What is a common sign of digoxin toxicity?

The correct answer is Choice D: Refer children with sore throats for throat cultures.

Choice A rationale:

Recommending salicylates instead of acetaminophen for minor discomforts is not relevant to the prevention of rheumatic fever. Rheumatic fever is primarily associated with untreated streptococcal infections, particularly streptococcal pharyngitis (strep throat), which can lead to complications such as rheumatic fever if left untreated. The choice of pain relievers like salicylates or acetaminophen doesn't play a significant role in preventing rheumatic fever.

Choice B rationale:

Encouraging routine cholesterol screenings is not relevant to the prevention of rheumatic fever. Rheumatic fever is an immune-mediated inflammatory response to certain strains of Streptococcus bacteria, particularly Streptococcus pyogenes. Cholesterol screenings are more related to assessing cardiovascular risk and are not directly linked to preventing rheumatic fever.

Choice C rationale:

Conducting routine blood pressure screenings is not directly related to the prevention of rheumatic fever. Blood pressure screenings are important for identifying hypertension and other cardiovascular risk factors, but they do not have a direct impact on preventing rheumatic fever, which is primarily a complication of untreated streptococcal infections.

Choice D rationale:

Refer children with sore throats for throat cultures. This is the correct choice. Rheumatic fever often develops as a result of untreated streptococcal pharyngitis (strep throat). Throat cultures are crucial for diagnosing streptococcal infections and determining the appropriate course of treatment with antibiotics. By identifying and treating streptococcal infections promptly, the risk of developing rheumatic fever can be significantly reduced.

The correct answer is choice D: Low in phosphorus.

Choice A rationale:

Supplemented with vitamins A, E, and K is not the characteristic of the diet for a child with chronic renal failure. While vitamin supplementation might be necessary in some cases, the primary dietary considerations in chronic renal failure are related to managing electrolyte imbalances, fluid retention, and waste buildup due to compromised kidney function.

Choice B rationale:

High in protein is not the recommended characteristic of the diet for a child with chronic renal failure. Kidneys affected by chronic renal failure have a reduced ability to filter and excrete waste products from protein metabolism. Excessive protein intake can lead to the accumulation of nitrogenous waste products, potentially worsening the condition and contributing to uremia.

Choice C rationale:

Low in vitamin D is not the primary characteristic of the diet for a child with chronic renal failure. Vitamin D metabolism can be affected by kidney dysfunction, but the focus of the diet in chronic renal failure is primarily on managing electrolyte levels, particularly phosphorus and potassium, as well as controlling fluid intake.

Choice D rationale:

Low in phosphorus is the correct characteristic of the diet for a child with chronic renal failure. Impaired kidney function in chronic renal failure leads to difficulty in excreting phosphorus, which can result in elevated blood phosphorus levels. High phosphorus levels can contribute to bone and mineral disorders and cardiovascular complications. Therefore, a diet low in phosphorus is crucial to prevent these complications and manage the progression of the disease.