A child has come into the emergency department after a confirmed bite from a brown recluse. Which action can the nurse take to alleviate pain?

The correct answers are Choice A: Diabetes mellitus, Choice E: Urinary tract infection (UTI).

Choice A rationale:

Diabetes mellitus. This is one of the correct choices. Diabetes can lead to increased urinary frequency, urgency, and secondary enuresis (bedwetting) due to the impact of elevated blood glucose levels on the kidneys and bladder function.

Choice B rationale:

Hypocalciuria is not directly relevant to evaluating secondary enuresis with dysuria or urgency. Hypocalciuria refers to a lower-than-normal level of calcium in the urine and is not a common cause of urinary symptoms in this context.

Choice C rationale:

Nephrotic syndrome primarily involves the kidneys and is characterized by proteinuria, edema, hypoalbuminemia, and hyperlipidemia. While it can cause changes in urinary patterns, it is not typically associated with dysuria or urgency.

Choice D rationale:

Glomerulonephritis refers to inflammation of the glomeruli, which are the tiny filters in the kidneys. It can lead to hematuria (blood in the urine) and proteinuria, but it is not commonly associated with dysuria or urgency.

Choice E rationale:

Urinary tract infection (UTI). This is one of the correct choices. UTIs can cause symptoms such as dysuria (painful urination), urgency, and frequency. These symptoms are especially relevant in the context of evaluating a child with secondary enuresis.

The correct answer is choice B: Lesions may extend to hairline or neck.

Choice A rationale:

Central clearing is not a prominent indicator of Tinea capitis. Tinea capitis is a fungal infection of the scalp and hair shafts, commonly caused by dermatophytes like Trichophyton species. The characteristic features include scaling, erythema, pustules, and hair loss. Unlike some other fungal infections, Tinea capitis does not typically have central clearing.

Choice B rationale:

Lesions extending to the hairline or neck is a correct aspect to include in education about Tinea capitis. The infection usually starts as small, scaly patches on the scalp and can progress to larger areas. It can extend to the hairline, neck, and even eyebrows and eyelashes. This is important information to convey to ensure proper recognition and timely treatment.

Choice C rationale:

Transmission of Tinea capitis mostly occurs from human-to-human rather than from dogs. While some animals can carry fungal infections that affect the skin, Tinea capitis is primarily spread through direct contact with an infected person or contaminated objects like combs, hats, and pillows.

Choice D rationale:

The appearance of Tinea capitis is not usually unilateral. This condition often presents with multiple, scattered areas of involvement on the scalp. It can cause varying degrees of inflammation, scaling, and hair loss in different areas, which may not follow a unilateral pattern.