A 9-year-old often comes to the school nurse complaining of stomach pains. The teacher says that the child has lately been somewhat aggressive and stubborn in the classroom. What should the school nurse recognize as the possible trigger for these behaviors?

The correct answer is Choice A.Choice A rationale:Vomiting is a common sign of digoxin toxicity. It occurs due to the drug's effects on the gastrointestinal system, which can lead to nausea and vomiting as the body attempts to expel the toxin. This symptom is particularly significant as it can indicate elevated digoxin levels that may require medical intervention.Choice B rationale:Tachycardia, or an increased heart rate, can occur with digoxin toxicity; however, it is more commonly associated with inadequate therapeutic levels rather than toxicity itself. Digoxin usually causes bradycardia (a slower heart rate) when at therapeutic levels, making tachycardia less indicative of toxicity.Choice C rationale:Bradypnea, or slow breathing, is not a typical sign of digoxin toxicity. While respiratory issues can arise from various conditions, they are not specifically linked to digoxin levels. Monitoring respiratory rate is essential in clinical settings but does not directly correlate with digoxin toxicity.Choice D rationale:Seizures are not a common sign of digoxin toxicity. While severe cases might lead to neurological symptoms due to electrolyte imbalances or other complications, seizures are not typically associated with digoxin overdose. Instead, they may suggest other underlying issues requiring evaluation.

The correct answer is choice C. The child needs opportunities to play with peers.

Choice A rationale:

While it's important for children with congenital heart disease to understand their limitations, it's not the primary concern in this scenario. Allowing the child to interact and play with peers is essential for their social, emotional, and psychological development.

Choice B rationale:

While parents play a crucial role in a child's care, completely isolating the child from peers is not ideal. Overprotectiveness can lead to social isolation and hinder the child's ability to develop important social skills.

Choice C rationale:

Children with congenital heart disease should be encouraged to engage in age-appropriate physical activities and play with peers. Of course, the level of activity should be discussed with the child's healthcare provider, but limiting the child's interactions could have negative consequences on their overall development and emotional well-being.

Choice D rationale:

While supervision is important for any child's safety, constant parental supervision to avoid overexertion might not be necessary or feasible. Educating the child about their limitations and providing opportunities for play while monitoring their comfort level is a more balanced approach.