A nurse is caring for a child who is postoperative following the insertion of a ventriculoperitoneal shunt. The nurse should place the child in which of the following positions?

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. Pulmonary function test:

Pulmonary function tests (PFTs) assess lung function by measuring airflow, lung volume, and gas exchange. While PFTs can provide valuable information about respiratory function, they are not specific to cystic fibrosis and may show abnormalities consistent with various respiratory conditions. However, PFTs are often performed in individuals with cystic fibrosis to monitor lung function over time and assess response to treatment. They are not considered the most definitive test for diagnosing cystic fibrosis.

B. Sweat chloride test:

This option is correct. The sweat chloride test is considered the most definitive diagnostic test for cystic fibrosis. It measures the concentration of chloride in sweat, which is typically elevated in individuals with cystic fibrosis due to defective chloride transport in sweat glands. A sweat chloride concentration above a certain threshold (usually ≥60 mmol/L) is diagnostic of cystic fibrosis, particularly when confirmed with repeat testing.

C. Stool fat content analysis:

Stool fat content analysis evaluates fat absorption and fecal fat excretion, which may be impaired in individuals with cystic fibrosis due to pancreatic insufficiency. However, while stool fat content analysis can provide supportive evidence of malabsorption in cystic fibrosis, it is not considered the most definitive test for diagnosing the condition. Stool fat content analysis is often used in conjunction with other diagnostic tests to assess pancreatic function and nutritional status in individuals with cystic fibrosis.

D. Sputum culture:

Sputum culture involves culturing respiratory secretions to identify bacterial pathogens, which can be useful for diagnosing respiratory infections in individuals with cystic fibrosis. However, sputum culture is not specific to cystic fibrosis and may show similar findings in other respiratory conditions. While respiratory cultures are important for guiding treatment in cystic fibrosis, they are not considered the most definitive test for diagnosing the condition.