A nurse is providing discharge teaching to the parents of a 6-month-old infant following a surgical procedure to repair a hypospadias. Which of the following instructions should the nurse include in the teaching?

"Apply a dry gauze dressing twice per day."

"Perform hourly measurements of the infant's urinary output."

"Offer the infant 12 to 18 ounces of fruit juice daily."

"Avoid giving the infant a tub bath until the stent is removed."

Answer and Explanation

The Correct Answer is D

A. "Apply a dry gauze dressing twice per day."

This instruction may not be necessary for a hypospadias repair procedure. Typically, the surgical site will have a dressing applied immediately after the surgery, but ongoing dressing changes may not be required once the infant is discharged. It's essential to follow the specific postoperative care plan provided by the healthcare provider.

B. "Perform hourly measurements of the infant's urinary output."

Hourly measurements of urinary output may not be necessary unless specifically instructed by the healthcare provider due to concerns such as urinary retention or dehydration. However, regular monitoring of urinary output as part of routine care may be appropriate.

C. "Offer the infant 12 to 18 ounces of fruit juice daily."

Offering 12 to 18 ounces of fruit juice daily to a 6-month-old infant is not recommended. Introduction of fruit juice should be gradual and in small amounts, following guidance from healthcare providers and infant nutrition guidelines. Excessive fruit juice consumption can lead to gastrointestinal issues and may not be suitable for all infants.

D. "Avoid giving the infant a tub bath until the stent is removed."

This instruction is appropriate. After hypospadias repair surgery, a stent or catheter may be placed to aid in healing and ensure proper urine drainage. It's essential to follow healthcare provider instructions regarding bathing and hygiene to minimize the risk of infection and to ensure the stent remains in place until it is ready to be removed.

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Correct Answer is D

Explanation

A. Depressed scalp veins: This is an incorrect choice. In hydrocephalus, there is increased pressure within the skull due to the accumulation of cerebrospinal fluid (CSF). This increased pressure typically leads to distended scalp veins rather than depressed ones.

B. Sunken anterior fontanels: This is an incorrect choice. The fontanel, also known as the soft spot on an infant's head, may actually bulge rather than appear sunken in cases of hydrocephalus due to increased intracranial pressure.

C.Bulging eyes:In individuals with hydrocephalus, especially infants and young children, bulging eyes can sometimes occur.The increased pressure inside the skull can affect various structures within the brain, including the optic nerve and the muscles that control eye movement. This can lead to a condition called papilledema, where the optic nerve becomes swollen due to the pressure. Papilledema can cause changes in vision and, in some cases, contribute to the appearance of bulging eyes.

D.Separated cranial sutures:The separation of cranial sutures in hydrocephalus occurs due to the increased pressure from the excess CSF. This pressure can cause the bones of the skull to move apart, leading to visible gaps or widening of the sutures. Clinically, this can be observed through imaging studies such as CT scans or MRI.

A. "You should give your child aspirin if they report pain at the site." B. "You can remove the pressure dressing 8 hours after the procedure." C. "Your child can soak in the bathtub 24 hours after the procedure." D. "Your child should avoid strenuous physical activities for several days."

Correct Answer is D

Explanation

A. "You should give your child aspirin if they report pain at the site."

This statement is incorrect. Aspirin is a blood-thinning medication that can increase the risk of bleeding, which is particularly concerning after a cardiac catheterization procedure. It is not recommended to administer aspirin unless specifically instructed by the healthcare provider.

B. "You can remove the pressure dressing 8 hours after the procedure."

This statement is incorrect. The pressure dressing applied after a cardiac catheterization procedure is typically left in place for a specific period of time, as determined by the healthcare provider. The dressing helps prevent bleeding at the insertion site. It is essential to follow the healthcare provider's instructions regarding the timing of dressing removal.

C. "Your child can soak in the bathtub 24 hours after the procedure."

This statement is incorrect. Immersing the insertion site in water, such as soaking in a bathtub, should be avoided for a certain period after a cardiac catheterization procedure to reduce the risk of infection. The healthcare provider will provide specific instructions on when it is safe for the child to bathe or shower.

D. "Your child should avoid strenuous physical activities for several days."

This statement is correct. After a cardiac catheterization procedure, it is typically recommended to avoid strenuous physical activities for a specified period to allow the insertion site to heal properly and reduce the risk of complications such as bleeding or hematoma formation.

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