A 9-week-old infant is scheduled for a cleft lip repair. What information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?

Urine specific gravity is 1.011

White blood cell count of 10,000/mm³

Weight gain of 2 pounds (0.91 kg) since birth

Red blood cell count of 2.3 x 10²/L

Answer and Explanation

The Correct Answer is D

Answer is... Choice D. Red blood cell count of 2.3 x 10²/L.

Choice A rationale:

In considering the 9-week-old infant scheduled for a cleft lip repair, it's crucial to evaluate various physiological parameters to ensure optimal surgical outcomes. The urine specific gravity of 1.011 falls within the normal range for infants, typically ranging from 1.001 to 1.020. This parameter primarily reflects the concentration of solutes in the urine and is influenced by hydration status. While deviations from the normal range may indicate certain renal conditions or hydration imbalances, a value of 1.011 alone does not signify a critical concern warranting immediate attention before surgery.

Choice B rationale:

A white blood cell count of 10,000/mm³ suggests a normal leukocyte count within the expected range for infants. The normal range for white blood cell count in infants is approximately 6,000 to 17,000/mm³. This parameter serves as an indicator of the body's immune response and can elevate in response to infection or inflammation. However, in the absence of clinical signs or symptoms suggestive of infection, such as fever or localized inflammation at the surgical site, a white blood cell count of 10,000/mm³ is not indicative of an urgent issue necessitating immediate communication with the surgeon.

Choice C rationale:

Weight gain of 2 pounds (0.91 kg) since birth is a positive indicator of growth and development in the infant. Infants typically exhibit rapid weight gain during the first few months of life, with an average weight gain of approximately 0.5 to 1 ounce per day or 1 to 2 pounds per month. This signifies adequate nutritional intake and physiological growth, which are essential for surgical readiness and postoperative recovery. However, while weight gain is an important parameter to monitor in pediatric patients, it does not directly impact the immediate preoperative considerations for a cleft lip repair.

Choice D rationale:

The red blood cell count of 2.3 x 10²/L is the most critical parameter requiring communication with the surgeon before transporting the infant to the surgical suite. A red blood cell count below the normal range can indicate anemia, which may pose risks during surgery, including impaired oxygen delivery to tissues and compromised hemostasis. Normal red blood cell counts in infants typically range from 3.9 to 5.2 x 10^12/L. Anemia in pediatric patients can result from various etiologies, including nutritional deficiencies, hemolytic disorders, or bone marrow suppression. Communicating a low red blood cell count ensures that the surgical team is aware of this potential risk factor and can take appropriate measures, such as transfusion or adjustments to the surgical plan, to mitigate perioperative complications.

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Correct Answer is B

Explanation

Choice A rationale
While it’s important to obtain essential information as quickly as possible, this approach may not be the most effective when a child is scared or upset. It’s important to create a safe and comfortable environment for the child.
Choice B rationale
Including the child’s toy in the collection of information can help to create a more familiar and comfortable environment for the child. This can help to reduce fear and anxiety, making it easier to collect the necessary information.
Choice C rationale
Documenting interactions between the parent and the child can provide valuable information about the child’s behavior and emotional state. However, this is not the most effective intervention in this situation.
Choice D rationale
Ignoring the child’s behavior and directing questions to a parent can make the child feel overlooked and may increase their fear and anxiety. It’s important to acknowledge the child’s feelings and work to create a safe and comfortable environment.

A. Use a disposable moist wipe to remove eye crusts. B. Prepare the child for blurry vision after ointment application. C. Remove secretions by wiping toward the opposite eye. D. Discontinue the ointment once drainage resolves.

Correct Answer is B

Explanation

Choice A rationale
Using a disposable moist wipe to remove eye crusts can be helpful, but it’s not the most important instruction for caregivers. The crusts are a symptom of the infection, and while removing them can make the child more comfortable, it doesn’t address the underlying issue.
Choice B rationale
When using an ophthalmic anti-infective ointment, it is important to prepare the child for blurry vision after ointment application. This is because the ointment can temporarily blur vision after application. It is important to follow the instructions on the medication label and continue using the ointment for the full course of treatment, even if symptoms improve before then.
Choice C rationale
While it’s important to keep the eye area clean, wiping towards the opposite eye could potentially spread the infection. Therefore, this is not the best advice for caregivers.
Choice D rationale
Discontinuing the ointment once drainage resolves could lead to an incomplete treatment of the infection. It’s crucial to use the ointment for the full course of treatment as prescribed by the healthcare provider, even if symptoms seem to improve.

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A 9-week-old infant is scheduled for a cleft lip repair. What information is most important for the nurse to convey to the surgeon before transporting the infant to the surgical suite?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse begins collecting the medical history of a child when the child screams and tries to hide behind the parent, dropping a stuffed toy. What intervention should the nurse implement?

Correct Answer is B

Explanation

The nurse is caring for a school-age child with crusting and swollen eyelids, purulent drainage, and inflamed conjunctiva. The child receives a prescription for an ophthalmic antinfective ointment. What instruction should the nurse provide the child’s caregivers during discharge education?

Correct Answer is B

Explanation

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