The nurse is conducting discharge teaching about signs and symptoms of heart failure to parents of an infant with a repaired tetralogy of Fallot. Which signs and symptoms should the nurse include? (Select all that apply.)

The correct answer is choice B. Administer supplemental oxygen before and after suctioning.

Choice A rationale:

Expect symptoms of respiratory distress when suctioning. While respiratory distress can occur during and after suctioning, it is not the main nursing consideration. The primary goal is to minimize any potential complications and ensure the child's safety during the procedure, which can be achieved by following appropriate guidelines.

Choice B rationale:

Administer supplemental oxygen before and after suctioning. Correct Answer. Administering supplemental oxygen before and after suctioning is crucial to maintain adequate oxygenation during and after the procedure. Suctioning can temporarily decrease oxygen levels and cause desaturation, especially in a child who has undergone heart surgery. Providing supplemental oxygen helps prevent hypoxia and supports respiratory function.

Choice C rationale:

Perform suctioning at least every hour. Frequent suctioning at least every hour is not a standard nursing practice, especially for a child who has had heart surgery. Suctioning should only be performed as needed based on the child's clinical condition, and excessive suctioning can irritate the airway and lead to complications.

Choice D rationale:

Suction for no longer than 30 seconds at a time. While limiting the duration of suctioning is important to prevent hypoxia and trauma to the airway, the specific duration of 30 seconds is not a universal rule. Suctioning should be performed for the shortest effective duration to minimize the risk of complications, but the optimal time can vary based on the child's condition and the type of suctioning being used.

The correct answer is choice D: Sex can be presented as a normal part of growth and development.

Choice A rationale:

Children in 5th grade are generally around 10 to 11 years old, which means they are approaching puberty and experiencing physical changes. While it might be tempting to think that they are too young for sex education, it's important to acknowledge that they are at an age where their bodies are undergoing significant transformations. Providing them with age-appropriate sex education can empower them to understand these changes and navigate them safely.

Choice B rationale:

Correct terminology should not be reserved solely for older children. Using accurate and age-appropriate terminology when discussing topics related to sex and development is crucial. Children in 5th grade are capable of understanding basic anatomical terms and concepts, which can help them better comprehend their own bodies and the changes they are experiencing.

Choice C rationale:

Encouraging children to ask questions is an essential part of sex education. s reflect curiosity and a desire to learn. Discouraging questions can lead to misinformation and misunderstandings. Open dialogue about sex and development can help dispel myths and promote healthy attitudes toward these topics.

Choice D rationale:

Presenting sex as a normal part of growth and development is the foundation of comprehensive and age-appropriate sex education. Children in 5th grade are entering a stage of life where they might start experiencing sexual curiosity and have questions about their bodies. Addressing these questions in a respectful and factual manner can help them develop a healthy understanding of their own sexuality and promote safe behaviors.