A pediatric nurse is concerned that her patient is exhibiting signs of infective endocarditis. Which of the following symptoms would lead the nurse to suspect that diagnosis?
Proteinuria
ESR-14 mm/hr (Normal: Children<10 mm/hr)
Weight gain of 2 kg since last well visit
Hemoglobin- 13.8 (Normal: children 11.2 to 14.5 g/dl)
Temperature – 102.5°F
The Correct Answer is E
Infective endocarditis is an infection of the inner lining of the heart chambers and valves. One of the hallmark signs of infective endocarditis is fever, often accompanied by other symptoms such as fatigue, chills, and joint pain. A persistent fever in a child, especially when associated with other signs or symptoms like new heart murmurs or petechiae (small red or purple spots on the skin), can be concerning for infective endocarditis.
The other symptoms and findings listed (proteinuria, ESR, weight gain, hemoglobin levels) are not specific to infective endocarditis and may have other potential causes or interpretations. It is important to consider a comprehensive clinical evaluation and laboratory tests when assessing a child with suspected infective endocarditis.
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Related Questions
Correct Answer is D
Explanation
Weight loss in a child with acute glomerulonephritis is often due to a reduction in edema (fluid retention and swelling). Acute glomerulonephritis can lead to significant edema, as the kidneys may not effectively filter excess fluid and waste products from the body. During hospitalization and treatment, interventions such as diuretics and improved kidney function may result in the gradual removal of excess fluid, leading to a decrease in edema and overall body weight.
The other options are less likely to be the primary cause of the weight loss:
A. Poor appetite: While acute glomerulonephritis can affect appetite, especially due to nausea or other symptoms, it is not typically the primary reason for significant weight loss over a short period.
B. Restriction to bed rest: While being on bed rest can lead to muscle atrophy and loss of lean body mass over an extended period, it is unlikely to result in an 8-pound weight loss in just 4 days unless there are additional factors at play.
C. Increased potassium intake: Increased potassium intake alone would not be a primary cause of significant weight loss. High potassium levels in the blood (hyperkalemia) can occur in kidney disease, but it is not typically associated with rapid weight loss.
Correct Answer is ["A","B","E"]
Explanation
The congenital heart diseases that often require multiple surgeries to correct are:
A.Tetralogy of Fallot usually requires staged surgical repairs, with multiple surgeries performed over time to address the various components of the defect.
B.Hypoplastic Left Heart Syndrome typically requires a series of staged surgeries, including the Norwood procedure, Glenn procedure, and Fontan procedure, to manage the condition.
E.While some cases can be corrected with a single surgery or catheter-based intervention, re-narrowing (re-coarctation) is common, especially in infants. This may necessitate repeat surgeries or balloon angioplasty later in life.
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