A nurse is contributing to the plan of care for a 12-month-old infant following cleft palate repair. Which of the following actions should the nurse include?

a. Giving broad openings

The nurse is using the therapeutic technique of giving broad openings. This technique encourages the client to freely express themselves and choose the focus of the conversation. By asking, "What has been happening with you today?" the nurse is inviting the client to share their thoughts, feelings, and experiences without imposing any specific topic or direction.

Explanation for the other options:

b. Focusing: Focusing is a therapeutic technique where the nurse directs the conversation to a specific topic or issue. In this scenario, the nurse is not guiding the client's response toward a particular area of discussion.

c. Reflecting: Reflecting is a therapeutic technique where the nurse repeats or paraphrases the client's words or feelings to demonstrate understanding and encourage further exploration. The nurse's statement in this scenario does not involve reflecting the client's words or feelings.

d. Seeking clarification: Seeking clarification is a therapeutic technique used to obtain more specific information or clear up any confusion. The nurse's statement in this scenario does not involve seeking clarification from the client.

In summary, by using a broad opening, the nurse allows the client to choose the focus of the conversation

and encourages them to share their experiences and concerns.

Answer: B. Stiff posture

Rationale:
A. Lip-smacking : Lip-smacking is not typically an indication of pain in newborns. It may be associated with hunger or neurological responses, but it does not directly indicate discomfort or pain caused by shoulder dystocia or other injuries.
B. Stiff posture : A stiff posture can indicate pain in newborns, as they often exhibit hypertonicity or rigidity when experiencing discomfort. This response is a protective mechanism and may suggest the newborn is reacting to pain from potential nerve or tissue damage caused by shoulder dystocia.
C. Weak cry : While a weak cry may indicate neurological or respiratory distress, it is not a specific sign of pain. In the context of shoulder dystocia, a weak cry could reflect complications such as brachial plexus injury but does not directly signify the presence of pain.
D. Tongue-darting : Tongue-darting is more commonly associated with neurological issues or feeding difficulties rather than pain. It is not a typical behavioral response to discomfort or injury in newborns experiencing complications like shoulder dystocia.