A client is transferred to the pediatric unit after repair of a cleft lip. The child has a Logan bow in place over the suture line and has elbow restraints applied to both arms. Which nursing intervention should take priority in her postoperative care plan?

Encourage attachment.

Minimize crying.

Restrict oral intake.

Initiate range of motion.

Answer and Explanation

The Correct Answer is B

Minimize crying.

Choice A rationale:

Encouraging attachment might be important for the child's emotional well-being, but in the immediate postoperative period after cleft lip repair, minimizing crying takes priority. Crying can place stress on the suture line and disrupt the healing process.

Choice B rationale:

Minimizing crying is crucial to prevent tension on the suture line and ensure proper healing of the cleft lip repair. Excessive crying can lead to increased pressure on the surgical site and potential complications. Elbow restraints are applied to prevent the child from touching the surgical site, so minimizing crying helps to maintain the effectiveness of these restraints.

Choice C rationale:

Restricting oral intake is not a priority in this case. While it's important to ensure the child doesn't consume anything that might harm the surgical site, it's not the highest priority action compared to preventing tension on the suture line.

Choice D rationale:

Initiating range of motion is not the priority postoperative intervention for a cleft lip repair. The primary concern at this stage is to prevent disruption of the surgical site and ensure proper healing, making minimizing crying a higher priority.

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Correct Answer is D

Explanation

Choice A rationale:

Painful joints are not a common side effect of prednisone. Prednisone can cause musculoskeletal issues, but painful joints are not a prominent manifestation.

Choice B rationale:

A decrease in appetite is a possible side effect of prednisone. However, it's not the focus of this question, as other choices are more relevant.

Choice C rationale:

A yellow tinge to the whites of the eyes (jaundice) is not a commonly associated side effect of prednisone. Jaundice is usually linked to liver dysfunction or other conditions affecting bilirubin metabolism.

Choice D rationale:

A round face, often referred to as "moon face,”. is a well-recognized side effect of prednisone. It occurs due to fluid retention and fat redistribution, leading to a characteristic facial appearance.

A. The mother places the infant on her left side with a pillow supporting her back after feeding. B. The mother covers the cast with a towel to prevent accidental soiling. C. The mother uses the football hold to position the infant securely to one side. D. The mother supports both the infant's head and cast when leaning her forward for burping.

Correct Answer is C

Explanation

Choice A rationale:

Placing the infant on her left side with a pillow supporting her back after feeding is appropriate as it prevents aspiration and reflux due to gravity.

Choice B rationale:

Covering the cast with a towel to prevent accidental soiling is a sensible action, ensuring the cast remains clean and dry.

Choice C rationale:

The mother using the football hold to position the infant securely to one side might hinder the cast's stability and could potentially cause discomfort or displacement.

Choice D rationale:

Supporting both the infant's head and cast when leaning her forward for burping is essential to maintain the cast's integrity and to prevent strain on the infant's body.

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A client is transferred to the pediatric unit after repair of a cleft lip. The child has a Logan bow in place over the suture line and has elbow restraints applied to both arms. Which nursing intervention should take priority in her postoperative care plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is teaching a parent about the side effects of prednisone. Which statement should be included in the information?

Correct Answer is D

Explanation

A 6-month-old patient with a plaster spica cast is being breastfed by her mother. Which action by the mother should the nurse question?

Correct Answer is C

Explanation

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