A nurse is providing discharge teaching to the parent of a school-age child who has pharyngitis caused by group A B-hemolytic streptococci (GABHS). Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

"Schedule a time for your child to receive the pneumococcal vaccine within 2 weeks."

"Provide your child with their own towel for drying their face and hands at home."

"Replace your child's toothbrush 24 hours after beginning antibiotic therapy."

"Your child can return to school 24 hours after their first does of antibiotics."

"Replace your child's orthodontic appliances prior to beginning antibiotic therapy."

Answer and Explanation

Correct Answer : B,C,D

A. "Schedule a time for your child to receive the pneumococcal vaccine within 2 weeks."

This statement is incorrect. Pharyngitis caused by group A beta-hemolytic streptococci (GABHS) is typically treated with antibiotics, but it does not necessitate pneumococcal vaccination. Pneumococcal vaccination is recommended for other purposes, such as preventing pneumonia and invasive pneumococcal disease.

B. "Provide your child with their own towel for drying their face and hands at home."

This statement is correct. Group A streptococci (GAS) can be transmitted through respiratory droplets or by direct contact with infected secretions. Providing the child with their own towel can help prevent the spread of the infection to other family members.

C. "Replace your child's toothbrush 24 hours after beginning antibiotic therapy."

This statement is correct. It is recommended to replace the child's toothbrush after starting antibiotic therapy to reduce the risk of re-infection with group A streptococci (GAS).

D. "Your child can return to school 24 hours after their first dose of antibiotics."

This statement is correct. After initiating antibiotic therapy for GABHS pharyngitis, the child is usually considered non-contagious and can return to school after completing 24 hours of antibiotic treatment.

E. "Replace your child's orthodontic appliances prior to beginning antibiotic therapy."

This statement is incorrect. There is no specific recommendation to replace orthodontic appliances before starting antibiotic therapy for GABHS pharyngitis unless otherwise advised by a dentist or healthcare provider.

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Correct Answer is C

Explanation

A. Steatorrhea: Steatorrhea refers to the presence of fat in the stool, which can indicate malabsorption or digestive issues, but it is not a typical symptom of a urinary tract infection (UTI). Therefore, it is not relevant to consider steatorrhea in the context of a UTI.

B. Jaundice: Jaundice is characterized by yellowing of the skin and eyes due to elevated levels of bilirubin in the blood. It is typically associated with liver or gallbladder problems and is not a common symptom of a UTI. Therefore, it is not relevant to consider jaundice in the context of a UTI.

C. Incontinence: Incontinence, or the inability to control urination, can be a symptom of a UTI in toddlers. UTIs can cause irritation of the bladder, leading to urgency, frequency, and in some cases, incontinence. Therefore, incontinence is a relevant finding to consider in the context of a UTI.

D. Rebound tenderness: Rebound tenderness is a sign of peritoneal irritation and is typically associated with conditions affecting the abdomen, such as appendicitis or peritonitis. It is not a typical symptom of a UTI. Therefore, it is not relevant to consider rebound tenderness in the context of a UTI.

A. Decreased calories B. Increased fluids C. Blood glucose monitoring every 8 hr D. Urine testing for leukocytes

Correct Answer is B

Explanation

A. Decreased calories:

During illness, it's important to ensure adequate calorie intake to meet the body's increased energy demands for fighting off infection. Decreasing calories is not appropriate and can lead to hypoglycemia in a child with diabetes mellitus.

B. Increased fluids:

This is the correct option. During illness, the body's fluid requirements increase due to fever, sweating, and increased urination. Providing increased fluids helps prevent dehydration, which can exacerbate hyperglycemia. Parents should encourage the child to drink plenty of water or other sugar-free fluids to stay hydrated.

C. Blood glucose monitoring every 8 hr:

During illness, blood glucose levels may fluctuate more than usual due to changes in food intake, activity level, and the body's response to stress. Therefore, more frequent blood glucose monitoring is necessary, typically every 2-4 hours or as directed by the healthcare provider, rather than every 8 hours.

D. Urine testing for leukocytes:

Urine testing for leukocytes is not directly related to managing diabetes mellitus during illness. It may be done to assess for urinary tract infections, which can occur more frequently in individuals with diabetes, but it is not a routine part of diabetes management during illness.

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A nurse is providing discharge teaching to the parent of a school-age child who has pharyngitis caused by group A B-hemolytic streptococci (GABHS). Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

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