The nurse is admitting a child with rheumatic fever. Which therapeutic management should the nurse expect to implement?
Imposing strict bed rest for 4 to 6 weeks.
Administering corticosteroids if chorea develops.
Administering penicillin.
Avoiding salicylates (aspirin).
The Correct Answer is C
The correct answer is choice C: Administering penicillin.
Choice A rationale:
Imposing strict bed rest for 4 to 6 weeks. This choice is not the most appropriate therapeutic management for rheumatic fever. While rest is important during the acute phase, strict bed rest for 4 to 6 weeks is excessive and could lead to physical deconditioning and psychological distress for the child.
Choice B rationale:
Administering corticosteroids if chorea develops. This choice is relevant to the management of rheumatic fever but is not the primary treatment. Chorea is a movement disorder that can occur as a complication of rheumatic fever. Corticosteroids may be used to manage chorea symptoms, but they are not the mainstay of treatment for rheumatic fever itself.
Choice C rationale:
Administering penicillin. This is the correct choice. Penicillin is the mainstay of treatment for rheumatic fever. It helps eradicate the group A streptococcal infection that triggers the inflammatory response leading to rheumatic fever. Penicillin is essential to prevent further complications such as rheumatic heart disease.
Choice D rationale:
Avoiding salicylates (aspirin). This choice is also relevant to the management of rheumatic fever. Salicylates, including aspirin, are used to relieve symptoms and reduce inflammation. However, in children with acute rheumatic fever, salicylates are contraindicated due to the risk of developing Reye's syndrome, a serious condition that affects the brain and liver.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. Slowed growth.
Choice A rationale:
Slowed growth is a potential risk associated with long-term use of inhaled steroids in children with asthma. Inhaled steroids are a cornerstone of asthma management due to their anti-inflammatory effects on the airways, but they can have systemic effects when absorbed in larger amounts. Prolonged use of these steroids can potentially lead to growth suppression in children by affecting the normal growth and development of bones and other tissues.
Choice B rationale:
Osteoporosis is not the primary concern in children taking inhaled steroids. While long-term use of high-dose systemic steroids can lead to bone loss and osteoporosis in adults, the risk of osteoporosis is much lower in children receiving inhaled steroids for asthma management. Inhaled steroids have a lower systemic absorption, reducing the risk of significant bone density reduction in children.
Choice C rationale:
Cushing's syndrome is a condition caused by prolonged exposure to high levels of cortisol, often due to excessive use of systemic steroids. Inhaled steroids, especially at recommended doses, have a lower likelihood of causing Cushing's syndrome compared to systemic steroids. The systemic absorption of inhaled steroids is limited, minimizing the risk of this syndrome.
Choice D rationale:
Cough is not the primary increased risk associated with long-term use of inhaled steroids in children with asthma. Inhaled steroids are actually used to help control and prevent asthma symptoms, including cough. They work by reducing inflammation in the airways, which helps alleviate symptoms like coughing, wheezing, and shortness of breath.
Correct Answer is D
Explanation
The correct answer is choice D. Epiglottitis.
Choice A rationale:
Laryngotracheobronchitis (LTB) is a viral infection commonly known as "croup." While it can cause airway inflammation and respiratory distress, it is usually not considered a medical emergency. LTB is characterized by barking cough, stridor, and hoarseness. It typically responds well to supportive care, humidity, and sometimes oral corticosteroids.
Choice B rationale:
Spasmodic croup is another type of viral croup, often triggered by allergies or irritants. It is characterized by sudden onset of symptoms, usually at night, including stridor and a barking cough. While it can be distressing, it is generally not considered a medical emergency. It usually responds to humidity and sometimes oral corticosteroids.
Choice C rationale:
Laryngitis involves inflammation of the larynx and is often caused by viral infections or excessive voice use. While it can lead to hoarseness and voice changes, it does not typically cause severe respiratory distress and is not considered a medical emergency. Resting the voice and staying hydrated are common interventions.
Choice D rationale:
Epiglottitis is a potentially life-threatening condition that causes inflammation of the epiglottis, a flap of tissue that prevents food from entering the windpipe during swallowing. It can rapidly progress to airway obstruction and respiratory failure. Children with epiglottitis often assume a "tripod" position, leaning forward to maintain an open airway. Immediate medical intervention, including securing the airway and administering antibiotics, is crucial.
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