Which therapeutic management should the nurse expect to implement for a child with rheumatic fever?

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: 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.

Correct Answer: D

Rationale: In the context of pediatric cardiovascular disorders nursing, understanding proximal renal tubular acidosis (RTA) is essential. The correct answer, option D, states that non-anion gap metabolic acidosis is common in proximal RTA. This is correct because proximal RTA is characterized by the inability of the proximal tubule to reabsorb bicarbonate, leading to a non-anion gap metabolic acidosis. Option A, stating that growth failure in the first few years of life is a characteristic presentation, is a common feature of proximal RTA due to the acidosis affecting growth and development. Option B, mentioning that urine pH cannot be reduced to < 5.5, is incorrect as in proximal RTA, the urine pH is typically greater than 5.5 due to impaired acidification of urine. Option C, suggesting that proximal RTA is usually a component of Fanconi syndrome, is also incorrect. While Fanconi syndrome involves dysfunction in the proximal renal tubule leading to multiple electrolyte abnormalities, it is not synonymous with proximal RTA, which specifically refers to the inability to reabsorb bicarbonate. Educationally, understanding the differences between various types of renal tubular acidosis is crucial in assessing and managing pediatric patients with cardiovascular disorders. Nurses need to recognize the clinical manifestations of proximal RTA to provide appropriate interventions and support to promote optimal patient outcomes.

Correct Answer: D

Rationale: In this question, the correct answer is D) Henoch-Schönlein purpura. This condition is not associated with antineutrophil cytoplasmic antibody (ANCA). Wegener granulomatosis, Churg-Strauss syndrome, and Microscopic polyangiitis are all immune-mediated diseases that are associated with ANCA. These conditions are characterized by inflammation of blood vessels and can lead to serious complications if not treated promptly. Henoch-Schönlein purpura, on the other hand, is a different condition that primarily affects children and is characterized by a form of blood vessel inflammation known as leukocytoclastic vasculitis. It typically presents with a rash, joint pain, abdominal pain, and kidney involvement, but it is not linked to ANCA. Understanding the associations of specific antibodies with different diseases is crucial in pharmacology and nursing practice, as it helps healthcare professionals make accurate diagnoses and provide appropriate treatment interventions. By knowing which conditions are linked to ANCA, nurses can better care for pediatric patients with cardiovascular disorders and ensure they receive the most effective care.