What instructions must the nurse include in the post-operative discharge instruction for a 6-year-old who just had a tonsillectomy? (Select All That Apply).

The nurse should include the following information in the teaching about home safety for a 10- month-old infant:

1. Keep plastic bags and plastic grocery bags in a secure place. Plastic bags pose a choking hazard for young children who can easily put them over their heads and suffocate.
2. Serve food in small pieces no larger than a cheerio. This reduces the risk of choking, as infants have limited chewing ability and can easily swallow large pieces of food whole.

E. Use plastic covers on all electrical outlets. This prevents the infant from sticking fingers or objects into the outlet, which could lead to electrical shock.

However, the following information is incorrect and should not be included:

C. Lower the crib rails to the lowest level. While lowering the crib rails might seem convenient, it actually increases the risk of the infant climbing out and potentially falling and injuring themselves. Crib rails should be kept at the highest level possible once the infant can sit up on their own.

D. Set the water heater to 65°C (149°F). This temperature is scalding hot and can cause severe burns in infants. The recommended safe water heater temperature is 120°F (48.9°C) or lower to prevent accidental scalding.

Therefore, the correct selections are A, B, and E. The nurse should emphasize the importance of creating a safe environment for the infant by keeping choking hazards out of reach, serving food in appropriate sizes, and preventing access to electrical outlets. Additionally, the nurse should educate parents about the safe water heater temperature to avoid scalding risks.

Choice A rationale

Administering enteral bolus feeds prior to surgery is not typically recommended for infants with a tracheoesophageal fistula. This is because the fistula can allow food or liquid to enter the trachea and lungs, leading to aspiration and potential respiratory complications.

Choice B rationale

Administering Famotidine prior to surgery can help reduce the risk of gastric acid reflux, which can lead to aspiration during surgery. This is particularly important in infants with a tracheoesophageal fistula, as the fistula can allow stomach contents to enter the trachea.

Choice C rationale

Administering IV antibiotics prior to surgery can help prevent infection. This is a common practice in many types of surgery, including surgery to repair a tracheoesophageal fistula.

Choice D rationale

Administering IV fluids during surgery can help maintain hydration and electrolyte balance. This is particularly important in infants, who have a higher risk of dehydration.

Choice E rationale

Administering 100% oxygen via a non-rebreather mask during surgery can help ensure that the infant has adequate oxygen levels. This is particularly important during surgery, as the infant will be under general anesthesia.