Which action by the school nurse is important in the prevention of rheumatic fever?

The correct answer is choice A, E.

Choice A rationale:

Using an air conditioner is an effective way to reduce exposure to pollens and dust. Air conditioners filter the air and help prevent outdoor allergens from entering the indoor environment. This choice is correct because it addresses one of the primary sources of exposure to allergens.

Choice B rationale:

Keeping humidity in the house above 60% is not a recommended approach. High humidity can promote the growth of mold and dust mites, which can exacerbate allergies. Maintaining humidity levels between 30-50% is generally recommended for reducing allergen exposure.

Choice C rationale:

Keeping pets outside might seem like a logical option to reduce allergen exposure; however, pet allergens can still be carried indoors on clothing and shoes. Moreover, if individuals are not allergic to pet dander, keeping the pets inside may not pose an issue.

Choice D rationale:

Replacing wall-to-wall carpeting with wood and tile floors is a good strategy for reducing allergen exposure. Carpets can trap dust, pollen, and other allergens, while hard surfaces are easier to clean and do not accumulate allergens as readily. This choice is correct because it addresses a common source of indoor allergens.

Choice E rationale:

Putting dust-proof covers on pillows and mattresses is another effective strategy for reducing allergen exposure. These covers create a barrier that prevents dust mites and their allergens from permeating the sleeping environment. This choice is correct because it directly addresses the issue of dust mite allergens.

The correct answer is choice B. Reduce gastric acid production.

Choice A rationale:

Preventing reflux is not the primary purpose of prescribing a histamine receptor antagonist. Histamine receptor antagonists work by reducing gastric acid production, which in turn can help alleviate symptoms of gastroesophageal reflux disease (GERD). They do not directly prevent the physical reflux of stomach contents into the esophagus.

Choice B rationale:

The primary purpose of prescribing a histamine receptor antagonist for an infant diagnosed with gastroesophageal reflux is to reduce gastric acid production. Histamine stimulates acid secretion in the stomach, and these medications (e.g., ranitidine, famotidine) block histamine receptors on stomach cells, leading to decreased acid secretion. This helps reduce the acidity of stomach contents that could contribute to esophageal irritation in GERD.

Choice C rationale:

Preventing hematemesis (vomiting blood) is not a primary action of histamine receptor antagonists. While reducing gastric acid production might indirectly help prevent complications such as bleeding due to irritation and inflammation of the esophagus, it's not the main purpose of these medications.

Choice D rationale:

Increasing gastric acid production is the opposite of the intended effect of histamine receptor antagonists. These medications are specifically used to decrease gastric acid production and provide relief from conditions where excess acid is causing problems, such as GERD.