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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A rationale

These therapies will decrease our child’s resistance to respiratory infections. This statement is incorrect. The therapies mentioned - chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine - do not directly decrease a child’s resistance to respiratory infections.

Instead, they help manage the symptoms of cystic fibrosis by helping to clear mucus from the lungs, which can improve lung function and reduce the risk of lung infections.

Choice B rationale

These therapies will only be done when our child is showing signs of illness. This statement is incorrect. These therapies are part of the daily management of cystic fibrosis and are typically done regularly, not just when the child is showing signs of illness.

Choice C rationale

These therapies will help to loosen our child’s secretions and allow for better expectoration. This statement is correct. The goal of these therapies is to help clear thick, sticky mucus from the lungs, which can improve breathing and reduce the risk of lung infections.

Choice D rationale

These therapies will allow for the removal of mucus from our child’s GI tract that blocks digestion. This statement is incorrect. While cystic fibrosis can affect the digestive system by causing thick mucus to block the tubes that carry digestive enzymes from your pancreas to your small intestine, the therapies mentioned are primarily used to help clear mucus from the lungs.

Correct Answer is C

Explanation

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The parents of a 7-year-old recently diagnosed with cystic fibrosis have received discharge instructions for chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine.Which of the following statements by the parents indicates understanding of the discharge instructions?

Correct Answer is C

Explanation

The parents of a 7-year-old recently diagnosed with cystic fibrosis have received discharge instructions for chest physiotherapy (CPT), use of a flutter valve, and a cough assist machine.Which of the following statements made by the parents indicates an understanding of the discharge instructions?

Correct Answer is C

Explanation

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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?