A nurse is caring for a 4-year-old child who is 2 days postoperative following the insertion of a ventriculoperitoneal shunt. Which of the following findings should the nurse identify as the priority?

A. "Your child's diet should be high in carbohydrates & proteins with no restriction of fats."

This statement is not entirely accurate. While it's true that children with cystic fibrosis often require a diet that is higher in calories and protein to support growth and weight gain, there is typically a need to restrict fat intake. Pancreatic insufficiency, which is common in cystic fibrosis, can lead to malabsorption of fats and fat-soluble vitamins. Therefore, a dietitian may recommend enzyme replacement therapy and a diet that is moderate in fat but high in calories and protein.

B. "Limit your child's intake of sodium to avoid complications."

This statement is not accurate. Cystic fibrosis can lead to excessive loss of salt in sweat, which can contribute to dehydration and electrolyte imbalances. Therefore, limiting sodium intake can cause electrolyte disturbances.

C. "A pigeon-shaped chest might become evident as the disease progresses."

This statement is accurate. Cystic fibrosis can cause chronic lung infections and inflammation, leading to structural changes in the chest over time. One common manifestation is a barrel-shaped or "pigeon-shaped" chest, which can occur as the disease progresses. This may result from hyperinflation of the lungs due to air trapping and chronic respiratory compromise.

D. "Administer a bronchodilator to the child after chest percussion therapy."

This statement is not necessarily accurate or applicable to all cases. Bronchodilators are medications used to help relax and open the airways in conditions such as asthma or chronic obstructive pulmonary disease (COPD). While bronchodilators may be part of the treatment regimen for some individuals with cystic fibrosis, their use after chest percussion therapy would depend on the individual's specific respiratory symptoms and treatment plan. It's important for the parents to follow the healthcare provider's instructions regarding medication administration.

A. Place the infant in prone position.

This option is incorrect. Placing the infant in the prone position (lying on the stomach) could put pressure on the spinal lesion, potentially causing discomfort or complications. It's important to minimize pressure on the affected area in infants with spina bifida.

B. Cover the infant's lesion with a dry cloth.

This option is incorrect. While keeping the lesion clean and dry is important for preventing infection, simply covering it with a dry cloth may not provide adequate protection. Proper wound care techniques, such as using sterile dressings and cleaning the area with prescribed solutions, are typically necessary to prevent infection and promote healing.

C. Feed the infant through an NG tube.

This option is incorrect. While infants with severe forms of spina bifida may have difficulty feeding due to associated complications, such as difficulty swallowing or weak sucking reflexes, feeding through a nasogastric (NG) tube is not a standard intervention for spina bifida itself. Feeding methods would depend on the specific needs and abilities of the infant, and may involve breastfeeding, bottle-feeding, or other methods under the guidance of healthcare professionals.

D. Diapering over a low defect will keep the infant free from infection.

This option is correct. Diapering over a low defect (the opening in the spine caused by spina bifida) helps to keep the area clean and reduce the risk of infection. By properly covering the defect with a diaper, exposure to urine and feces, which can increase the risk of infection, is minimized. Additionally, regular diaper changes and proper hygiene practices are essential for preventing complications in infants with spina bifida.