A nurse is presenting an in-service about the use of postural drainage for infants who have cystic fibrosis. Which of the following positions should the nurse identify as being contraindicated for the infant?
Sitting on a nurse's lap leaning forward
Trendelensburg
Supine
Sitting on a nurse's lap leaning backward
The Correct Answer is B
A. Sitting on a nurse's lap leaning forward is a safe position for postural drainage as it promotes drainage from the upper lobes of the lungs.
B. The Trendelenburg position, where the body is laid flat on the back with the feet higher than the head, is contraindicated for infants with cystic fibrosis because it can increase the risk of gastroesophageal reflux and aspiration.
C. The supine position is generally safe but does not facilitate effective postural drainage compared to other positions.
D. Sitting on a nurse's lap leaning backward is safe and can be used for drainage from the anterior lung segments.
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Related Questions
Correct Answer is ["B","D","E","H"]
Explanation
A. While the child’s oral intake is reduced, it is not as immediately critical as the other findings. However, it should still be monitored and managed.
B. The child’s blood pressure has dropped to 88/48 mm Hg on Day 3, which is significantly lower than the initial value and may indicate hypotension. This could be a sign of worsening condition or dehydration and needs to be reported for further evaluation and intervention.
C. The temperature of 38.1° C (100.6° F) on Day 3 indicates a fever but is lower than the initial admission temperature. It is important but not as critical as the other findings in this scenario.
D. The oxygen saturation has decreased to 88% on room air, which is below the normal range and indicates hypoxemia. This is critical in a patient with pneumonia and cystic fibrosis, and it requires immediate attention to manage respiratory function and oxygenation.
E. The child has passed three large, frothy, foul-smelling stools, which could be indicative of a gastrointestinal complication, possibly related to cystic fibrosis. This change in bowel habits should be reported as it may impact the child’s overall condition and treatment plan.
F. The sputum is thick, yellow, and blood-streaked, which is consistent with the condition but does not require immediate reporting unless there is a significant change in color or consistency.
G. The reported pain level of 4 on a scale of 0 to 10 is moderate but not life-threatening. It should be managed, but it is less urgent compared to other assessment findings.
H. The child is using accessory muscles for respiration and is experiencing dyspnea while at rest, which suggests worsening respiratory distress. This is crucial to report as it reflects the severity of the pneumonia and may need adjustments in the treatment plan.
Correct Answer is B
Explanation
A. Talking to the baby is beneficial but is not as crucial as responding to their needs consistently.
B. Consistently responding to the baby's needs is critical for developing trust and a secure attachment, as it helps the baby feel safe and cared for.
C. Having many caregivers can be confusing and may disrupt the development of trust. Consistent caregivers are more beneficial.
D. While stimulation is important, consistent and responsive care is more fundamental to developing trust.
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