To enhance the effectiveness of the pharmacological pain intervention administered to a 4-year old child with an injured knee, the nurse plans to add a nonpharmacological intervention. Which of the following actions would be appropriate for the nurse to perform? (select all that apply)

A. She returns the blocks to the same spot on the table.

This behavior is more related to a sense of order or routine rather than object permanence. It doesn't directly demonstrate understanding object permanence.

B. She looks for the toy the parents hide under the blanket.

This behavior is consistent with the concept of object permanence. If the child searches for a hidden toy, it indicates an understanding that the object still exists even when out of sight.

C. She bangs two cubes held in her hands.

Banging cubes is not directly related to object permanence. It might demonstrate exploration or cause-and-effect understanding, but it doesn't specifically indicate object permanence.

D. She recognizes that a ball of clay is the same when flattened out.

This behavior demonstrates an understanding of conservation, which is different from object permanence. Conservation involves recognizing that the quantity of a substance remains the same despite changes in shape.

A. Hyperactivity of sweat glands:

In cystic fibrosis (CF), there is an abnormality in the CF transmembrane conductance regulator (CFTR) protein, leading to increased salt concentration in sweat. However, this is not the primary factor responsible for the diverse clinical manifestations in CF. The primary issue lies in the abnormal production of thick and sticky mucus affecting various organs.

B. Mechanical obstruction caused by increased viscosity of mucous gland secretion:

This is the correct choice. CF is characterized by the production of thick and sticky mucus due to abnormal CFTR protein function. This increased viscosity leads to mechanical obstruction in organs such as the respiratory, digestive, and reproductive systems, causing a range of clinical manifestations.

C. Hypoactivity of the autonomic nervous system:

CF is not characterized by hypoactivity of the autonomic nervous system. The primary issue lies in the mechanical obstruction caused by the abnormal mucus production.

D. Atrophic changes in the mucosal wall of the intestines:

Atrophic changes in the mucosal wall of the intestines are not the primary factor responsible for the clinical manifestations of CF. The key problem is the mechanical obstruction due to increased viscosity of mucous gland secretions.