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. "Anencephaly affects male fetuses more than female fetuses." Anencephaly occurs more frequently in female fetuses than in males. Studies suggest a slightly higher prevalence in female infants, though the exact reason is unclear.

B. "Cancer during pregnancy is a risk factor for anencephaly." There is no known link between cancer during pregnancy and anencephaly. The primary risk factors include folic acid deficiency, maternal diabetes, and exposure to teratogens (e.g., certain medications, high temperatures, or environmental toxins).

C. "These defects occur in the embryonic stage of pregnancy." Anencephaly is a neural tube defect (NTD) that occurs during the embryonic stage, specifically between weeks 3 and 4 of gestation. During this period, the neural tube fails to close properly, leading to incomplete development of the brain and skull.

D. "Most newborns who have anencephaly survive 1 month." Anencephaly is almost always fatal, with most affected newborns dying within hours to days after birth. There is no cure, and long-term survival is extremely rare due to the severe brain malformation.