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
Montelukast is a leukotriene receptor antagonist used for long-term control and prevention of asthma symptoms. It is not a rescue medication and does not provide immediate relief during an acute asthma attack. Montelukast works by reducing inflammation and preventing bronchoconstriction, but its effects are not rapid enough to address the immediate needs of a patient experiencing an acute asthma attack.
Choice B rationale
Albuterol is a short-acting beta-agonist (SABA) that provides rapid bronchodilation and is the first-line treatment for acute asthma attacks. It works by relaxing the smooth muscles in the airways, leading to quick relief of bronchospasm and improved airflow. Administering albuterol promptly can help alleviate symptoms and prevent the progression of an asthma attack, making it the priority medication in this scenario.
Choice C rationale
Fluticasone is an inhaled corticosteroid used for long-term control of asthma. It helps reduce inflammation in the airways and prevent asthma symptoms but is not effective as a rescue medication during an acute asthma attack. Inhaled corticosteroids are typically used as part of a daily maintenance regimen to manage chronic asthma and prevent exacerbations.
Choice D rationale
Budesonide is another inhaled corticosteroid used for long-term asthma control. Like fluticasone, it helps reduce airway inflammation and prevent asthma symptoms but is not suitable for immediate relief during an acute asthma attack. Inhaled corticosteroids are important for managing chronic asthma but do not provide the rapid bronchodilation needed in an emergency situation.
Correct Answer is D
Explanation
Choice A rationale
Referring the child to social work for early intervention is important, but it is not the immediate priority. The nurse should first discuss the assessment findings with the primary care provider to confirm the diagnosis and plan the next steps.
Choice B rationale
Educating the parents on the developmental delays their child is diagnosed with is essential, but it should come after a confirmed diagnosis and a comprehensive plan is in place. The primary care provider should be involved in this process.
Choice C rationale
Providing the parents with pamphlets for support groups is supportive but not the immediate priority. The nurse should first ensure that the primary care provider is aware of the assessment findings to confirm the diagnosis and plan appropriate interventions.
Choice D rationale
Discussing the assessment findings with the primary care provider is the priority action. This ensures that the child receives a thorough evaluation and appropriate interventions are planned based on a confirmed diagnosis.