A nurse is caring for an 18-month-old infant who is 12 hours postoperative following a myringotomy. Which of the following pain rating scales should the nurse use?

Choice A rationale:
Occupational therapy is the appropriate referral for an adolescent with rheumatoid arthritis who is having difficulty feeding themselves. Rheumatoid arthritis is a chronic autoimmune disorder that can lead to joint inflammation and deformities. Occupational therapy focuses on helping individuals improve their ability to perform daily activities, which includes activities like feeding, dressing, and grooming. Occupational therapists work with patients to develop strategies and use adaptive equipment to make these tasks more manageable. In the case of an adolescent with rheumatoid arthritis, occupational therapy can provide techniques and tools to facilitate feeding independently despite joint limitations.
Choice B rationale:
Physical therapy primarily focuses on improving mobility, strength, and function in individuals with musculoskeletal issues. While physical therapy could be beneficial for an adolescent with rheumatoid arthritis to address joint mobility and muscle strength, it might not directly address the difficulty in feeding. Therefore, although physical therapy can be a helpful component of care for patients with rheumatoid arthritis, it might not be the first choice for addressing feeding difficulties.
Choice C rationale:
Speech therapy is not the most appropriate referral for an adolescent with rheumatoid arthritis experiencing feeding difficulties. Speech therapy primarily addresses communication and swallowing disorders. While swallowing difficulties might be relevant in some cases of rheumatoid arthritis due to potential joint involvement in the jaw, the primary focus should be on addressing joint limitations and adaptive techniques for feeding, making occupational therapy a more suitable referral.
Choice D rationale:
A case manager is not the recommended referral for an adolescent with rheumatoid arthritis and feeding difficulties. Case managers typically coordinate and facilitate various aspects of a patient's care, such as arranging appointments and services. While case managers play a valuable role in healthcare, the immediate concern of feeding difficulties in an adolescent with rheumatoid arthritis is best addressed through specialized interventions like occupational therapy.

Choice A rationale:
A positive leukocyte esterase test indicates the presence of white blood cells (leukocytes) in the urine, which can be an indicator of a urinary tract infection (UTI). White blood cells are part of the body's immune response and their presence in the urine suggests inflammation and infection in the urinary tract.
Choice B rationale:
Deep gold-colored urine is not typically associated with a urinary tract infection. Normally, urine color can vary based on hydration, diet, and other factors, but color alone is not a reliable indicator of a UTI.
Choice C rationale:
The osmolality of 700 mOsm/L is not a specific finding related to urinary tract infections. Osmolality measures the concentration of particles in the urine and can vary based on hydration status. While it might be elevated in a concentrated urine sample, it is not a direct indicator of a UTI.
Choice D rationale:
A specific gravity of 1.015 is within the normal range and does not necessarily indicate a urinary tract infection. Specific gravity measures the concentration of solutes in the urine and can be influenced by hydration levels and kidney function. A UTI would primarily be indicated by the presence of white blood cells and other signs of infection in the urine.