A nurse is caring for a child who has cystic fibrosis and requires postural drainage.

Which of the following actions should the nurse take?

Hold hand flat to perform percussions on the child.

Perform the procedure twice each d

Perform the procedure prior to meals.

Administer a bronchodilator after the procedure

Answer and Explanation

The Correct Answer is C

The correct answer is choice C. Perform the procedure prior to meals.

This is because postural drainage involves positioning the child in different ways to help drain the mucus from the lungs.

If the child has a full stomach, this can cause nausea, vomiting, or aspiration. Therefore, the nurse should perform the procedure before meals or at least 1 hour after meals.

Choice A is wrong because the nurse should not hold the hand flat to perform percussions on the child.

Percussions are rhythmic clapping on the chest wall to loosen the mucus. The nurse should use a cupped hand to create a small air pocket that enhances the vibrations and prevents bruising.

Choice B is wrong because the nurse should not perform the procedure twice a day. The recommended frequency of postural drainage is 3 to 4 times a day, or more if needed, depending on the child’s condition and tolerance.

Choice D is wrong because the nurse should not administer a bronchodilator after the procedure.

A bronchodilator is a medication that relaxes and widens the airways, making it easier to breathe. The nurse should administer a bronchodilator before the procedure to enhance the effectiveness of postural drainage.

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Correct Answer is D

Explanation

The correct answer is choice D. The client is oriented times three.

This means that the client knows who they are, where they are, and what time it is. This indicates a high level of consciousness and a normal Glasgow coma scale (GCS) rating of 15.

Choice A is wrong because the client withdraws from pain.

This means that the client reacts to a painful stimulus by pulling away from it. This indicates a lower level of consciousness and a GCS rating of 4 for motor response.

Choice B is wrong because the client is unable to obey commands.

This means that the client does not follow simple instructions such as moving a limb or opening their eyes. This indicates a lower level of consciousness and a GCS rating of 1 or 2 for motor response.

Choice C is wrong because the client opens eyes to sound.

This means that the client does not open their eyes spontaneously, but only when they hear a loud noise. This indicates a lower level of consciousness and a GCS rating of 3 for eye opening.

The Glasgow coma scale is a clinical tool used to assess the level of consciousness of a person after a brain injury.

It consists of three tests: eye opening, verbal response, and motor response.

Each test has a score range from 1 to 6, with higher scores indicating higher levels of consciousness. The total score ranges from 3 to 15, with lower scores indicating higher risk of death.

A. Administer naloxone to the newborn. B. Minimize noise in the newborn's environment. C. Swaddle the newborn with his leg extended. D. Maintain eye contact with the newborn during feedings.

Correct Answer is B

Explanation

Choice A reason
Administering naloxone to the newborn is not appropriate. Naloxone is an opioid antagonist used to reverse the effects of opioid overdose in adults. It is not typically used for newborns with neonatal abstinence syndrome. The management of NAS is primarily supportive, and medications may be prescribed to help manage specific withdrawal symptoms, but naloxone is not a standard treatment for NAS.

Choice B reason:

Minimizing noise in the newborn's environment is a crucial action in the plan of care is the correct action to be included. Newborns experiencing NAS can be easily overstimulated, and loud noises can exacerbate their withdrawal symptoms and distress. Creating a calm and quiet environment helps reduce agitation and promotes better sleep and overall comfort.

Choice C reason

Swaddling the newborn with his leg extended is not appropriate in this case. Swaddling can be beneficial for some newborns, but the specific positioning and swaddling techniques should be individualized based on the newborn's needs and preferences. Extending the newborn's legs may not necessarily be the best approach, as it may not provide comfort or address the symptoms associated with NAS.

Choice D reason:

Maintaining eye contact with the newborn during feedings is not appropriate in this case. While maintaining eye contact during feedings is an essential aspect of bonding and promoting parent-newborn attachment, it may not be the primary focus in managing neonatal abstinence syndrome. The plan of care for a newborn with NAS would primarily involve managing withdrawal symptoms, providing comfort measures, and addressing the newborn's unique needs during this challenging period.

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A nurse is caring for a child who has cystic fibrosis and requires postural drainage.

Which of the following actions should the nurse take?