Which statement indicates that parents understand how to feed their infant who had a surgical repair for a cleft lip?
We are feeding the baby with a dropper for 2 weeks.
We started the baby on solid food yesterday.
We resumed bottle feeding after discharge.
The baby is drinking well from a straw.
The Correct Answer is A
Choice A rationale
Dropper feeding for the initial post-operative period (typically 1–2 weeks) is a standard measure to minimize tension and stress on the newly repaired cleft lip suture line. Using a soft, controlled delivery method prevents the strong sucking action required for a bottle or straw, which could disrupt the delicate surgical approximation of the muscles and skin, compromising the cosmetic and functional outcome and increasing the risk of wound dehiscence or infection.
Choice B rationale
Introduction of solid food is inappropriate in the immediate post-operative phase, typically weeks to months after the procedure, depending on the infant's overall recovery and ability to tolerate thicker textures. Early introduction could introduce particulate matter to the surgical site, increasing the risk of contamination and infection. Furthermore, chewing and manipulation of solids would place excessive, potentially damaging, mechanical stress on the healing tissues.
Choice C rationale
Bottle feeding necessitates vigorous sucking and facial muscle movement to extract milk, which directly contradicts the post-operative goal of minimizing tension on the repair. The pressure created by sucking can exert shearing forces and excessive stretching on the surgically joined tissues, potentially leading to wound dehiscence (rupture or opening) or a less favorable long-term scar. Alternative feeding methods like a syringe or special cleft palate feeders are generally used.
Choice D rationale
Drinking from a straw requires a significant amount of negative pressure (suction) generated by the oral muscles and cheeks, which exerts substantial force on the healing lip structure. This forceful action is highly likely to disrupt the delicate surgical closure, leading to separation of the wound edges (dehiscence) and poor healing. Specialized feeding techniques are necessary to ensure adequate nutrition while protecting the surgical site integrity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Cold stress is a condition where excessive heat loss forces a newborn to use compensatory mechanisms like non-shivering thermogenesis (metabolism of brown fat) to maintain body temperature. While this increases oxygen consumption and can lead to respiratory distress, nasal flaring, retractions, and grunting are direct mechanical signs of the respiratory system struggling to maintain adequate gas exchange, specifically indicating increased work of breathing.
Choice B rationale
Postmaturity syndrome (post-term infant) occurs after 42 weeks gestation and is characterized by dry, cracked, peeling skin, a wasted appearance due to decreased subcutaneous fat, and often meconium staining. These infants may have chronic intrauterine hypoxia but the acute signs of nasal flaring, retractions, and grunting are immediately related to the physical effort of breathing.
Choice C rationale
An apneic episode is a cessation of breathing for 20 seconds or longer, or for a shorter period when accompanied by bradycardia or cyanosis. While it represents a serious respiratory event, the described signs (flaring, retractions, grunting) are active attempts to breathe in the presence of increased airway resistance or decreased lung compliance, not a cessation of breathing.
Choice D rationale
Respiratory distress syndrome (RDS), typically due to pulmonary surfactant deficiency in the preterm lung, causes reduced lung compliance and widespread atelectasis. To compensate for the difficulty in oxygenating, the infant exhibits nasal flaring (to decrease airway resistance), retractions (using accessory muscles to increase negative intrathoracic pressure), and expiratory grunting (to maintain positive end-expiratory pressure, keeping alveoli open).
Correct Answer is A
Explanation
Choice A rationale
Post-term pregnancy, defined as a gestation extending past 42 weeks, is a valid indication for oxytocin induction. This is because the risk of placental insufficiency, fetal macrosomia, oligohydramnios, and subsequent fetal distress or stillbirth increases significantly after the estimated due date has passed the 42-week mark.
Choice B rationale
Polyhydramnios, an excess of amniotic fluid, is not a standard indication for oxytocin induction; it is often associated with conditions like gestational diabetes or fetal anomalies. While it can cause maternal discomfort or uterine overdistension, induction is usually only necessary if associated complications threaten maternal or fetal well-being.
Choice C rationale
A history of long labors is a retrospective observation, not a medical indication for the induction of labor in the current pregnancy. Labor induction is based on current maternal or fetal health risks, not prior labor patterns. Oxytocin induction itself carries risks, and a prior long labor does not necessitate intervention this time.
Choice D rationale
Multiple fetuses (e.g., twins) is not an acceptable indication for routine oxytocin induction and often presents a relative contraindication. Multiple gestations carry a higher risk of complications like preterm labor and uterine overdistension, and labor management often requires careful monitoring, sometimes leading to a Cesarean section.
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