A nurse is caring for a child who is having difficulty breathing due to an asthma exacerbation. Which of the following areas should the nurse determine if the child is experiencing subcostal retractions? (You will find hot spots to select in the artwork below. Select only the hot corresponds to your answer.)

A) Place the client in a supine position for the first 12 hr postoperative: Following surgery for a ruptured appendix, placing the child in a supine position for the first 12 hours can be inappropriate. It may be more beneficial to position the child in a semi-Fowler's position to promote drainage of any remaining infection and reduce the risk of respiratory complications.

B) Pack the open wound with a dry gauze dressing: For a postoperative wound following a ruptured appendix, using a dry gauze dressing might not be the best practice. A moist dressing can promote better healing and reduce the risk of infection. Wet-to-dry or other appropriate dressings are typically recommended based on the surgeon's instructions.

C) Administer naproxen orally for pain 30 min prior to ambulation: While managing pain is important, naproxen is a nonsteroidal anti-inflammatory drug (NSAID) that is typically not the first choice for postoperative pain management in children. Additionally, oral medication might not be recommended immediately post-surgery, especially if the child has an NG tube or other contraindications for oral intake.

D) Maintain an NG tube on low intermittent suction until bowel sounds return: This is a standard postoperative practice for children who have had surgery for a ruptured appendix. The NG tube helps to decompress the stomach, preventing vomiting and aspiration, and helps manage bowel function until normal activity resumes, which is crucial for postoperative recovery.

A) "I should make sure that most of my meals contain fried foods to maintain my calorie count": Fried foods are generally high in fat and can be difficult to digest, particularly for individuals with malabsorption syndrome. They are not recommended as a primary source of calories due to their potential to exacerbate gastrointestinal symptoms.

B) "I should change to a gluten-free diet to rest my bowel": A gluten-free diet is beneficial for individuals with celiac disease, but it is not universally required for all inflammatory bowel diseases. The decision to adopt a gluten-free diet should be based on specific medical advice rather than general guidelines for inflammatory bowel disease.

C) "I should try to limit foods containing lactose to prevent bloating and cramping": Limiting lactose-containing foods is a common recommendation for individuals with malabsorption syndrome, especially if lactose intolerance is present. Lactose can exacerbate bloating and cramping, so managing intake can help alleviate these symptoms.

D) "I should eat a high-fiber diet daily to decrease my episodes of flare-ups": High-fiber diets are not always recommended for individuals with inflammatory bowel disease, as fiber can exacerbate symptoms and contribute to flare-ups. A low-fiber or modified fiber diet may be more appropriate depending on the individual’s symptoms and disease state.