A nurse is communicating with a child who has hearing loss. Which of the following actions should the nurse take?

Postoperative care following a tonsillectomy focuses on monitoring for complications such as hemorrhage, airway obstruction, and dehydration. Because the surgical site is highly vascular, bleeding is the most serious early complication. Children may swallow blood instead of spitting it out, making subtle signs of hemorrhage especially important to detect. Nurses must closely observe for early indicators of bleeding and airway compromise to ensure prompt intervention.

Rationale:
A. Continuous swallowing is a key early sign of postoperative hemorrhage after tonsillectomy. Blood from the surgical site may trickle into the throat and be swallowed repeatedly, especially in children who cannot verbalize symptoms effectively. This behavior often precedes visible bleeding and requires immediate assessment and intervention.

B. Inflamed throat is an expected postoperative finding following tonsillectomy due to surgical tissue trauma. Mild to moderate throat inflammation, pain, and redness are normal during the healing process. This finding alone does not indicate a complication unless it is accompanied by signs of infection or bleeding.

C. Impaired taste is not a common or clinically significant complication following tonsillectomy. Temporary taste changes may occur due to swelling or discomfort, but they are not considered a warning sign of postoperative complications. This symptom is usually transient and resolves with healing.

D. Dark blood in emesis may indicate partially digested blood but is not as reliable or early a sign of hemorrhage as continuous swallowing. It can suggest bleeding, but it often appears after blood has accumulated in the stomach. Early detection is more effectively achieved by observing swallowing patterns and throat assessment rather than waiting for emesis.

Heart failure in infants occurs when the heart is unable to pump effectively to meet the body’s metabolic demands, often due to congenital heart defects or cardiomyopathy. These infants tire easily, especially during feeding and activity, because of increased oxygen consumption and cardiac workload. Nursing care focuses on conserving energy, reducing stress, and supporting adequate nutrition and oxygenation. Teaching caregivers how to minimize cardiac demand is essential for preventing worsening symptoms.

Rationale:
A. Minimizing the infant’s environmental stimuli is important because excessive crying, noise, or activity increases oxygen demand and cardiac workload. Infants with heart failure have limited cardiac reserve and can quickly become fatigued or develop respiratory distress. A calm, quiet environment helps conserve energy and reduces stress on the heart.

B. Placing the infant in a supine position is not ideal because it can worsen breathing difficulty by increasing venous return and reducing lung expansion. Infants with heart failure often breathe more comfortably in a semi-upright or elevated position, which decreases work of breathing and improves oxygenation. Supine positioning may increase respiratory distress.

C. Bathing the infant every day may be too tiring for an infant with heart failure, especially if prolonged handling causes fatigue. Care should focus on clustering activities and conserving energy rather than creating unnecessary exertion. Hygiene is important, but bathing should be planned to avoid excessive stress and exhaustion.

D. Allowing the infant to sleep through night feedings is inappropriate because infants with heart failure often require frequent, smaller feedings to meet nutritional needs without causing fatigue. Skipping nighttime feedings may result in inadequate caloric intake and poor weight gain. Consistent nutritional support is essential for growth and cardiac stability.