A child has come into the emergency department after a confirmed bite from a brown recluse. Which action can the nurse take to alleviate pain?

The correct answer is Choice D: Refer children with sore throats for throat cultures.

Choice A rationale:

Recommending salicylates instead of acetaminophen for minor discomforts is not relevant to the prevention of rheumatic fever. Rheumatic fever is primarily associated with untreated streptococcal infections, particularly streptococcal pharyngitis (strep throat), which can lead to complications such as rheumatic fever if left untreated. The choice of pain relievers like salicylates or acetaminophen doesn't play a significant role in preventing rheumatic fever.

Choice B rationale:

Encouraging routine cholesterol screenings is not relevant to the prevention of rheumatic fever. Rheumatic fever is an immune-mediated inflammatory response to certain strains of Streptococcus bacteria, particularly Streptococcus pyogenes. Cholesterol screenings are more related to assessing cardiovascular risk and are not directly linked to preventing rheumatic fever.

Choice C rationale:

Conducting routine blood pressure screenings is not directly related to the prevention of rheumatic fever. Blood pressure screenings are important for identifying hypertension and other cardiovascular risk factors, but they do not have a direct impact on preventing rheumatic fever, which is primarily a complication of untreated streptococcal infections.

Choice D rationale:

Refer children with sore throats for throat cultures. This is the correct choice. Rheumatic fever often develops as a result of untreated streptococcal pharyngitis (strep throat). Throat cultures are crucial for diagnosing streptococcal infections and determining the appropriate course of treatment with antibiotics. By identifying and treating streptococcal infections promptly, the risk of developing rheumatic fever can be significantly reduced.

The correct answer is choice C. Sparse hair.

Choice A rationale:

Sleepiness is not a typical symptom of hypothyroidism. Hypothyroidism, a condition where the thyroid gland doesn't produce enough thyroid hormone, leads to a slower metabolism which can cause fatigue, but not necessarily sleepiness.

Choice B rationale:

Weight loss is not associated with hypothyroidism. In fact, weight gain is a common symptom due to the reduced metabolic rate caused by insufficient thyroid hormone levels.

Choice C rationale:

Sparse hair is a characteristic symptom of hypothyroidism. The thyroid hormones play a crucial role in the growth and maintenance of hair follicles. In hypothyroidism, hair can become brittle, thin, and sparse.

Choice D rationale:

Diarrhea is not a typical symptom of hypothyroidism. Constipation, on the other hand, is more commonly associated with this condition due to the slowed digestive processes caused by low thyroid hormone levels.

Choice E rationale:

Puffiness around the eyes is not typically associated with hypothyroidism. However, it is a symptom of another thyroid disorder known as Graves' disease, which is characterized by hyperthyroidism (overactive thyroid).