The nurse, caring for an infant whose cleft lip was repaired, should include which interventions in the infant's postoperative plan of care? (Select all that apply.).

The correct answer is choice A: Avoiding use for more than 3 days.

Choice A rationale:

Recommending avoiding the use of decongestant nose drops for more than 3 days is crucial due to the risk of rebound congestion. Decongestant nose drops work by constricting blood vessels in the nasal passages to alleviate congestion. Prolonged use can lead to a phenomenon known as rebound congestion, where the nasal passages become more congested once the medication wears off, causing the person to use the drops more frequently. This can result in a cycle of worsening congestion and overuse of the medication, which can be counterproductive and harmful. Limiting the use of decongestant nose drops to 3 days helps prevent this rebound effect and encourages the use of alternative treatments if congestion persists.

Choice B rationale:

Administering drops until nasal congestion subsides is not the recommended approach. Prolonged use of decongestant nose drops can lead to rebound congestion, as mentioned earlier. Using the drops until congestion subsides might extend their use beyond the safe period and increase the risk of adverse effects.

Choice C rationale:

Keeping drops to use again for nasal congestion is not advised. While it's important to follow the medication's storage instructions, relying on decongestant nose drops for recurring nasal congestion can lead to overuse and rebound congestion. This choice does not address the potential risks associated with prolonged use.

Choice D rationale:

Administering drops after feedings and at bedtime is not a standard recommendation for decongestant nose drops. The timing of administration is not a primary concern in the context of decongestant use. Instead, the focus should be on the duration of use and the potential for rebound congestion.

Choice A rationale:

Calcium carbonate is often given with meals to individuals with chronic renal disease, especially those on dialysis. One of the primary purposes is to bind dietary phosphorus in the gastrointestinal tract. In chronic renal disease, the kidneys are less effective at filtering out excess phosphorus from the blood, leading to elevated phosphorus levels (hyperphosphatemia). Elevated phosphorus levels can contribute to bone and mineral disorders in these patients. Calcium carbonate forms insoluble calcium phosphate complexes with dietary phosphorus, preventing its absorption and facilitating its elimination from the body through the feces.

Choice B rationale:

While calcium carbonate can interact with fat-soluble vitamins like vitamin D, the primary reason for administering it to individuals with chronic renal disease is to manage phosphorus levels. Calcium carbonate can bind phosphorus and prevent its absorption, which is particularly important for patients with compromised kidney function.

Choice C rationale:

Stimulating appetite is not a primary purpose of administering calcium carbonate to children with chronic renal disease. The main focus is on managing phosphorus levels and preventing complications associated with hyperphosphatemia.

Choice D rationale:

Preventing vomiting is not a primary purpose of giving calcium carbonate to children with chronic renal disease. Calcium carbonate is typically used to manage phosphorus levels and complications related to hyperphosphatemia in this population.