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

Correct Answer: C

Rationale: Referring children with sore throats for throat cultures is important in the prevention of rheumatic fever. Rheumatic fever is a complication of untreated streptococcal throat infections, specifically caused by group A Streptococcus bacteria. By identifying and treating streptococcal infections promptly with antibiotics, the risk of developing rheumatic fever is significantly reduced. The school nurse plays a crucial role in recognizing the symptoms of strep throat and ensuring that affected children are appropriately referred for testing and treatment. This can help prevent the serious consequences of rheumatic fever, which can affect the heart, joints, skin, and brain if left untreated. Encouraging routine cholesterol screenings (choice A) and blood pressure screenings (choice B) are important for overall health monitoring but are not directly related to the prevention of rheumatic fever. Recommending salicylates over acetaminophen (choice D) is not advisable in children due to the risk of Reye's syndrome

Correct Answer: C

Rationale: A rise in temperature is concerning after a medical or surgical procedure as it can indicate infection or other complications. A temperature above 102F is typically considered a significant fever, especially in the postoperative period. It is essential to notify the physician promptly to assess the patient's condition and provide appropriate interventions to address the underlying cause of the fever.

Correct Answer: D

Rationale: Calcium gluconate is administered intravenously in the setting of severe hyperkalemia to antagonize the effects of potassium on the heart. Hyperkalemia can lead to dangerous cardiac arrhythmias due to the changes in membrane potential of cardiac cells caused by increased extracellular potassium levels. Administration of calcium gluconate helps stabilize the cardiac cell membrane potential, protecting against the risk of life-threatening arrhythmias. It doesn't provide an immediate decrease in serum potassium levels (Choice A) or prevent transient renal failure (TRF) (Choice B). Therefore, the correct answer is D, as calcium gluconate primarily acts to counteract the effects of hyperkalemia on the heart.

Correct Answer: A

Rationale: The observation that indicates adequate tissue perfusion to vital organs is a urinary output of 30 ml in an hour. Adequate tissue perfusion is essential to ensure that vital organs receive enough blood and oxygen. Monitoring urinary output is a crucial indicator of perfusion status, as it reflects the perfusion of the kidneys. A urinary output of at least 30 ml/hour or more indicates that the kidneys are receiving sufficient blood flow and are able to produce urine, which helps in removing waste products from the body. In this case, a urinary output of 30 ml in an hour suggests adequate tissue perfusion to vital organs. The other options do not directly reflect tissue perfusion to vital organs and may indicate inadequate perfusion or compromised hemodynamic status.

Correct Answer: A

Rationale: Salt tablets should be considered for mild deficits of serum sodium. Salt tablets contain sodium chloride, which helps increase the sodium levels in the body. In cases of mild deficits of serum sodium, also known as hyponatremia, salt tablets can help replenish the sodium levels and correct the electrolyte imbalance. However, for severe deficits of serum magnesium, potassium, or calcium, other specific electrolyte replacement therapies are usually preferred over salt tablets. It is important to consult a healthcare professional for proper diagnosis and treatment of electrolyte imbalances.