A nurse is reinforcing education to the caregiver of a 2-year-old toddler diagnosed with lead poisoning. Which of the following statements should the nurse make?

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.

A. Weight gain. Corticosteroids cause fluid retention and increased appetite, leading to significant weight gain. In a 6-year-old, this can affect self-esteem and social interactions, potentially leading to body image concerns and difficulty fitting in with peers.

B. Irritability. Mood changes, including irritability, anxiety, and mood swings, are common side effects of corticosteroids. These emotional changes can impact relationships with family and friends, affecting the child's psychosocial well-being.

C. Osteoporosis. While long-term corticosteroid use can lead to osteoporosis, it is primarily a physical concern rather than a psychosocial one. Bone health issues typically become more evident later in life rather than in early childhood.

D. Hypertension. Elevated blood pressure is a physiological side effect of corticosteroids but does not directly impact the child’s psychosocial development. It is more of a medical concern requiring monitoring rather than a factor affecting social interactions.

E. Nausea. Although nausea can cause discomfort, it does not have a significant impact on the child's psychosocial development compared to mood changes and body image issues caused by corticosteroid therapy.