A nurse is contributing to the plan of care of a 14-month-old toddler who is 24 h postoperative following a cleft palate repair. Which of the following interventions should the nurse include in the plan?

A. "Your child's diet should be high in carbohydrates & proteins with no restriction of fats."

This statement is not entirely accurate. While it's true that children with cystic fibrosis often require a diet that is higher in calories and protein to support growth and weight gain, there is typically a need to restrict fat intake. Pancreatic insufficiency, which is common in cystic fibrosis, can lead to malabsorption of fats and fat-soluble vitamins. Therefore, a dietitian may recommend enzyme replacement therapy and a diet that is moderate in fat but high in calories and protein.

B. "Limit your child's intake of sodium to avoid complications."

This statement is not accurate. Cystic fibrosis can lead to excessive loss of salt in sweat, which can contribute to dehydration and electrolyte imbalances. Therefore, limiting sodium intake can cause electrolyte disturbances.

C. "A pigeon-shaped chest might become evident as the disease progresses."

This statement is accurate. Cystic fibrosis can cause chronic lung infections and inflammation, leading to structural changes in the chest over time. One common manifestation is a barrel-shaped or "pigeon-shaped" chest, which can occur as the disease progresses. This may result from hyperinflation of the lungs due to air trapping and chronic respiratory compromise.

D. "Administer a bronchodilator to the child after chest percussion therapy."

This statement is not necessarily accurate or applicable to all cases. Bronchodilators are medications used to help relax and open the airways in conditions such as asthma or chronic obstructive pulmonary disease (COPD). While bronchodilators may be part of the treatment regimen for some individuals with cystic fibrosis, their use after chest percussion therapy would depend on the individual's specific respiratory symptoms and treatment plan. It's important for the parents to follow the healthcare provider's instructions regarding medication administration.

A. "When I use this technique the medication will not run out of the ear."

This explanation is not entirely accurate. While pulling the auricle down and back may help prevent ear drops from immediately dripping out of the ear, the primary purpose of this technique is to straighten the ear canal, facilitating the passage of the medication into the inner ear region for optimal effectiveness. The prevention of medication runoff is a secondary benefit.

B. “This opens the ear canal, allowing medication to reach the inner ear region.”

This explanation is correct. Pulling the auricle down and back helps to straighten the ear canal, making it easier for the ear drops to enter the ear canal and reach the inner ear where they can effectively treat the condition. This is the main purpose of using this technique.

C. “This is the safest and easiest way to administer this medication.”

While pulling the auricle down and back is a commonly used technique for administering ear drops, describing it as the safest and easiest way may not fully capture its purpose. Safety and ease of administration are important considerations, but the primary rationale for this technique is to facilitate the delivery of medication to the inner ear.

D. “When I use the technique, your child experiences less pain.”

This explanation is inaccurate. Pulling the auricle down and back may not directly reduce pain. The main purpose of this technique is to ensure that the medication reaches the inner ear region for effective treatment. While discomfort during administration may be minimized with proper technique, the primary focus is on medication delivery rather than pain reduction.