A 5-year-old has enlarged tonsils and has history of four throat infections in the previous year with fever, cervical lymphadenopathy, and positive Group A Streptococcus pyogenes (GABHS) cultures. The parent reports that the child snores at night and expresses concerns about the child's quality of sleep. The next step in managing this child's condition is to:

refer to a pulmonologist for polysomnography evaluation

Explanation:

Based on the information provided within the question it can be said that the next step in managing this child's condition is to refer to a pulmonologist for polysomnography evaluation. This is because the child has a high potential for having sleep apnea since the parents are reporting that the child snores and has frequent throat infections and he does not have a high enough number of GABHS throat infections to warrant tonsillectomy.

c

explanation:

4.) metal

"-the movement of carbon from the nonliving environment into living things and back to the environment

-carbon is the essential component of proteins, fats, and carbohydrates (which make up all organisms)

-carbon exists in air, water, and living organisms

-producers convert carbon dioxide in the atmosphere into carbohydrates during photosynthesis

-bacteria in the atmosphere cycles through the system in filtration units

-in cellular respiration, carbon is released back into the atmosphere as carbon dioxide

-some carbon is stored in limestone (forming one of the largest "carbon sinks" on earth)

-largest carbon reservoir on earth= limestone

-carbon stored in the bodies of organisms as fat, oils, or other molecules may be released into the soil or air when the organism dies

-this may form deposits of coal, oil, or natural gas (fossil fuels, which increased the atmospheric carbon dioxide)

-fossil fuels store carbon left over from bodies of organisms that died millions of years ago

-they are located in the surface of earth, deep within the earth and beneath the ocean floor."