The nurse is admitting a patient with possible rheumatic fever. ...

[Diane]

The nurse is admitting a patient with possible rheumatic fever. Which question on the admission health history will be most pertinent to ask?
 
  a. Do you use any illegal IV drugs?
  b. Have you had a recent sore throat?
  c. Have you injured your chest in the last few weeks?
  d. Do you have a family history of congenital heart disease?

Question 2

The nurse has identified a nursing diagnosis of acute pain related to inflammatory process for a patient with acute pericarditis. The priority intervention by the nurse for this problem is to
 
  a. teach the patient to take deep, slow breaths to control the pain.
  b. force fluids to 3000 mL/day to decrease fever and inflammation.
  c. remind the patient to request opioid pain medication every 4 hours.
  d. place the patient in Fowler's position, leaning forward on the overbed table.

[Dunkey]

Answer to Question 1

ANS: B
Rheumatic fever occurs as a result of an abnormal immune response to a streptococcal infection. Although illicit IV drug use should be discussed with the patient before discharge, it is not a risk factor for rheumatic fever, and would not be as pertinent when admitting the patient. Family history is not a risk factor for rheumatic fever. Chest injury would cause musculoskeletal chest pain rather than rheumatic fever.

Answer to Question 2

ANS: D
Sitting upright and leaning forward frequently will decrease the pain associated with pericarditis. Forcing fluids will not decrease the inflammation or pain. Taking deep breaths will tend to increase pericardial pain. Opioids are not very effective at controlling pain caused by acute inflammatory conditions and are usually ordered PRN. The patient would receive scheduled doses of a nonsteroidal antiinflammatory drug (NSAID).

[Diane]

Gracias!

[LVPMS]

Excellent