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A nurse is caring for a toddler in the outpatient setting.

Exhibits

Complete the following sentence by using the lists of options.

The nurse recognizes the toddler has likely developed

due to .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Rationale for Correct Choices:

  • Reye's syndrome: The toddler's worsening condition including vomiting, lethargy, and altered consciousness after a viral illness (influenza A) is consistent with Reye’s syndrome, which affects the liver and brain. The progression from mild viral symptoms to neurologic decline without respiratory compromise further supports this diagnosis.
  • Aspirin administration: Giving aspirin during a viral illness in children is a well-known precipitant of Reye’s syndrome. The caregivers' report of alternating aspirin with acetaminophen confirms the exposure necessary to trigger the condition in a susceptible child.

Rationale for Incorrect Choices:

  • Gastroenteritis: While vomiting is a feature of gastroenteritis, the absence of diarrhea and the presence of neurologic changes like lethargy and poor responsiveness make this unlikely. Additionally, the clear vomiting and lack of fluid intake without prior GI focus suggest another etiology.
  • Bronchitis: Bronchitis typically causes a productive cough with wheezing, chest discomfort, and possible fever. This toddler's lungs are clear with a nonproductive cough, and neurologic signs are not typical of bronchitis.
  • Acetaminophen administration: Acetaminophen is safe and commonly used to treat fever in toddlers. It is not associated with hepatic encephalopathy or neurologic complications seen in this scenario.
  • Oseltamivir administration: Though oseltamivir may cause gastrointestinal side effects like nausea or vomiting, it does not explain the altered mental status and lethargy. It is also unlikely to cause such a significant clinical deterioration on its own.


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Related Questions

Correct Answer is B

Explanation

Rationale:

A. Expresses pain freely and loudly: Many Chinese American clients may view overt pain expression as a loss of control or dignity. Cultural norms often encourage stoicism, and clients may underreport pain unless directly asked in a sensitive and respectful manner.

B. Prefers foods that maintain a balance of hot and cold within the body: Traditional Chinese medicine emphasizes balance, particularly of hot and cold elements, especially during the postpartum period. Clients may prefer warm foods and drinks to restore balance and promote healing after childbirth.

C. Prefers to make direct eye contact with health care personnel: In Chinese cultural contexts, direct eye contact can be considered disrespectful or confrontational, especially toward authority figures. Avoiding eye contact may be a sign of respect rather than disinterest.

D. Tends to be very expressive with gestures and body language: Chinese American clients may communicate in a more reserved and controlled manner, often minimizing the use of expressive gestures. Nonverbal communication may be subtle, requiring attentive observation.

Correct Answer is C

Explanation

Rationale:

A. "Rinse your mouth with an alcohol-based mouthwash.": Alcohol-based mouthwashes can further irritate the mucous membranes, worsen oral discomfort, and dry the oral tissues, especially in clients with mucositis or candidiasis common in AIDS.

B. "Eat foods served at hot temperatures.": Hot foods can aggravate oral sores and cause more pain or tissue damage. Cool or room-temperature foods are typically better tolerated when the mouth is sore.

C. "Use ice chips to numb your mouth.": Ice chips can provide temporary relief by numbing oral tissues, reducing inflammation, and making eating more comfortable. This is a helpful, non-pharmacologic intervention for oral pain.

D. "Add salt to season foods.": Salt can irritate open or inflamed oral tissues and worsen the discomfort. Bland, soft foods without strong seasonings are usually better tolerated in cases of mouth soreness.

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