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.
Supine.
Sitting on a nurse’s lap leaning backward.
Trendelenburg.
The Correct Answer is D
Choice A rationale
Sitting on a nurse’s lap leaning forward is a position that can be used for postural drainage in infants with cystic fibrosis. This position helps drain secretions from the upper lobes of the lungs.
Choice B rationale
The supine position (lying on the back) is also used for postural drainage to target different areas of the lungs. It is not contraindicated for infants with cystic fibrosis.
Choice C rationale
Sitting on a nurse’s lap leaning backward is another position that can be used for postural drainage. This position helps drain secretions from the lower lobes of the lungs.
Choice D rationale
The Trendelenburg position (lying flat on the back with the feet elevated higher than the head) is contraindicated for infants with cystic fibrosis. This position can increase the risk of gastroesophageal reflux and aspiration, which can worsen respiratory symptoms.
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Correct Answer is B
Explanation
Choice A rationale
Obtaining a throat culture is contraindicated in suspected epiglottitis. This procedure can cause further irritation and potentially lead to airway obstruction. Epiglottitis is a medical emergency, and the priority is to maintain a patent airway.
Choice B rationale
Placing the child in an upright position is the correct action. This position helps improve breathing and reduces the risk of airway obstruction. It also allows for better visualization and assessment of the child’s respiratory status.
Choice C rationale
Visualizing the epiglottis with a tongue depressor is not recommended in suspected epiglottitis. This action can cause further irritation and potentially lead to airway obstruction. The priority is to maintain a patent airway and avoid any procedures that could exacerbate the condition.
Choice D rationale
Transporting the child to radiology for a throat x-ray is not the immediate priority. While imaging may be necessary for diagnosis, the primary focus should be on maintaining a patent airway and ensuring the child’s respiratory status is stable.
Correct Answer is B
Explanation
Choice A rationale
Notifying the health care provider immediately may be necessary if the bleeding is severe or persistent. However, in the case of small amounts of blood, it is important to continue assessing for bleeding to determine if the situation worsens. Immediate notification may not be necessary for minor bleeding.
Choice B rationale
Continuing to assess for bleeding is the best intervention for a child spitting up small amounts of blood after a tonsillectomy. This allows the nurse to monitor the situation and determine if the bleeding is worsening or if it resolves on its own. It is important to keep the child calm and avoid any actions that could exacerbate the bleeding.
Choice C rationale
Encouraging the child to cough can increase the risk of further bleeding. Coughing can dislodge clots and cause additional trauma to the surgical site. It is important to keep the child calm and avoid actions that could worsen the bleeding.
Choice D rationale
Suctioning the back of the throat can cause additional trauma to the surgical site and increase the risk of bleeding. It is important to avoid invasive procedures and continue to assess for bleeding. If the bleeding worsens, further medical intervention may be necessary.