A neonate is born with bilateral mild talipes equinovarus (clubfoot). When the parents ask the nurse how this will be corrected, the nurse should give which explanation?

 

Choice A reason:

Assessing skin turgor underneath the cast is not feasible because the cast covers the skin, making it difficult to evaluate turgor directly. Skin turgor is typically assessed to determine hydration status, but it is not a primary concern when monitoring a child with a cast. The focus should be on assessing for signs of complications such as swelling, circulation issues, and pain.

Choice B reason:

Skin temperature is an important assessment when a child has a cast. Changes in skin temperature, such as increased warmth, can indicate infection or inflammation, while a cooler temperature may suggest compromised circulation. Regularly checking the skin temperature around the cast can help identify potential complications early.

Choice C reason:

Assessing pulses is crucial when a child has a cast. Checking the pulses distal to the cast (e.g., in the fingers or toes) helps ensure that there is adequate blood flow to the extremity. Diminished or absent pulses can indicate compromised circulation, which requires immediate medical attention to prevent tissue damage.

Choice D reason:

Pain assessment is essential for a child with a cast. Pain can be an indicator of complications such as pressure sores, infection, or compartment syndrome. Monitoring the child’s pain levels and addressing any complaints of pain promptly is important for their comfort and to prevent further issues.

Choice A reason:

Feeding an infant with gastroesophageal reflux formula instead of breast milk is not necessary. Breast milk is often easier for infants to digest and can be beneficial for reducing reflux symptoms. According to the American Academy of Pediatrics, breastfeeding should be continued if possible, as it has numerous health benefits for both the infant and the mother. If formula feeding is necessary, specialized formulas designed for infants with reflux can be used, but this does not mean breast milk should be avoided.

Choice B reason:

Thinning the baby’s formula with water is not recommended. This practice can dilute the essential nutrients in the formula, leading to inadequate nutrition for the infant. Instead, thickening agents such as rice cereal can be added to the formula to help reduce reflux symptoms. This approach helps the formula stay down in the stomach and reduces the likelihood of regurgitation.

Choice C reason:

Positioning the baby side-lying during sleep is not recommended for infants with gastroesophageal reflux. The American Academy of Pediatrics advises that infants should be placed on their backs to sleep to reduce the risk of sudden infant death syndrome (SIDS). Side-lying or prone positions are not safe for sleep and do not effectively reduce reflux symptoms.

Choice D reason:

Keeping the baby in an upright position after feedings is the correct approach for managing gastroesophageal reflux. This position helps prevent the stomach contents from flowing back into the esophagus, reducing the likelihood of reflux. It is recommended to hold the baby upright for at least 20-30 minutes after feeding to allow gravity to assist in keeping the stomach contents down.