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 A
Explanation
Choice A rationale
A blood pressure of 90/40 mm Hg, heart rate of 135/min, respirations of 32/min, and an oral temperature of 38°C (100.4°F) indicate potential signs of sepsis or another serious condition. The elevated heart rate and respiratory rate, along with the fever, suggest an infection that requires immediate medical attention.
Choice B rationale
While the vital signs in this option are slightly elevated, they are not as concerning as those in Choice A. The heart rate and respiratory rate are within acceptable ranges for a 2-year-old, and the temperature is only slightly elevated.
Choice C rationale
The vital signs in this option are within normal ranges for a 2-year-old child. There is no immediate cause for concern based on these vital signs.
Choice D rationale
The vital signs in this option are also within acceptable ranges for a 2-year-old child. While the heart rate is slightly elevated, it is not as concerning as the vital signs in Choice A.
Correct Answer is C
Explanation
Choice A rationale
Administering an inhaled glucocorticoid can help reduce inflammation in the airways, but it is not the priority intervention in an acute asthma exacerbation. The primary concern is to provide rapid bronchodilator.
Choice B rationale
Obtaining a peak flow reading can help assess the severity of the asthma exacerbation, but it is not the priority intervention. The primary concern is to provide rapid bronchodilator.
Choice C rationale
Administering a short-acting beta-agonist (SABA) is the priority intervention. SABAs, such as albuterol, provide rapid bronchodilation and relieve bronchospasm, which are the main features of status asthmatics.
Choice D rationale
Determining the cause of the acute exacerbation can help guide long-term management, but it is not the priority intervention in an acute asthma exacerbation. The primary concern is to provide rapid bronchodilation.