A nurse is assisting with the care of a preschooler who is postoperative following tetralogy of Fallot correction. Which of the following manifestations indicates the child is possibly experiencing decreased cardiac output?

Choice A rationale:
Occupational therapy is the appropriate referral for an adolescent with rheumatoid arthritis who is having difficulty feeding themselves. Rheumatoid arthritis is a chronic autoimmune disorder that can lead to joint inflammation and deformities. Occupational therapy focuses on helping individuals improve their ability to perform daily activities, which includes activities like feeding, dressing, and grooming. Occupational therapists work with patients to develop strategies and use adaptive equipment to make these tasks more manageable. In the case of an adolescent with rheumatoid arthritis, occupational therapy can provide techniques and tools to facilitate feeding independently despite joint limitations.
Choice B rationale:
Physical therapy primarily focuses on improving mobility, strength, and function in individuals with musculoskeletal issues. While physical therapy could be beneficial for an adolescent with rheumatoid arthritis to address joint mobility and muscle strength, it might not directly address the difficulty in feeding. Therefore, although physical therapy can be a helpful component of care for patients with rheumatoid arthritis, it might not be the first choice for addressing feeding difficulties.
Choice C rationale:
Speech therapy is not the most appropriate referral for an adolescent with rheumatoid arthritis experiencing feeding difficulties. Speech therapy primarily addresses communication and swallowing disorders. While swallowing difficulties might be relevant in some cases of rheumatoid arthritis due to potential joint involvement in the jaw, the primary focus should be on addressing joint limitations and adaptive techniques for feeding, making occupational therapy a more suitable referral.
Choice D rationale:
A case manager is not the recommended referral for an adolescent with rheumatoid arthritis and feeding difficulties. Case managers typically coordinate and facilitate various aspects of a patient's care, such as arranging appointments and services. While case managers play a valuable role in healthcare, the immediate concern of feeding difficulties in an adolescent with rheumatoid arthritis is best addressed through specialized interventions like occupational therapy.

Choice A rationale:
Contact precautions are indicated when the client has a condition that can be easily transmitted through direct contact with the client or their environment. Measles, which is an airborne disease, requires more stringent precautions due to its mode of transmission.
Choice B rationale:
The correct choice. Measles is spread through airborne particles, making airborne precautions necessary. These precautions include placing the client in a negative pressure room, wearing appropriate respiratory protection (e.g., N95 mask), and ensuring that healthcare providers are properly protected from inhaling infectious particles.
Choice C rationale:
A protective environment is a specialized form of isolation used for clients with compromised immune systems, such as those undergoing stem cell transplants. It involves maintaining a sterile environment to prevent the introduction of pathogens. This level of precautions is not applicable to clients with measles.
Choice D rationale:
Droplet precautions are appropriate for diseases that are transmitted through respiratory droplets generated by coughing, sneezing, or talking. Measles, however, is transmitted through smaller airborne particles that can remain suspended in the air for longer periods, making airborne precautions the most suitable choice.