A nurse in a provider's office is reviewing data from a client's medical record. Which of the following findings should the nurse identify as a risk factor for cardiovascular disease?

Choice A Reason:

A school-age child who has diabetes mellitus and a blood glucose of 200 mg/dL. A blood glucose level of 200 mg/dL in a child with diabetes may require management but is not an immediate life-threatening situation.

Choice B Reason:

A toddler who has nephrotic syndrome and facial edema. Facial edema in a child with nephrotic syndrome requires assessment and potential intervention but might not present an immediate threat to life compared to an airway obstruction.

Choice C Reason:

A preschool-age child who has a muffled voice and no spontaneous cough. The combination of muffled voice and the absence of spontaneous cough can be indicative of an upper airway obstruction, which can be life-threatening. This requires immediate assessment and intervention to ensure the child's airway is clear and that breathing is not compromised.

Choice D Reason:

An adolescent who has Crohn's disease and a recent weight loss of 5 kg (11 lb). Weight loss in an adolescent with Crohn's disease is concerning but might not represent an immediate life-threatening situation compared to a potential airway obstruction.

Choice A Reason:

Relaxed facial expression is correct. Opioids, when effectively managing pain, can lead to a more relaxed facial expression in infants. It's a common indicator that the pain is being controlled and the infant is experiencing relief.

Choice B Reason:

Increased blood pressure is incorrect. Opioids usually cause a decrease in blood pressure rather than an increase. Elevated blood pressure wouldn't typically signify a therapeutic effect of opioids; it might indicate other factors such as stress, discomfort, or an adverse reaction.

Choice C Reason:

Limb withdrawal is incorrect. Limb withdrawal is a reflex action and might occur in response to a stimulus. It's not a direct indicator of pain relief; rather, it's a reflexive response to a sensation.

Choice D Reason:

Bradycardia is incorrect. Bradycardia, a slowed heart rate, can be a side effect of opioid medications. However, it's not an indicator of the therapeutic effect of pain relief. In fact, bradycardia might signal an adverse reaction or a dose that's too high for the infant.