A nurse is reinforcing discharge instructions with a parent of a child who has cystic fibrosis. Which of the following statements by the parent indicates an understanding of the teaching?

A. Flaccid paralysis of lower extremities:

Flaccid paralysis refers to a weakness or loss of muscle tone in the affected muscles, leading to decreased or absent movement. This finding is not typically associated with spina bifida occulta. Instead, it is more commonly seen in more severe forms of spina bifida, such as myelomeningocele, where there is significant involvement of the spinal cord and nerves.

B. Hip dislocation:

Hip dislocation can occur in individuals with myelomeningocele due to muscle weakness, abnormal muscle tone, and joint deformities associated with spinal cord defects. However, it is not typically associated with spina bifida occulta, which usually presents with less severe spinal cord involvement.

C. Hydrocephalus:

Hydrocephalus, characterized by the accumulation of cerebrospinal fluid within the brain, is a common complication of myelomeningocele due to disturbances in the flow and absorption of cerebrospinal fluid caused by the spinal defect. It is less commonly associated with spina bifida occulta, which typically involves a less severe spinal cord defect.

D. Dimple in sacral area:

This is the correct choice. A dimple, patch of hair, or birthmark in the lower back or sacral area is a common finding in spina bifida occulta. It occurs due to the incomplete closure of the spinal column during fetal development, leading to a small defect in the vertebrae. This is often a subtle manifestation of spina bifida occulta and may not cause significant symptoms or functional impairment.

A. "I will restrict the amount of salt in my child's meals."

Restricting salt intake is not typically recommended for children with cystic fibrosis (CF). In fact, individuals with CF often have increased salt requirements due to excessive salt loss through sweat. Restricting salt intake could potentially lead to electrolyte imbalances. Therefore, this statement does not demonstrate an understanding of the dietary management necessary for CF.

B. "I will put my child in daycare to ensure that she socializes with other children."

While socialization is important for a child's development, placing a child with CF in daycare may increase their risk of exposure to respiratory infections, which can be particularly dangerous for individuals with CF due to their compromised respiratory function. Therefore, this statement does not demonstrate an understanding of the infection control measures necessary for managing CF.

C. "I will make sure my child washes her hands before eating.”

This statement demonstrates an understanding of infection control measures, which are crucial for individuals with CF to reduce the risk of respiratory infections. Washing hands before eating helps prevent the transmission of bacteria and viruses that can cause respiratory infections. Therefore, this statement indicates an understanding of an important aspect of managing CF.

D. “I will provide low-fat meals for my child."

Providing low-fat meals is not typically recommended for children with CF. CF often leads to malabsorption of fats, so a diet high in calories and fat is typically recommended to ensure adequate nutrition and weight gain. Therefore, this statement does not demonstrate an understanding of the dietary recommendations necessary for managing CF.