A nurse is caring for a child who is 2 hr postoperative following a tonsillectomy. Which of the following fluid items should the nurse offer the child at this time?
Cranberry juice
Crushed ice
Vanilla milkshake
Orange juice
The Correct Answer is B
A. Cranberry juice
Explanation: Acidic and citrus juices, including cranberry and orange juice, should be avoided in the immediate postoperative period as they can be irritating to the surgical site and may increase the risk of bleeding.
B. Crushed ice
Explanation:
After a tonsillectomy, it's important to provide cold and clear fluids to soothe the throat and prevent bleeding. Crushed ice is a suitable option as it helps keep the throat cool and provides hydration without irritating the surgical site. Cold liquids can help minimize swelling and provide comfort.
C. Vanilla milkshake
Explanation: While milkshakes may be appealing, dairy products can coat the throat and may not be recommended immediately after surgery. Additionally, it's crucial to avoid using straws, as sucking can increase the risk of bleeding.
D. Orange juice
Explanation: As mentioned earlier, citrus juices like orange juice can be irritating to the surgical site and are not recommended in the early postoperative period after a tonsillectomy. It's essential to choose clear and non-acidic fluids to support healing and prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "Carry a water bottle with me because I drink a lot of water."
Explanation: Staying hydrated is crucial, especially for individuals with paralysis who may be prone to urinary issues. Carrying a water bottle is a good practice to maintain adequate hydration.
B. "Use a suppository every night to have a bowel movement."
Explanation: Using a suppository for regular bowel movements is a positive self-care behavior. It helps manage bowel care, which is important for individuals with paralysis.
C. "I do wheelchair exercises while watching TV."
Explanation: Engaging in wheelchair exercises to maintain mobility is a positive self-care behavior. It helps prevent complications related to being sedentary, such as muscle atrophy.
D. "I only need to catheterize myself twice every day."
Explanation: This statement may indicate a need for further teaching. Individuals with paralysis, especially due to conditions like spina bifida, often have neurogenic bladder dysfunction. They typically require more frequent catheterization, potentially every 4-6 hours, to ensure adequate bladder emptying and reduce the risk of complications like urinary tract infections (UTIs) or bladder infections.
Correct Answer is A
Explanation
A. Orthopnea
Explanation:
Orthopnea refers to difficulty breathing that occurs when lying flat. In heart failure, fluid may accumulate in the lungs, leading to respiratory distress when the child is in a supine position. Orthopnea is a common symptom of heart failure in both adults and children.
B. Bradycardia
Explanation: Bradycardia (slow heart rate) is not a typical finding in heart failure. Heart failure often leads to compensatory mechanisms, including an increased heart rate (tachycardia), to maintain cardiac output.
C. Weight loss
Explanation: Weight loss is not a typical finding in heart failure. In fact, heart failure in children may lead to fluid retention and weight gain rather than weight loss.
D. Increased urine output
Explanation: Heart failure in toddlers is more likely to be associated with decreased urine output rather than increased urine output. Reduced cardiac output can result in decreased blood flow to the kidneys, leading to decreased urine production and potential fluid retention. Increased urine output is not a characteristic finding in heart failure.
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