A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?

"Was your son born with this cardiac defect?"

"Has your child had any injuries recently?"

"Have you given your child aspirin in the past 2 weeks?"

"Has your son had a sore throat recently?"

Answer and Explanation

The Correct Answer is D

A.   This question is not relevant to the assessment for acute rheumatic fever. ARF is not a congenital cardiac defect but rather an acquired condition resulting from an abnormal immune response to a streptococcal infection.
B.   Injuries are not typically associated with the development of acute rheumatic fever. ARF is primarily triggered by an untreated or inadequately treated streptococcal infection, particularly streptococcal pharyngitis.
C.   Aspirin use is not a specific question related to the assessment of acute rheumatic fever. Aspirin therapy may be indicated for managing symptoms of ARF, but it is not a diagnostic criterion for the condition.
D.   Acute rheumatic fever (ARF) is an autoimmune condition affecting the heart, joints, skin, and central nervous system. It follows an untreated or inadequately treated group A streptococcal infection, particularly streptococcal pharyngitis (strep throat).

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Correct Answer is B

Explanation

A. Application of antibiotic ointment to the pin sites is not necessary as pins drilled into the bone are not used in buck extension traction.

B. Traction can be removed briefly during baths in cases where a pre-made boot is being used

C. Adequate hydration is essential for overall health and well-being, and fluid restriction could lead to dehydration, especially in a child with increased metabolic demands due to illness or injury.

D. Repositioning every 2 hours may not be necessary, as the child's position is generally stable with the traction device in place.

A. Avoid the use of a draw sheet when turning B. Post a turning schedule at the client's bedside C. Vigorously massage lotion into bony prominences D. Turn and reposition the client at least every 4 hours

Correct Answer is B

Explanation

Turning and repositioning the client at regular intervals is essential for preventing pressure ulcers in pediatric clients, especially those in the PICU who may be immobilized or have limited mobility due to their condition or treatment. Repositioning helps relieve pressure on bony prominences and redistributes pressure on the skin, reducing the risk of pressure ulcers. Turning schedules should be individualized based on the child's condition, mobility, and risk factors for pressure ulcers.

A. Avoid the use of a draw sheet when turning: Using a draw sheet can facilitate safe and smooth turning of the client without causing shear or friction forces. It helps distribute the weight evenly and reduces the risk of injury to the client or caregiver during the turning process. Therefore, avoiding the use of a draw sheet may increase the risk of pressure ulcers rather than prevent them.
B. Post a turning schedule at the client's bedside: While posting a turning schedule may serve as a reminder for staff, it alone does not provide direct intervention to prevent pressure ulcers. The crucial aspect is implementing the turning schedule consistently and ensuring that the client is repositioned at appropriate intervals.
C. Vigorously massage lotion into bony prominences: Massaging lotion into bony prominences can increase friction and shear forces on the skin, potentially causing tissue damage rather than preventing pressure ulcers. Additionally, vigorous massage may be uncomfortable or painful for the client, especially if they have fragile skin or existing pressure ulcers.

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A nurse is obtaining a health history from a child who has suspected acute rheumatic fever. Which of the following questions should the nurse ask?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has Legg-Calve-Perthes disease and is in Buck extension traction. Which of the following actions should the nurse take?

Correct Answer is B

Explanation

A nurse is caring for a child in the PICU. To prevent pressure ulcers, which intervention should the nurse include in the child's plan of care?

Correct Answer is B

Explanation

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