A nurse is caring for a preschooler who is postoperative following a tonsillectomy. The child is now ready to resume oral intake.
Which of the following dietary choices should the nurse offer the child?
Lime-flavored ice pop.
Sugar-free cherry gelatin.
Vanilla ice cream.
Chocolate milk.
The Correct Answer is A
The correct answer is Choice A.
Choice A rationale: Lime-flavored ice pops are cold and soothing, which helps reduce throat pain and swelling post-tonsillectomy. They also provide hydration and are less likely to irritate the surgical site compared to dairy products.
Choice B rationale: Sugar-free cherry gelatin, while hydrating and easy to swallow, may not be recommended immediately post-tonsillectomy. The red dye can be confused with blood if the child vomits, making it harder to assess post-surgical complications.
Choice C rationale: Vanilla ice cream contains dairy, which can increase mucus production and cause throat irritation, potentially making it uncomfortable for a child post-tonsillectomy. It's better to avoid dairy products initially to prevent such issues.
Choice D rationale: Chocolate milk, like vanilla ice cream, contains dairy that can increase mucus production. Additionally, the chocolate can be irritating to a healing throat. Cold, clear, non-dairy fluids are preferable initially post-tonsillectomy for comfort and safety.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
A blood pressure of 95/56 mm Hg is within the normal range for a 5-year-old child. While assessing vital signs, the nurse should consider the patient's age-specific parameters. In this case, the blood pressure is not indicative of hemorrhage.
Choice B rationale:
Flushing of the face might be a common postoperative finding and is not necessarily indicative of hemorrhage. It can be caused by various factors such as anesthesia or emotional states. Flushing alone is not a reliable sign of hemorrhage and should be assessed in conjunction with other symptoms.
Choice C rationale:
Continuous swallowing, especially with an increased heart rate and signs of restlessness, can be indicative of hemorrhage after a tonsillectomy and adenoidectomy. Frequent swallowing suggests the presence of blood in the mouth or throat, indicating possible bleeding at the surgical site. This finding requires immediate attention and intervention by the nurse.
Choice D rationale:
A heart rate of 54/min is below the normal range for a 5-year-old child, which typically ranges from 70 to 120 beats per minute. While bradycardia can be a concern, the more specific and immediate indication of hemorrhage in this case is continuous swallowing, which signals active bleeding from the surgical site.
Correct Answer is D
Explanation
Choice A rationale:
Inserting an IV catheter is essential for administering medications and fluids but is not the immediate priority in this scenario. The toddler's airway and breathing are compromised, making airway management the top priority.
Choice B rationale:
Administering an antibiotic is necessary for treating a potential infection, but securing the airway takes precedence when a child is experiencing severe dyspnea and drooling. The toddler's ability to breathe effectively needs to be addressed urgently.
Choice C rationale:
Obtaining a blood culture is important for identifying the source of infection but does not address the toddler's immediate breathing difficulty. Securing the airway is the primary concern in this situation.
Choice D rationale:
Hyperpyrexia (extremely high fever) along with severe dyspnea and drooling suggests a potentially life-threatening condition like epiglottitis, which requires immediate intervention. Nasotracheal intubation ensures a patent airway, allowing the child to breathe adequately. Once the airway is secure, further assessments and treatments can be administered.
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