurance, and provider recommendations. Most children require more than a few days before resuming full school activities.

Climbing and contact sports are restricted for 1 week: Contact sports and climbing are usually restricted for several weeks, not just one. The sternum and surgical site require adequate healing to prevent injury or wound disruption.

Weight gain is more consistent with fluid retention from worsening heart failure, not digoxin toxicity.

Digoxin toxicity more commonly causes bradycardia and dysrhythmias, not tachycardia.

Seizures can occur in severe or advanced toxicity, but they are not an early or typical finding and would indicate a life-threatening progression rather than initial suspicion.

Angiotensin-converting enzyme (ACE) inhibitor such as enalapril and captopril reduce afterload and preload by blocking the renin–angiotensin–aldosterone system. Digoxin does not act on this system.

Diuretic such as furosemide reduce fluid overload by increasing urine output. Digoxin does not promote diuresis.

Vasodilator decrease vascular resistance to improve forward blood flow. Digoxin’s primary action is increasing contractility, not dilating blood vessels.