Rheumatic fever presents with a red rash over the trunk and extremities, fever, and a sore throat. It is caused by an untreated Streptococcus infection in the previous 2-6 weeks, such as strep throat, and can be confirmed with a positive antistreptolysin O titer.

Nystatin is an anti fungal medication, not effective in treating viral infections such HSV. Antiviral medications such as acyclovir, famciclovir, and valacyclovir would be prescribed to control symptoms and shorten episodes. These drugs are not curative. 

A sickle cell crisis will require interventions to control the client's pain due to widespread tissue ischemia. Oxygen is needed to treat hypoxia and control the amount of red bood cell sickling. Blood transfusions are usually not first line treatment in a crisis. 

The SIRS criteria includes 4 factors. 1.) temperature greater than  or less than  2.) A respiratory rate > 20, or  < , 3.) Heart rate greater than , and 4.) , , or immature neutrophils greater than 10% bands. To meet the SIRS definition must have 2 or more of these findings. 

The terms outbreak and epidemic are very similar, except an outbreak is confined to a smaller place. Both indicate an increase in incidence of disease. An endemic disease is always present in the community in a low level. An example is the common cold. A pandemic is an epidemic that occurs across multiple continents. A sporadic disease disease occurs randomly or in scattered incidence.

Opioid (heroin) overdose is marked by a decreased respiratory drive, shallow breathing, and pin-point pupils. Treatment is with naloxone and reverses overdose quickly. Heroin overdoses can be fatal if untreated because of the respiratory depression.

This patient likely has opioid (heroin) overdose. Common signs of overdose include: altered mental states, decreased respiratory rate and effort, and pin-point pupils. Treatment includes inhalation of naltrexone to remove the opioids off their receptors in the body. Additionally, track marks are a sign that the patient injects heroin.

The first-line treatment for uncomplicated urinary tract infection with Proteus mirabilis is a 3 day course of either oral quinolone or trimethoprim/sulfamethoxazole (TMP/SMZ). 10-21 day courses are only appropriate in patients with complicated UTI or co-infections. Ampicillin and cefalexin are poor choices for initial treatment due to a 10-20% rate of resistance in Proteus species.

While all of the organisms listed are capable of causing UTI's, Staphylococcus species are all Gram-positive. Escherichia coli, while responsible for 75-95% of all UTI's, would not result in a urinary pH of 9.5. The high alkalinity of this patient's urine suggest a urea-splitting bacteria such as Proteus. 

Due to its production of urease, Proteus mirabilis infection results in alkalinization of urine (as urease hydrolyzes urea to produce ammonia). This can cause the formation of calcium, struvite, or apatite crystals in the urine, which may form renal calculi. 

P. mirabilis is not associated with increased risk for infertility, PID, or bladder cancer.