Which should the nurse consider when preparing a school-age child and the family for heart surgery?

Correct Answer: B

Rationale: The child and family should be exposed to the sights and sounds of the intensive care unit (ICU). All positive, nonfrightening aspects of the environment are emphasized. The child should be shown unfamiliar equipment and its use demonstrated on a doll. Carefully prepare the child for the postoperative experience, including intravenous (IV) lines, incision, and endotracheal tube.

Correct Answer: A

Rationale: The goal of medical management is the eradication of the hemolytic streptococci. Penicillin is the drug of choice. Salicylates can be used to control the inflammatory process, especially in the joints, and reduce the fever and discomfort. Bed rest is recommended for the acute febrile stage, but it does not need to be strict. The chorea is transient and will resolve without treatment.

Correct Answer: B

Rationale: Blood loss is the most frequent cause of hypovolemic shock in children. Sepsis causes septic shock, which is overwhelming sepsis and circulating bacterial toxins. Anaphylactic shock results from extreme allergy or hypersensitivity to a foreign substance. Congenital heart disease contributes to hypervolemia, not hypovolemia.

Correct Answer: C

Rationale: In toxic shock syndrome (TSS), which is a rare but serious condition caused by toxins produced by certain bacteria, the clinical manifestation of an erythematous macular rash is included. This rash is typically described as a diffuse, red, flat rash that can resemble a sunburn. The presence of this specific rash is a key diagnostic feature of TSS. Option A) Severe hypertension is not a typical clinical manifestation of toxic shock syndrome. While patients with TSS may experience low blood pressure (hypotension) due to the toxins affecting the cardiovascular system, severe hypertension is not a common finding. Option B) Subnormal temperature, meaning a temperature below normal range, is also not a characteristic feature of toxic shock syndrome. Patients with TSS often present with a high fever rather than a low body temperature. Option D) Papular rash over extremities is not a typical manifestation of toxic shock syndrome. The rash associated with TSS is more diffuse and erythematous rather than papular and localized to the extremities. Educational Context: Understanding the clinical manifestations of toxic shock syndrome is crucial for healthcare providers, especially nurses caring for pediatric patients with cardiovascular disorders. Recognizing the specific rash pattern associated with TSS can aid in early identification and prompt treatment of this potentially life-threatening condition. Nurses play a vital role in monitoring for signs and symptoms of TSS and initiating appropriate interventions to ensure positive patient outcomes.

Correct Answer: B

Rationale: In pediatric pharmacology, understanding the causes of testicular pain in boys is crucial for nurses caring for pediatric patients. In this scenario, the correct answer is B) Torsion of appendix testis. The torsion of appendix testis is the most common cause of testicular pain in boys aged 2-10 years. The appendix testis is a small vestigial remnant of the Müllerian duct, prone to torsion, leading to acute pain. This condition is more prevalent in this age group compared to other causes. Regarding the other options: A) Testicular torsion typically occurs in adolescents and presents with sudden severe pain, swelling, and discoloration of the affected testicle. C) Epididymitis is more common in older boys and adolescents, usually associated with urinary tract infections or sexually transmitted infections. D) Congenital varicocele is uncommon in this age group and is more often seen in adolescents. Educational Context: Understanding the differential diagnosis of testicular pain in pediatric patients is vital for nurses to provide timely and appropriate care. Knowledge of age-specific conditions helps in accurate assessment and prompt referral to healthcare providers for further evaluation and management. Nurses play a key role in recognizing such emergencies and ensuring timely interventions to prevent complications.