A nurse is applying soft limb restraints to a child who is acting aggressively toward staff. Which of the following actions should the nurse take?

Condition Most Likely Experiencing

• Pyloric stenosis causes projectile vomiting, dehydration, and hunger.
• Cystic fibrosis causes chronic respiratory infections, steatorrhea, and failure to thrive.
• The condition that the infant is most likely experiencing is congestive heart failure, which can cause poor weight gain, tachypnea, decreased appetite, and periorbital edema.
• Respiratory syncytial virus bronchiolitis causes wheezing, coughing, and respiratory distress.

Actions to Take

• Digoxin is a medication commonly prescribed to manage congestive heart failure in infants by improving cardiac contractility and reducing heart rate.
• Elevating the head of the bed helps reduce venous return to the heart, thereby decreasing preload and relieving symptoms of congestion in congestive heart failure.
• Contact precautions are not indicated for congestive heart failure, but for infections that are transmitted by direct or indirect contact.
• Chest physiotherapy and postural drainage are not indicated for congestive heart failure, but for conditions that cause excessive mucus production and retention.

Parameters to Monitor

• Number of steatorrhea stools is not relevant for congestive heart failure, but for cystic fibrosis or other malabsorption disorders.
• Monitoring intake and output is crucial in assessing fluid balance, especially in congestive heart failure where fluid retention can lead to volume overload.
• Monitoring respiratory status is essential in congestive heart failure to assess for signs of pulmonary congestion and respiratory distress, such as tachypnea, retractions, and crackles.
• Presence of periorbital edema is not a parameter to monitor, but a sign of fluid overload.

A. Meperidine is a narcotic analgesic used for pain relief and is not typically indicated for the management of cystic fibrosis.
B. Dornase alfa is a medication commonly used in the management of cystic fibrosis to help improve respiratory function by reducing the viscosity of mucus in the airways.
C. While acetaminophen may be used for managing fever or pain in children with cystic fibrosis, it is not specifically indicated as a standard medication for cystic fibrosis management.
D. Children with cystic fibrosis often have deficiencies in fat-soluble vitamins (A, D, E, and K) due to malabsorption. Fat-soluble forms of these vitamins are typically prescribed to address these deficiencies.

E. Pancreatic enzyme replacement therapy, such as pancreatic lipase, is necessary for children with cystic fibrosis who have pancreatic insufficiency. This medication helps improve digestion and absorption of nutrients by replacing the deficient pancreatic enzymes.