During the preconception phase, the nurse should teach about which infectious diseases as risk factors for maternal complications? (Select all that apply).

Choice A rationale:
Fever as high as 40° C (104° F). Fever is not typically a common sign or symptom of chronic otitis media with effusion (OME). Chronic OME is characterized by the presence of fluid in the middle ear without signs of acute infection. While fever might occur in acute otitis media, it is not a typical feature of chronic OME.
Choice B rationale:
Severe pain in the ear. Severe pain in the ear is more commonly associated with acute otitis media rather than chronic otitis media with effusion. Chronic OME usually presents with a sensation of fullness or hearing loss in the affected ear due to the accumulation of fluid in the middle ear, but it does not cause severe ear pain.
Choice C rationale:
Nausea and vomiting. Nausea and vomiting are not typical signs or symptoms of chronic otitis media with effusion. These symptoms are more likely to occur in conditions affecting the inner ear or vestibular system, not in chronic OME.
Choice D rationale:
A feeling of fullness in the ear. A feeling of fullness in the ear is a common sign of chronic otitis media with effusion. The accumulation of fluid in the middle ear can cause a sense of fullness or pressure in the affected ear. This sensation might be accompanied by mild hearing loss.

Choice A rationale:

Asthma. Rationale: A chronic, nonproductive cough and diffuse wheezing during the expiratory phase of respiration are classic symptoms of asthma. Asthma is a chronic inflammatory condition of the airways characterized by bronchoconstriction, leading to symptoms such as wheezing, coughing, and shortness of breath. These symptoms often worsen during the expiratory phase of respiration, leading to the characteristic expiratory wheezing.

Choice B rationale:

Pneumonia. Rationale: Pneumonia is characterized by inflammation of the lung tissue and is often associated with productive cough, fever, chest pain, and sometimes wheezing. However, diffuse wheezing during the expiratory phase without significant productive cough is not a typical presentation of pneumonia.

Choice C rationale:

Bronchiolitis. Rationale: Bronchiolitis, caused by viruses such as RSV, commonly affects infants and young children. It presents with symptoms such as cough, wheezing, and respiratory distress. However, bronchiolitis typically involves lower airway inflammation and is often associated with viral upper respiratory symptoms. The presented case, with a chronic, nonproductive cough and diffuse wheezing during the expiratory phase, is more indicative of asthma.

Choice D rationale:

Foreign body in the trachea. Rationale: A foreign body in the trachea can cause acute respiratory distress and coughing. While it can lead to wheezing, the chronic nature of the symptoms described in the scenario (chronic, nonproductive cough and diffuse wheezing during the expiratory phase) is not consistent with a foreign body in the trachea.