Exhibit 1. Exhibit 2. Provider Prescriptions.
Exhibit 3. Pancrelipase 8,000 units PO with each meal and snack.
Chest physiotherapy three times daily.
A nurse is reviewing the medical record of a school-age child who has cystic fibrosis.
Which of the following findings should the nurse report to the provider? (Click on the "Exhibit" button for additional information about the client.
There are three tabs that contain separate categories of data.)

Choice A rationale:

Partial thromboplastin time (PTT) measures the time it takes for blood to clot and is used to monitor conditions like bleeding disorders or the effectiveness of anticoagulant therapy. PTT is not specific to rheumatic fever and does not contribute to confirming this diagnosis.

Choice B rationale:

Blood urea nitrogen (BUN) measures the amount of nitrogen in the blood that comes from urea. It is a marker of kidney function and hydration status. BUN levels are not directly related to rheumatic fever and do not play a role in confirming this diagnosis.

Choice C rationale:

Erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation in the body. Elevated ESR levels indicate the presence of inflammation but do not confirm a specific diagnosis. In the context of suspected rheumatic fever, elevated ESR levels, along with other clinical findings, can support the diagnosis.

Choice D rationale:

Antistreptolysin O (ASO) titer measures the level of antibodies against streptolysin O, a toxin produced by group A Streptococcus bacteria. Elevated ASO titers indicate a recent streptococcal infection, which is a common trigger for rheumatic fever. Positive ASO titers, along with clinical symptoms and other laboratory findings, contribute to confirming the diagnosis of rheumatic fever.

Choice E rationale:

C-reactive protein (CRP) is another marker of inflammation in the body. Elevated CRP levels indicate the presence of inflammation but do not confirm a specific diagnosis. In the context of suspected rheumatic fever, elevated CRP levels, along with other clinical and laboratory findings, can support the diagnosis by indicating the presence of inflammation.

Choice A rationale:

Administer cool, humidified oxygen via nasal cannula. Infants with heart failure often experience respiratory distress due to inadequate oxygenation. Administering cool, humidified oxygen via nasal cannula helps improve oxygen saturation and alleviate respiratory distress. Humidified oxygen prevents the mucous membranes from drying out, making breathing easier for the infant. Cool oxygen is preferred to reduce the work of breathing and to soothe irritated airways, improving the overall comfort of the infant.

Choice B rationale:

Provide less frequent, higher volume feedings. Infants with heart failure may have difficulty feeding due to fatigue and increased respiratory effort. Providing less frequent, higher volume feedings ensures that the infant receives adequate nutrition without becoming overly fatigued during feeding sessions. It allows the infant to obtain the necessary nutrients without putting excessive stress on their weakened cardiovascular system.

Choice C rationale:

Place the infant in a prone position. Placing the infant in a prone position is not recommended in the care of a child with heart failure. Placing the infant in an upright or semi-upright position is more appropriate as it reduces the workload on the heart and improves respiratory function. Placing the infant flat on their back may cause increased pressure on the diaphragm and worsen respiratory distress.

Choice D rationale:

Repeat a digoxin dosage if the infant vomits within 1 hr of administration. Digoxin is a medication commonly prescribed for heart failure. However, if the infant vomits shortly after receiving a dose, repeating the dose is not advisable. Vomiting may indicate that the medication was not properly absorbed, and administering an additional dose could lead to an overdose. Instead, the nurse should consult the healthcare provider for further instructions and closely monitor the infant's condition.