The nurse is taking a health history on an adolescent. Which best describes how the chief complaint should be determined?

The correct answer is choice A: Anaphylactic shock.

Choice A rationale:

Anaphylactic shock is the correct answer. Anaphylactic shock is a severe and potentially life-threatening allergic reaction that causes massive vasodilation, capillary leakage, and bronchoconstriction. It can occur rapidly after exposure to an allergen such as certain foods, insect stings, medications, or latex. The release of histamine and other inflammatory mediators leads to systemic vasodilation and increased permeability of blood vessels, resulting in a sudden drop in blood pressure and compromised organ perfusion.

Choice B rationale:

Cardiogenic shock is characterized by inadequate cardiac output due to severe heart dysfunction. It is typically caused by conditions like myocardial infarction, heart failure, or other cardiac issues. While allergic reactions can potentially affect the cardiovascular system, the symptoms described in the question are more indicative of anaphylactic shock.

Choice C rationale:

Neurogenic shock results from disruption of sympathetic nervous system control over blood vessel tone, often due to spinal cord injury or severe emotional distress. This leads to widespread vasodilation and a sudden drop in blood pressure. While it can cause hemodynamic instability, it doesn't specifically involve the hypersensitivity reaction and capillary leaks associated with anaphylactic shock.

Choice D rationale:

Hypovolemic shock is caused by a significant loss of blood volume or bodily fluids, leading to decreased intravascular volume and subsequent inadequate tissue perfusion. This shock type is not directly related to a hypersensitivity reaction or capillary leakage caused by allergic responses. 2 / 2

The correct answer is Choice D: Refer children with sore throats for throat cultures.

Choice A rationale:

Recommending salicylates instead of acetaminophen for minor discomforts is not relevant to the prevention of rheumatic fever. Rheumatic fever is primarily associated with untreated streptococcal infections, particularly streptococcal pharyngitis (strep throat), which can lead to complications such as rheumatic fever if left untreated. The choice of pain relievers like salicylates or acetaminophen doesn't play a significant role in preventing rheumatic fever.

Choice B rationale:

Encouraging routine cholesterol screenings is not relevant to the prevention of rheumatic fever. Rheumatic fever is an immune-mediated inflammatory response to certain strains of Streptococcus bacteria, particularly Streptococcus pyogenes. Cholesterol screenings are more related to assessing cardiovascular risk and are not directly linked to preventing rheumatic fever.

Choice C rationale:

Conducting routine blood pressure screenings is not directly related to the prevention of rheumatic fever. Blood pressure screenings are important for identifying hypertension and other cardiovascular risk factors, but they do not have a direct impact on preventing rheumatic fever, which is primarily a complication of untreated streptococcal infections.

Choice D rationale:

Refer children with sore throats for throat cultures. This is the correct choice. Rheumatic fever often develops as a result of untreated streptococcal pharyngitis (strep throat). Throat cultures are crucial for diagnosing streptococcal infections and determining the appropriate course of treatment with antibiotics. By identifying and treating streptococcal infections promptly, the risk of developing rheumatic fever can be significantly reduced.