The nurse is caring for a school-age child with hyperthyroidism (Graves' disease). Which clinical manifestations should the nurse monitor that may indicate a thyroid storm? (Select all that apply.)

The correct answer is choice D. It is a belief common at this age.

Choice A rationale:

The statement does not suggest a failed attempt to develop a conscience. The scenario described is more related to the cognitive development of an 8-year-old child. Children at this age often have magical thinking and may interpret events, such as illness, as punishments for perceived wrongdoing. This is a normal aspect of their cognitive development rather than a reflection of a failed attempt to develop a conscience.

Choice B rationale:

While beliefs about punishment and consequences are present in many religions, the scenario is not about a general religious belief but rather a specific belief held by the individual child. This belief is reflective of the child's cognitive understanding and not necessarily a religious teaching common to most religions.

Choice C rationale:

The belief is not necessarily suggestive of excessive family pressure. While family dynamics can influence a child's beliefs and behaviors, the scenario describes a typical cognitive developmental stage where children are still learning to differentiate between reality and their own thoughts, leading to magical thinking and unique interpretations.

Choice D rationale:

The belief is indeed common at this age. During middle childhood, children often exhibit concrete operational thinking, which includes a tendency to interpret events in a self-centered and concrete manner. Beliefs like the one described in the scenario, where the child connects her illness to perceived bad behavior and potential consequences, are characteristic of this developmental stage.

The correct answer is choice A. Wearing cotton underpants.

Choice A rationale:

Wearing cotton underpants is the recommended option to prevent urinary tract infections (UTIs) in young girls. Cotton underpants allow better air circulation, which helps to keep the perineal area dry. This reduces the growth of bacteria and prevents moisture buildup, which are crucial in preventing UTIs. Synthetic fabrics can trap moisture and create a conducive environment for bacterial growth, increasing the risk of UTIs.

Choice B rationale:

Limiting bathing as much as possible is not an appropriate recommendation for preventing UTIs. Hygiene is essential to prevent UTIs, and regular bathing is part of maintaining cleanliness. Overly limiting bathing can lead to poor hygiene practices and may not significantly prevent UTIs, as they are often caused by factors beyond bathing frequency.

Choice C rationale:

Increasing fluids and decreasing salt intake can be beneficial for overall health but may not directly prevent UTIs. While staying hydrated is important for maintaining urinary health, simply increasing fluids and reducing salt intake might not be sufficient to prevent UTIs. Hygiene practices and proper perineal care play a more significant role in preventing UTIs.

Choice D rationale:

Cleansing the perineum with water after voiding is a good hygiene practice, but it alone may not be enough to prevent UTIs. While maintaining cleanliness is crucial, using water to cleanse the perineum after voiding should be combined with other practices, such as wearing cotton underpants and proper wiping techniques, to effectively prevent UTIs.