Which action by the school nurse is important in the prevention of rheumatic fever?

Choice A rationale:

Increased appetite is a common side effect of corticosteroid therapy. Corticosteroids are known to affect various metabolic processes, and one of the effects is an increase in appetite. This can lead to weight gain, especially when the increased calorie intake is not balanced by physical activity.

Choice B rationale:

Fever is not a typical side effect of corticosteroid therapy. Corticosteroids are often used to reduce inflammation and suppress the immune response, which can help in managing conditions like autoimmune diseases, allergies, and inflammatory disorders. Fever is not a direct result of corticosteroid administration.

Choice C rationale:

Weight loss is not a common side effect of corticosteroid therapy. In fact, corticosteroids are more likely to cause weight gain due to their influence on appetite, metabolism, and fluid retention.

Choice D rationale:

Hypertension (high blood pressure) can indeed be a side effect of corticosteroid therapy. Corticosteroids can lead to sodium and water retention, which can contribute to increased blood pressure, particularly in individuals who are already at risk for hypertension. However, among the options provided, increased appetite is a more directly associated side effect of corticosteroid therapy.

The correct answer is choice B. A feeling of fullness in the ear.

Choice A rationale:

Nausea and vomiting are not typical symptoms of chronic otitis media with effusion (OME). OME involves fluid accumulation in the middle ear without signs of acute infection. It is commonly seen in children and may cause mild hearing impairment and a feeling of fullness in the ear.

Choice B rationale:

A feeling of fullness in the ear is a common symptom of OME. The fluid accumulation in the middle ear can lead to a sensation of pressure or fullness, as well as mild hearing loss. This can impact a child's ability to hear and communicate effectively.

Choice C rationale:

Severe pain in the ear is more characteristic of acute otitis media (AOM), which is an infection of the middle ear with signs of inflammation. In OME, pain is typically not a prominent symptom unless there is an underlying AOM episode.

Choice D rationale:

Fever as high as 40°C (104°F) is not a typical symptom of OME. OME is generally a chronic condition without acute signs of infection such as fever. However, if a fever is present, it might indicate a concurrent infection that needs further evaluation.