A nurse is providing instructions about a 24-hour urine collection to an adolescent client. Which of the following should the nurse include in the teaching?
Discard the first voided specimen.
Void every hour.
Save the final specimen in a separate container.
Cleanse the perineum with a povidone-iodine solution prior to voiding.
The Correct Answer is A
Choice A rationale
The first voided specimen is discarded to ensure that the 24-hour urine collection starts with an empty bladder and accurately reflects the urine produced over the entire period.
Choice B rationale
Voiding every hour is not necessary and may not be practical for a 24-hour urine collection.
Choice C rationale
The final specimen should be included in the same container as the rest of the 24-hour urine collection.
Choice D rationale
Cleansing the perineum with a povidone-iodine solution is not required for a 24-hour urine collection.
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Correct Answer is D
Explanation
Choice A rationale
A digoxin level of 1.2 ng/mL is within the therapeutic range (0.8 to 2 ng/mL) for toddlers receiving digoxin therapy. This level does not require a revision of the plan of care.
Choice B rationale
An apical pulse of 100/min is within the normal range for toddlers. Digoxin therapy requires monitoring of the heart rate, but this pulse rate does not necessitate a change in the plan of care.
Choice C rationale
A potassium level of 4.0 mEq/L is within the normal range (3.4 to 4.7 mEq/L) for toddlers. This electrolyte level does not require a revision of the plan of care.
Choice D rationale
Vomiting is a potential sign of digoxin toxicity. A toddler who has vomited 2 times in the last hour may be experiencing digoxin toxicity, and the plan of care should be revised to address this issue.
Correct Answer is ["A","D","E"]
Explanation
Choice A rationale
Antistreptolysin O (ASO) titer is a blood test used to detect antibodies against streptolysin O, a substance produced by group A Streptococcus bacteria. Elevated ASO titers indicate a recent streptococcal infection, which is a common precursor to rheumatic fever.
Choice B rationale
Partial thromboplastin time (PTT) measures the time it takes for blood to clot and is used to evaluate bleeding disorders. It is not relevant for diagnosing rheumatic fever, which is an inflammatory disease.
Choice C rationale
Blood urea nitrogen (BUN) measures kidney function and is not used to diagnose rheumatic fever. Rheumatic fever is diagnosed based on evidence of a preceding streptococcal infection and clinical criteria.
Choice D rationale
Erythrocyte sedimentation rate (ESR) is a blood test that measures inflammation in the body. Elevated ESR levels are one of the minor criteria for diagnosing rheumatic fever, indicating the presence of inflammation.
Choice E rationale
C-reactive protein (CRP) is another marker of inflammation. Elevated CRP levels are also one of the minor criteria for diagnosing rheumatic fever, reflecting the inflammatory response in the body.