A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?

"Was your son born with this cardiac defect?"

"Has your child had any injuries recently?"

"Have you given your child aspirin in the past 2 weeks?"

"Has your son had a sore throat recently?"

Answer and Explanation

The Correct Answer is D

A.   This question is not relevant to the assessment for acute rheumatic fever. ARF is not a congenital cardiac defect but rather an acquired condition resulting from an abnormal immune response to a streptococcal infection.
B.   Injuries are not typically associated with the development of acute rheumatic fever. ARF is primarily triggered by an untreated or inadequately treated streptococcal infection, particularly streptococcal pharyngitis.
C.   Aspirin use is not a specific question related to the assessment of acute rheumatic fever. Aspirin therapy may be indicated for managing symptoms of ARF, but it is not a diagnostic criterion for the condition.
D.   Acute rheumatic fever (ARF) is an autoimmune condition affecting the heart, joints, skin, and central nervous system. It follows an untreated or inadequately treated group A streptococcal infection, particularly streptococcal pharyngitis (strep throat).

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Correct Answer is C

Explanation

A. While assessing for pain is important, it is not the priority in this situation. The presence of pink- colored urine and a palpable mass in the abdominal area are more concerning findings that warrant immediate investigation.

B. Obtaining a urine specimen for analysis is important for diagnosing the cause of the hematuria (blood in the urine), which is a common symptom of Wilms tumor. However, this is not the immediate priority compared to preventing potential harm to the child by avoiding pressure on the abdominal area.

C. Instructing the parent to avoid pressing on the abdominal area is the priority action. Wilms tumor can rupture with pressure, which can lead to the spread of cancer cells. It is crucial to minimize handling of the tumor to prevent tumor spillage into the abdominal cavity.

D. The decision to schedule additional diagnostic tests, such as an abdominal ultrasound, can be made based on the results of the urinalysis and further clinical assessment.

A. Avoid the use of a draw sheet when turning B. Post a turning schedule at the client's bedside C. Vigorously massage lotion into bony prominences D. Turn and reposition the client at least every 4 hours

Correct Answer is B

Explanation

Turning and repositioning the client at regular intervals is essential for preventing pressure ulcers in pediatric clients, especially those in the PICU who may be immobilized or have limited mobility due to their condition or treatment. Repositioning helps relieve pressure on bony prominences and redistributes pressure on the skin, reducing the risk of pressure ulcers. Turning schedules should be individualized based on the child's condition, mobility, and risk factors for pressure ulcers.

A. Avoid the use of a draw sheet when turning: Using a draw sheet can facilitate safe and smooth turning of the client without causing shear or friction forces. It helps distribute the weight evenly and reduces the risk of injury to the client or caregiver during the turning process. Therefore, avoiding the use of a draw sheet may increase the risk of pressure ulcers rather than prevent them.
B. Post a turning schedule at the client's bedside: While posting a turning schedule may serve as a reminder for staff, it alone does not provide direct intervention to prevent pressure ulcers. The crucial aspect is implementing the turning schedule consistently and ensuring that the client is repositioned at appropriate intervals.
C. Vigorously massage lotion into bony prominences: Massaging lotion into bony prominences can increase friction and shear forces on the skin, potentially causing tissue damage rather than preventing pressure ulcers. Additionally, vigorous massage may be uncomfortable or painful for the client, especially if they have fragile skin or existing pressure ulcers.

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A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a toddler whose parent states while bathing the child she noticed a mass in his abdominal area and that his urine is a pink color. Which of the following actions is the nurse's priority?

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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