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 D
Explanation
Choice A rationale
A diastolic murmur is not a typical finding in coarctation of the aorta. This condition is more commonly associated with systolic murmurs.
Choice B rationale
Hypotension is not a common finding in coarctation of the aorta. In fact, hypertension in the upper extremities is more typical due to the narrowing of the aorta.
Choice C rationale
Excessive crying is not a specific indicator of coarctation of the aorta. It can be a symptom of many different conditions and is not diagnostic.
Choice D rationale
Unequal upper and lower extremity pulses are a key finding in coarctation of the aorta. The narrowing of the aorta causes reduced blood flow to the lower extremities, resulting in weaker pulses compared to the upper extremities.