A nurse is assisting with the admission of a 9-year-old child who has acute rheumatic fever. When obtaining the client's history, it is appropriate for the nurse to ask the parent which of the following questions?

A. Measure the elixir in a medicine cup before transferring to a syringe:

This option involves measuring the medication using a medicine cup before transferring it to an oral medication syringe. While measuring the medication accurately is important, transferring it from a medicine cup to a syringe introduces an extra step that may increase the risk of spillage or dosage error. It's generally more efficient and accurate to directly draw the medication into the oral syringe.

B. Place the infant supine in a crib prior to administration:

Placing the infant in a supine (lying flat on the back) position in a crib prior to administering oral medication is not recommended, particularly for infants of this age. This position increases the risk of choking or aspiration, as it may cause the medication to flow toward the back of the throat rather than being swallowed properly. It's safer to administer oral medication to infants in an upright or slightly reclined position.

C. Position the syringe to the side of the infant's tongue:

This is the correct choice. Positioning the syringe to the side of the infant's tongue helps facilitate swallowing and reduces the risk of choking or aspiration. Placing the syringe toward the cheek allows the infant to more easily swallow the medication, as it minimizes the chance of the medication flowing toward the back of the throat.

D. Mix the medication with 10 mL of formula:

Mixing medication with formula is not a standard practice for administering oral medication using an oral syringe, particularly without specific instructions from the healthcare provider. Mixing medication with formula may alter the medication's effectiveness and is unnecessary for most oral medications. It's important to administer oral medication directly using an oral syringe to ensure accurate dosing and effectiveness.

A. Machine-like murmur:

A machine-like murmur typically refers to a continuous murmur, which can be heard throughout systole and diastole. While machine-like murmurs can be associated with certain cardiac conditions, such as patent ductus arteriosus (PDA), they are not typically heard in coarctation of the aorta. In coarctation of the aorta, a systolic ejection murmur may be heard over the upper left sternal border due to turbulent blood flow across the narrowed aortic segment.

B. Severe cyanosis:

Cyanosis refers to a bluish discoloration of the skin and mucous membranes due to decreased oxygenation of the blood. While cyanosis can occur in various congenital heart defects, such as tetralogy of Fallot, it is not a characteristic manifestation of coarctation of the aorta. Coarctation of the aorta typically results in decreased blood flow to the lower extremities rather than mixing of oxygenated and deoxygenated blood.

C. Decreased blood pressure in the legs:

This is the correct choice. Coarctation of the aorta is characterized by narrowing of the aorta, which leads to decreased blood flow to the lower extremities. Consequently, blood pressure measurements in the legs may be lower compared to those in the arms. This finding is often a key indicator of coarctation of the aorta.

D. Pulmonary edema:

Pulmonary edema refers to the accumulation of fluid in the lungs and is typically associated with conditions such as heart failure or fluid overload. While some congenital heart defects may lead to heart failure and subsequent pulmonary edema, coarctation of the aorta does not directly cause pulmonary edema. Instead, it primarily affects blood flow to the lower extremities due to the narrowing of the aorta.