The nurse is examining a child. The child's pharynx is reddened, with yellow exudate noted on each tonsil. The tongue is red with enlarged taste buds. Petechiae are visualized on the child's soft palate near the uvula

Which of the following physician orders is most important and appropriate for this child? 1. Saline mouth rinses
2. Throat culture
3. Dental referral
4. Aspirin for pain


2
Rationale 1: Saline mouth rinses may help with the client's discomfort but is not the most important intervention. This child needs to be started on the appropriate antibiotic if the child has strep throat.
Rationale 2: Strep throat infection, caused by group A beta-hemolytic Streptococcus pyogenes, may cause yellow tonsillar exudates, erythematous and edematous pharynx, red tongue with prominent taste buds (strawberry tongue), and petechial hemorrhages on the soft palate near the uvula.
Rationale 3: A dental referral is inappropriate. This child needs to be started on the appropriate antibiotic if the child has strep throat.
Rationale 4: Aspirin for pain is inappropriate because it can result in Reye's syndrome when taken by children.

Nursing

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