A nurse is caring for a client who has a spinal cord injury. Which of the following support devices should the nurse plan to use to prevent plantar flexion contractures?

Rationale:

A. Human papillomavirus: HPV is a common viral STI, but it is not classified as a nationally notifiable disease. Although certain strains are linked to cervical cancer, cases of HPV infection are not routinely reported to public health authorities.

B. Candidiasis: Candidiasis is a fungal infection, not a sexually transmitted infection. It is typically caused by Candida overgrowth and does not require notification to public health departments, as it is not considered a reportable condition.

C. Chlamydia: Chlamydia is one of the most commonly reported nationally notifiable STIs in the U.S. All confirmed cases must be reported to state or local health departments for monitoring, surveillance, and public health intervention.

D. Herpes simplex virus: Although HSV is a common STI, it is not routinely included on the list of nationally notifiable diseases unless part of an outbreak or neonatal herpes case. Therefore, individual adult cases are typically not reported.

Rationale:

• Drooling: Drooling is classic in epiglottitis due to severe throat pain and an inability to swallow. It is not commonly seen in RSV or streptococcal pharyngitis, where swallowing remains relatively intact.
• Hypoxia: Both epiglottitis and RSV can cause hypoxia. In epiglottitis, airway obstruction can quickly compromise oxygenation. In RSV, hypoxia results from inflammation and mucus plugging in the small airways.
• Fever: Fever is a nonspecific but common finding across all three conditions. It signals an inflammatory or infectious process, whether viral (RSV), bacterial (Streptococcus), or in epiglottitis (often Haemophilus influenzae type b if unimmunized).
• Tachypnea: Tachypnea may occur in both epiglottitis and RSV as the body compensates for airway compromise and impaired gas exchange. It is not a typical feature of uncomplicated streptococcal pharyngitis.
• Exudate on pharynx: Pharyngeal exudates are common in streptococcal pharyngitis and help differentiate it from viral causes. They are typically absent in RSV and epiglottitis, where the pathology lies elsewhere (lower airways or supraglottic structures).
• Wheezing upon auscultation: Wheezing is a hallmark of RSV due to bronchiolar inflammation and narrowing. It is not seen in epiglottitis or streptococcal pharyngitis, as those conditions do not primarily affect the bronchioles.