The nurse is developing a teaching plan for the parents of a 12-year-old boy with cystic fibrosis. For which piece of equipment should the nurse prioritize education?

Flutter valve device

Peak Flow Meter

Nebulizer

Metered-dose inhaler

Answer and Explanation

The Correct Answer is A

Rationale:

A. Flutter valve device: The flutter valve device helps loosen and clear thick mucus from the lungs, which is a primary concern in cystic fibrosis. Teaching parents how to properly use this device is essential to maintain airway clearance and reduce respiratory infections.

B. Peak Flow Meter: While useful for monitoring lung function in asthma, the peak flow meter is less critical in cystic fibrosis management. It does not directly assist in clearing mucus or delivering medication.

C. Nebulizer: Nebulizers are important for delivering inhaled medications and airway clearance therapies, but initial priority is often given to devices that facilitate mucus clearance like the flutter valve.

D. Metered-dose inhaler: Metered-dose inhalers deliver bronchodilators or steroids but require coordination and proper technique, which can be challenging for some children. Education on this device is important but secondary to airway clearance tools in CF care.

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Correct Answer is B

Explanation

Rationale:

A. "The ductus arteriosus is a shunt that allows oxygenated blood in the umbilical vein to bypass the liver and go to the heart.": The ductus arteriosus connects the pulmonary artery to the aorta, allowing blood to bypass the fetal lungs, not the liver.

B. "The ductus venosus is a shunt that allows oxygenated blood in the umbilical vein to bypass the liver and go to the heart.": The ductus venosus carries well-oxygenated blood from the placenta past the liver and into the inferior vena cava, directing it toward the fetal heart.

C. "The foramen ovale is a shunt that allows deoxygenated blood in the umbilical vein to bypass the liver and go to the heart.": The foramen ovale is an opening between the right and left atria that bypasses the lungs and it carries mixed oxygen blood not solely deoxygenated blood.

D. "The ductus aorta is a shunt that allows deoxygenated blood in the umbilical artery to bypass the liver and go to the heart”: There is no fetal shunt called the “ductus aorta,” and the umbilical arteries carry deoxygenated blood from the fetus to the placenta not to the heart.

A. "I understand that my baby will be given multiple IV medications. Some of these medications might include opioids for pain management and antibiotics to protect her from infection." B. "I understand that I will need to be careful when picking up my baby, I will need to pick her up by the head and bottom to protect her sternum." C. "I understand that it is important my baby continues to do tummy time once a day so her motor development does not suffer while in the hospital." D. "I understand that we will be in the hospital for a couple of weeks for treatment and monitoring post-op and then we will need close follow up with cardiology and the surgery team."

Correct Answer is C

Explanation

Rationale:

B. "I understand that I will need to be careful when picking up my baby, I will need to pick her up by the head and bottom to protect her sternum.": Sternal precautions are critical to prevent strain on the healing sternum.

C. "I understand that it is important my baby continues to do tummy time once a day so her motor development does not suffer while in the hospital.": Tummy time after recent sternotomy can place pressure on the chest incision and stress the healing sternum, increasing risk of complications. It should be delayed until cleared by the surgical team.

D. "I understand that we will be in the hospital for a couple of weeks for treatment and monitoring post-op and then we will need close follow up with cardiology and the surgery team.": Post-op recovery often requires extended hospitalization and long-term follow-up to monitor cardiac function and surgical healing.

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The nurse is developing a teaching plan for the parents of a 12-year-old boy with cystic fibrosis. For which piece of equipment should the nurse prioritize education?

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