A nurse is assisting with the care of a child who is receiving palliative care. Which of the following actions should the nurse take?

A. Gently cleanse the surgical site with sterile gauze: direct vigorous cleansing of the palate surgical site with gauze is generally avoided to prevent disruption of sutures. Oral rinses or specific gentle cleaning methods may be prescribed, but direct gauze wiping is usually not recommended.
B. Offer a pacifier with glucose syrup: acifiers and any sucking on objects (including straws, spoons, or toys) are typically contraindicated after cleft palate repair because the sucking motion puts stress on the suture line and can disrupt healing.
C. Apply elbow immobilizers to both arms: Elbow immobilizers prevent the infant from bending their elbows and bringing their hands to their mouth or face, which could disrupt the surgical sutures, cause trauma, or introduce infection to the delicate palate repair.
D. Place the infant in a supine position: A semi-upright position is usually preferred to reduce pressure on the surgical site and prevent aspiration, rather than placing the infant flat on their back.

• Steatorrhea: Steatorrhea (fatty stools) is a common symptom of cystic fibrosis due to pancreatic insufficiency. It is not directly related to the current acute infection (Streptococcus pneumonia).
• Barrel chest: A barrel chest is a chronic sign of cystic fibrosis caused by long-standing lung disease and airway obstruction. It is not related to the acute infection (Streptococcus pneumonia) but reflects the long-term effects of cystic fibrosis.
• Hemoptysis 300 mL: Hemoptysis, 300 mL, is a significant and concerning sign of potential worsening condition. While blood-streaked sputum was initially noted, a large volume like 300 mL indicates significant bleeding from the lungs.
• WBC count 17,000/mm³: The initial WBC count was 22,000/mm3, indicating an active bacterial infection. A decrease to 17,000/mm3, while still elevated, suggests that the body's inflammatory response is potentially improving and that the infection IS responding to treatment.
• Oxygen saturation 95% on 1 L oxygen via nasal cannula: The oxygen saturation has improved (from 92% to 95%) with a reduction in the amount of supplemental oxygen, indicating that the patient’s respiratory status is improving.
• Respiratory rate 32/min: The respiratory rate has decreased slightly from 36/min to 32/min, indicating that the patient’s breathing is becoming more stable as the condition improves. However, respiratory rate should still be closely monitored as part of overall progress.