A nurse is caring for an adolescent in an emergency department who was brought to the emergency department by their parent. The adolescent reports intermittent low-grade fever and anorexia. Manifestations presented a few days after having dental work performed. Now they are worse. The adolescent noticed shortness of breath with exertion today. The nurse reports the 2400 assessment findings to the provider. Which of the following should the nurse anticipate the provider will prescribe? For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
Administer antibiotic therapy
Obtain an echocardiogram
Obtain blood cultures x3
Restrict dental hygiene
Perform strenuous exercise regimen twice a day
The Correct Answer is A
Choice A reason: Administering antibiotic therapy is an anticipated prescription for the client, as it can treat the possible bacterial infection that is causing the fever, anorexia, and shortness of breath. The client may have developed infective endocarditis, a serious condition that affects the heart valves and can lead to heart failure or stroke. Antibiotic therapy can help prevent further complications and reduce the risk of mortality.
Choice B reason: Obtaining an echocardiogram is an anticipated prescription for the client, as it can help diagnose the presence and severity of infective endocarditis. An echocardiogram is a noninvasive test that uses sound waves to create images of the heart and its structures. It can show if there is any damage to the heart valves, vegetation (clumps of bacteria and cells) on the valves, or signs of heart failure.
Choice C reason: Obtaining blood cultures x3 is an anticipated prescription for the client, as it can help identify the causative organism of the infection and guide the appropriate antibiotic therapy. Blood cultures are samples of blood that are taken from different sites and times and tested for the presence of bacteria or other microorganisms. They can confirm the diagnosis of infective endocarditis and determine the sensitivity and resistance of the bacteria to different antibiotics.
Choice D reason: Restricting dental hygiene is a contraindicated prescription for the client, as it can worsen the oral health and increase the risk of infection. Dental hygiene is important for preventing plaque and tartar buildup, which can harbor bacteria and cause dental caries, gingivitis, or periodontitis. These conditions can increase the risk of bacteremia (bacteria in the blood) and infective endocarditis. The nurse should teach the client to maintain good oral hygiene and use a soft-bristled toothbrush and gentle flossing.
Choice E reason: Performing a strenuous exercise regimen twice a day is a contraindicated prescription for the client, as it can increase the cardiac workload and exacerbate the symptoms of infective endocarditis. Strenuous exercise can cause tachycardia (fast heart rate), dyspnea (difficulty breathing), chest pain, and fatigue, which can worsen the condition of the heart and the valves. The nurse should advise the client to avoid strenuous exercise and limit physical activity to a level that does not cause symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Tracheoesophageal fistula is a congenital anomaly that results from an abnormal connection between the trachea and the esophagus. It causes respiratory distress, choking, coughing, and cyanosis during feeding, and increased risk of aspiration pneumonia.
Choice B reason: Inguinal hernia is a protrusion of abdominal organs through the inguinal canal into the scrotum or labia. It causes a bulge in the groin area that may increase in size with crying or straining. It may also cause pain, vomiting, and impaired blood flow to the herniated tissue.
Choice C reason: Intussusception is a telescoping of one segment of the bowel into another, causing obstruction and impaired blood supply. It causes a palpable mass in the upper right quadrant, stools mixed with blood and mucus (resembling currant jelly), abdominal pain, vomiting, and shock.
Choice D reason: Hypertrophic pyloric stenosis is a narrowing of the pyloric sphincter due to hypertrophy of the surrounding muscle. It causes projectile vomiting, dehydration, weight loss, and a palpable olive-shaped mass in the upper right quadrant.
Correct Answer is A
Explanation
Choice A reason: Intravenous immunoglobulin (IVIG) is the main treatment for Kawasaki disease, as it reduces the inflammation of the blood vessels and the risk of coronary artery aneurysms. IVIG is given as a single infusion over 10 to 12 hours, within the first 10 days of the onset of fever.
Choice B reason: Aspirin is also used to treat Kawasaki disease, as it reduces the fever, pain, and inflammation. However, it is not the first-line treatment, and it is given after IVIG to prevent thrombosis and platelet aggregation. Aspirin is given at a high dose during the acute phase, and then at a low dose until the inflammation subsides.
Choice C reason: Penicillin is not indicated for Kawasaki disease, as it is an antibiotic that treats bacterial infections. Kawasaki disease is not caused by bacteria, but by an unknown trigger that activates the immune system and causes systemic vasculitis.
Choice D reason: Acetaminophen is not effective for Kawasaki disease, as it does not reduce the inflammation or the risk of complications. Acetaminophen may be used to treat mild pain or fever, but it is not the main treatment. Moreover, acetaminophen may mask the fever and delay the diagnosis of Kawasaki disease.
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