A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?

Choice A reason: This choice is correct because a child who has nephrotic syndrome is the most appropriate roommate for a child who has leukemia. Nephrotic syndrome is a kidney disorder that causes proteinuria, edema, hypoalbuminemia, and hyperlipidemia. It does not pose any risk of infection or injury to the child who has leukemia, and it does not require any isolation or special precautions. Therefore, placing these two children in the same room can help to conserve resources and promote socialization.

Choice B reason: This choice is incorrect because a child recovering from a ruptured appendix is not an appropriate roommate for a child who has leukemia. A ruptured appendix is a medical emergency that occurs when the appendix becomes inflamed and bursts, releasing bacteria and pus into the abdominal cavity. It may cause peritonitis, sepsis, or abscess formation, and it requires surgery and antibiotics. It may pose a risk of infection to a child who has leukemia, who has a weakened immune system due to chemotherapy or bone marrow suppression. Therefore, placing these two children in the same room can increase the chance of cross-contamination and complications.

Choice C reason: This choice is incorrect because a child who has rheumatic fever is not an appropriate roommate for a child who has leukemia. Rheumatic fever is an inflammatory disease that occurs as a complication of streptococcal infection, such as strep throat or scarlet fever. It may affect the heart, joints, skin, or nervous system, and it requires anti-inflammatory and antibiotic medications. It may pose a risk of infection to the child who has leukemia, who has a compromised immune system due to cancer or treatment. Therefore, placing these two children in the same room can increase the likelihood of transmission and infection.

Choice D reason: This choice is incorrect because a child who has cystic fibrosis is not an appropriate roommate for a child who has leukemia. Cystic fibrosis is a genetic disorder that affects the mucus glands of the lungs, pancreas, liver, intestines, and reproductive organs. It causes thick and sticky mucus to build up in the organs, leading to chronic lung infections, pancreatic insufficiency, malnutrition, and infertility. It requires respiratory therapy, enzyme supplements, nutritional support, and antibiotics. It may pose a risk of infection to the child who has leukemia, who has a reduced ability to fight germs due to malignancy or therapy. Therefore, placing these two children in the same room can increase the possibility of exposure and infection.

Choice A: This statement is correct, as the mother should notify the doctor if the child's temperature is not controlled with acetaminophen, which is an antipyretic and analgesic medication that can lower fever and relieve pain. A high fever can increase the child's metabolic rate and insulin requirements, which can lead to hyperglycemia or ketoacidosis.

Choice B: This statement is incorrect, as the mother should check the child's blood sugar more frequently than two times every day, especially when the child is sick. An upper respiratory infection can cause inflammation and stress hormones, which can increase the child's blood sugar levels and insulin needs. The mother should monitor the child's blood sugar at least four times a day or more often if indicated by symptoms or ketone testing.

Choice C: This statement is correct, as the mother should encourage the child to drink half a cup of water or sugar-free fluids every 30 minutes, which can prevent dehydration and flush out excess glucose and ketones from the body. Dehydration can worsen hyperglycemia and ketoacidosis, which are serious complications of diabetes.

Choice D: This statement is correct, as the mother should report a change in the child's breathing or any signs of confusion, which can indicate respiratory distress or cerebral edema. Respiratory distress can occur due to hypoxia or acidosis, which can impair oxygen delivery and carbon dioxide elimination. Cerebral edema can occur due to fluid shifts or electrolyte imbalances, which can cause increased intracranial pressure and neurological impairment.