The nurse is caring for a newborn infant with a cleft lip and palate.
Which of the following is the FIRST priority nursing goal when caring for this infant?
Positioning to prevent fluid accumulation in the middle ear which will result in infection.
Facilitating immediate repair of the cleft palate to ease the feeding difficulties.
Assisting the mother to bond with the baby by providing emotional support.
Establishing adequate feeding and sucking to promote growth and development.
The Correct Answer is D
Choice A rationale
While positioning to prevent fluid accumulation in the middle ear is important in the care of a newborn with a cleft lip and palate, it is not the first priority. Middle ear infections are common in children with cleft palate because the muscles that open the eustachian tubes (which drain fluid from the middle ear) may not work well. However, this is typically addressed after feeding issues are managed.
Choice B rationale
Facilitating immediate repair of the cleft palate to ease feeding difficulties is important, but it is not the first priority. Surgery to repair cleft palate is usually done when the child is older,
between 6 and 12 months of age. The timing of surgery depends on the child’s overall health and the type and severity of the cleft.
Choice C rationale
Assisting the mother to bond with the baby by providing emotional support is an important aspect of care. However, it is not the first priority. The initial focus is on addressing the baby’s immediate physical needs, such as feeding and breathing.
Choice D rationale
Establishing adequate feeding and sucking is the first priority when caring for a newborn with a cleft lip and palate. Babies with a cleft palate may have difficulty creating enough suction to breastfeed or bottle-feed effectively. Special feeding techniques and equipment may be needed to help these babies get enough nutrition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A rationale
Adding a school breakfast program is a crucial step in promoting health and wellness in schools. It ensures that all students, regardless of their socioeconomic status, start their day with a nutritious meal. This can improve their concentration, cognitive function, and academic performance.
Choice B rationale
Reducing saturated fat in the school lunch offering is another important measure. High intake of saturated fats is associated with increased risk of heart disease and obesity. By offering meals low in saturated fats, schools can help instill healthy eating habits in students.
Choice C rationale
Calorically sweetened beverages are not recommended for inclusion in school health and wellness programs. These beverages are high in sugar and can contribute to obesity, tooth decay, and other health problems.
Choice D rationale
Making fruits or vegetables available with all meals is a key part of a balanced diet. They provide essential vitamins, minerals, and dietary fiber, and their consumption can help prevent chronic diseases.
Choice E rationale
Offering after-school physical fitness activities can help students meet the recommended levels of physical activity, improve their physical fitness, and reduce the risk of obesity. These activities also provide opportunities for social interaction and skill development.
Correct Answer is A
Explanation
Choice A rationale
After a laparoscopically assisted endorectal pull-through procedure for Hirschsprung’s disease, it is important to monitor for the return of bowel sounds. This indicates that the gastrointestinal tract is starting to recover and function again after surgery. Until bowel
sounds return, indicating that peristalsis has resumed, the child should remain NPO (nothing by mouth) to prevent vomiting and aspiration.
Choice B rationale
Applying barrier cream to the diaper area is generally good practice for infants to prevent diaper rash, but it is not specifically related to the care of a child who has just undergone surgery for Hirschsprung’s disease.
Choice C rationale
While it is important to assess the surgical site regularly to check for signs of infection or complications, this does not need to be done every 2 hours. A more typical frequency might be every 4 to 8 hours, depending on the child’s condition and hospital policy.
Choice D rationale
Monitoring rectal temperature every 8 hours is not specifically related to the care of a child who has just undergone surgery for Hirschsprung’s disease. While it is important to monitor for fever as a sign of infection, temperature can usually be measured less invasively.
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