The nurse reviews the physician's prescriptions for a child with ...

[audragclark]

The nurse reviews the physician's prescriptions for a child with a streptococcal infection. The physician prescribes an antistreptolysin O titer. Based on this prescription, which of the following would the nurse suspect in the child?
 
  1. Rheumatic fever (RF)
  2. Aortic valve disease (AVD)
  3. Pulmonic valve disease (PVD)
  4. Congestive heart failure (CHF)

Question 2

A hospitalized client with a history of alcohol abuse tells the nurse, I am leaving now. I don't want help. I have other things to attend to that are more important.
 
   The nurse attempts to dis-cuss the client's concerns, but the client dresses and begins to walk out of the hospital room. The nurse should take which of the following actions at this time? 1. Call the nursing supervisor.
  2. Restrain the client, and call the physician.
  3. Call security to block the exits to the nursing unit.
  4. Tell the client that readmission is not possible after leaving against medical advice (AMA).

[KKcool]

Answer to Question 1

1

Rationale: A diagnosis of RF is confirmed by the presence of two major manifestations or one major and two minor manifestations from the Jones criteria. Additionally, evidence of a recent streptococcal infection is confirmed by positive antistreptolysin O titer, Streptozyme slide tests, or anti-DNase B assays. An antistreptolysin O titer is not a specific laboratory test for the condi-tions identified in aortic valve disease (AVD), pulmonic valve disease (PVD), and conges-tive heart failure (CHF).

Answer to Question 2

1

Rationale: The nurse should call the nursing supervisor. When clients leave against medical ad-vice (AMA), most health care facilities have documents relating to the client's responsibilities, which the client is asked to sign before leaving. The nurse should request that the client speak to the physician before leaving, but if the client refuses, the nurse cannot hold the client against his or her will. Any client has a right to health care and cannot be told otherwise (tell the client that readmission is not possible after leaving against medical advice (AMA)). A nurse can be charged with false imprisonment if a client is made to wrongfully believe that he or she cannot leave the hospital (restrain the client, and call the physician and call security to block the exits to the nursing unit).

[audragclark]

TYSM

[FergA]

Gracias!