A nurse is assessing a newborn who has a coarctation of the aorta. Which of the following should the nurse recognize as a clinical manifestation of coarctation of the aorta?

Choice A Reason:

Allowing for imaginative play with peers without supervision is not advisable for children with autism spectrum disorder. These children often require structured environments and close supervision to ensure their safety and to help them navigate social interactions. Unsupervised play can lead to misunderstandings, conflicts, or even safety issues. Therefore, this choice is not suitable for the plan of care.

Choice B Reason:

Establishing a reward system for positive behavior is an effective intervention for children with autism spectrum disorder. Positive reinforcement helps in encouraging desirable behaviors and can significantly improve the child’s ability to follow routines and engage in appropriate social interactions. Reward systems can be tailored to the child’s preferences and can include tangible rewards, praise, or other forms of positive reinforcement. This approach is widely supported by research and is considered a best practice in managing behaviors in children with autism.

Choice C Reason:

Providing a flexible schedule that adjusts to the child’s interests may seem beneficial, but it can actually be counterproductive for children with autism spectrum disorder. These children often thrive on routine and predictability. A flexible schedule can create confusion and anxiety, making it difficult for the child to understand what is expected of them. Consistent routines help in reducing anxiety and improving the child’s ability to function in various settings.

Choice D Reason:

Allowing for adjustment of rules to correlate with the child’s behavior is not recommended. Consistent and clear rules are essential for children with autism spectrum disorder. Adjusting rules based on behavior can lead to inconsistency, which can be confusing and stressful for the child. It is important to establish and maintain clear expectations to help the child understand boundaries and develop appropriate behaviors.

Choice A Reason:

A sputum culture is used to identify specific bacteria or fungi in the lungs and airways, which can help in managing infections in cystic fibrosis (CF) patients. However, it does not confirm the diagnosis of CF. The primary purpose of a sputum culture is to guide antibiotic therapy by identifying the pathogens causing respiratory infections.

Choice B Reason:

Pulmonary function tests (PFTs) measure how well the lungs are working by assessing lung volumes, capacities, and flow rates. While PFTs are crucial for monitoring lung function and disease progression in CF patients, they do not confirm the diagnosis. PFTs help in evaluating the severity of lung disease and the effectiveness of treatments.

Choice C Reason:

The sweat chloride test is the gold standard for diagnosing cystic fibrosis. This test measures the concentration of chloride in the sweat. Elevated levels of chloride (typically above 60 mmol/L) indicate CF. The test is based on the principle that individuals with CF have defective CFTR proteins, leading to abnormal chloride transport and higher chloride levels in sweat.

Choice D Reason:

A stool fat content analysis measures the amount of fat in the stool to assess digestive function and fat absorption. While this test can indicate malabsorption issues common in CF due to pancreatic insufficiency, it does not confirm the diagnosis. Elevated fecal fat levels can suggest CF but are not definitive without further testing.