A nurse is discussing contraceptives with an adolescent who has disabilities. The adolescent has difficulty with motor movements and decreased memory. Which of the following birth control methods would be most appropriate for this child?

A. Administering the insulin injection quickly to minimize discomfort. Administering an injection quickly may reduce discomfort, but it does not address the emotional and psychological aspects of atraumatic care. The goal is to minimize fear and distress, not just physical pain.

B. Explaining the procedure in simple terms to the client before administering the insulin. Providing a clear, age-appropriate explanation helps reduce anxiety and fosters trust between the child and the nurse. Understanding what to expect allows the child to feel a sense of control, which is a key principle of atraumatic care.

C. Asking the client to look away during the injection to reduce anxiety. While looking away may help some children, it does not promote understanding or involvement in their care. Instead, explaining the procedure allows the child to develop coping strategies and feel more secure.

D. Using a larger needle to ensure accurate insulin delivery. Insulin is administered using a small-gauge needle to minimize pain. A larger needle is unnecessary and could increase discomfort, contradicting the principles of atraumatic care.

A. Atrial fibrillation on the cardiac monitor. Rheumatic fever can cause carditis, but atrial fibrillation is not a typical finding. Instead, valvular damage, tachycardia, or murmurs are more commonly observed.

B. Elevated BUN and creatinine on morning laboratory results. Rheumatic fever primarily affects the heart, joints, skin, and brain, not the kidneys. Elevated BUN and creatinine are more indicative of post-streptococcal glomerulonephritis, a separate complication of streptococcal infection.

C. Involuntary movements of extremities. Sydenham’s chorea, characterized by involuntary, jerky movements, is a classic neurologic manifestation of rheumatic fever. It results from inflammation affecting the basal ganglia of the brain.

D. Alopecia. Rheumatic fever does not cause alopecia. Hair loss is more commonly associated with autoimmune diseases such as lupus, not post-streptococcal complications.

E. Report of chest pain. Chest pain can indicate carditis, a major criterion for rheumatic fever. Inflammation of the heart's endocardium, myocardium, or pericardium may lead to pain, murmurs, or heart failure symptoms.

F. Oliguria. Decreased urine output is more commonly seen in post-streptococcal glomerulonephritis rather than rheumatic fever, as rheumatic fever primarily affects the heart, joints, and nervous system.