A nurse is planning care for a preschooler who has leukemia. After reviewing the child's information, which of the following potential issues should the nurse identify that the child is at risk for developing? (Select all that apply.)

Choice A reason: This statement does not indicate a risk for rheumatic carditis, but rather a possible respiratory infection or asthma. Rheumatic carditis is an inflammatory condition of the heart valves that can result from untreated streptococcal pharyngitis.

Choice B reason: This statement does not indicate a risk for rheumatic carditis, but rather a sign of heart failure. Dyspnea, tachypnea, and hypoxia are common manifestations of heart failure in children with congenital heart defects.

Choice C reason: This statement does not indicate a risk for rheumatic carditis, but rather a normal finding for a client who has an IV access. A peripheral saline lock is used to administer fluids and medications as needed, and it should be monitored for signs of infection, infiltration, or phlebitis.

Choice D reason: This statement indicates a risk for rheumatic carditis, as lower extremity edema and decreased skin pigmentation are signs of erythema marginatum, a characteristic rash that occurs in some cases of rheumatic fever. Erythema marginatum is a pink or red rash that spreads from the trunk to the extremities, and it may fade and reappear with changes in temperature.

Choice A reason: Elbow restraints are commonly used for infants who have undergone cleft lip and palate repair to prevent them from touching or rubbing their incisions, which could cause bleeding, infection, or disruption of the sutures¹².

Choice B reason: Wrist restraints are not appropriate for infants who have undergone cleft lip and palate repair because they do not prevent the infant from reaching their mouth with their fingers or objects. Wrist restraints are more suitable for older children or adults who need to avoid pulling out tubes or catheters³.

Choice C reason: Jacket restraints are not indicated for infants who have undergone cleft lip and palate repair because they do not restrict the movement of the arms or hands. Jacket restraints are more useful for children who need to be secured to a bed or chair to prevent falls or injuries³.

Choice D reason: Mummy restraints are not recommended for infants who have undergone cleft lip and palate repair because they immobilize the entire body and can cause respiratory distress, overheating, or skin breakdown. Mummy restraints are only used for short procedures that require minimal movement, such as venipuncture or lumbar puncture³.