A nurse is caring for a toddler who has acute laryngotracheobronchitis and has been placed in a cool mist tent. Which of the following findings indicates that the treatment has been effective?

Choice A reason: This is the correct instruction for the nurse to include in the plan. Mumps is a viral infection that causes inflammation of the salivary glands. It is transmitted by respiratory droplets from coughing, sneezing, or talking. The nurse should initiate droplet precautions, which include wearing a surgical mask, gloves, and gown, and keeping the child in a private room or with other children who have mumps.

Choice B reason: This is not the correct instruction for the nurse to include in the plan. Airborne precautions are used for infections that are transmitted by small particles that can remain suspended in the air for long periods of time, such as tuberculosis, chickenpox, or measles. Mumps is not an airborne infection, and the nurse does not need to wear a respirator or place the child in a negative pressure room.

Choice C reason: This is not the correct instruction for the nurse to include in the plan. Contact precautions are used for infections that are transmitted by direct or indirect contact with the infected person or their environment, such as scabies, impetigo, or MRSA. Mumps is not a contact infection, and the nurse does not need to wear gloves and gown for all interactions with the child or use disposable equipment.

Choice D reason: This is not the correct instruction for the nurse to include in the plan. Standard precautions are the minimum level of infection control that should be used for all patients, regardless of their diagnosis or presumed infection status. They include hand hygiene, use of personal protective equipment, safe injection practices, and environmental cleaning. However, they are not sufficient for preventing the transmission of mumps, and the nurse should use additional precautions.

Choice A reason: This is the most likely source of the child's infection. Rheumatic fever is a complication of an untreated or poorly treated streptococcal infection, such as strep throat or scarlet fever. It usually occurs 2 to 4 weeks after the initial infection and causes inflammation of the heart, joints, skin, and nervous system. The nurse should ask the parent if the sibling was tested and treated for strep throat, and if the child was exposed to the sibling.

Choice B reason: This is not a likely source of the child's infection. Chickenpox is caused by the varicella-zoster virus, not by streptococci. It is a highly contagious disease that causes a blister-like rash, itching, fever, and fatigue. It does not cause rheumatic fever, but it can lead to other complications, such as bacterial skin infections, pneumonia, or encephalitis.

Choice C reason: This is not a likely source of the child's infection. Fifth disease is caused by the parvovirus B19, not by streptococci. It is a mild illness that causes a distinctive red rash on the face, body, and limbs, as well as fever, headache, and sore throat. It does not cause rheumatic fever, but it can affect the production of red blood cells and cause anemia in some people.

Choice D reason: This is not a likely source of the child's infection. Gastritis is the inflammation of the stomach lining, which can be caused by various factors, such as bacteria, viruses, medications, alcohol, or stress. It is not caused by streptococci, nor does it cause rheumatic fever. It can cause symptoms such as abdominal pain, nausea, vomiting, and loss of appetite.