What significant finding in a 2-month-old infant with a ventricular septal defect should the nurse report?

In assessing a 2-month-old infant with a ventricular septal defect (VSD), a weight gain of 1.8 kg (4 lb) is a significant finding that should be reported. In infants with congenital heart defects such as VSD, adequate weight gain is typically a positive sign, as it indicates that the child is generally receiving enough nutrition and the heart is functioning well enough to support growth.

However, weight gain in this context must be examined in relation to the infant's overall clinical picture, especially given the potential for congestive heart failure associated with VSD. If the weight gain is excessive or rapid, it could indicate fluid retention rather than true nutritional growth, which is concerning in cases of heart defects where fluid overload can occur. This situation could lead to further complications requiring medical intervention.

The other findings mentioned may not indicate an immediate concern. Persistent coughing can occur for various reasons, but in isolation may not be critical. Increased feeding tolerance is generally a positive development, and while a fever of 101°F (38.3°C) could indicate an infection, it is not as directly linked to the immediate concerns associated with the condition of VSD as weight gain is. Thus, the notable aspect in this clinical scenario is the nature