A nurse is providing teaching for a parent of a preschool-aged child who had a myringotomy with a tympanoplasty tube insertion 4 days ago. Which of the following actions should the nurse identify as an indication that the teaching was effective?
The child's parent applies the prescribed medication as instructed.
The parent allows their child to attempt to lift their older sibling above the ground.
The child's parent enforces nose blowing only when necessary.
The child's parent states that they developed a plan to have their child use ear plugs in the shower.
The parent noticed purulent drainage from their child's ear and immediately reported it to the surgeon.
Correct Answer : A,C,D,E
A. The parent applying prescribed medication as instructed indicates proper understanding of post-operative care and adherence to treatment.
B. Allowing the child to lift their older sibling above the ground is inappropriate as it can lead to increased pressure on the ear, risking complications.
C. Enforcing nose blowing only when necessary is a correct action since excessive force can displace the tympanoplasty tube or introduce bacteria into the ear.
D. Planning to have the child use ear plugs in the shower is an effective precaution to protect the ears from water exposure, which is essential post-surgery.
E. Reporting purulent drainage immediately to the surgeon shows awareness of potential complications and the need for prompt medical attention.
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Correct Answer is D
Explanation
A. Weak pulses are more indicative of reduced cardiac output or other cardiac issues, rather than specifically a large patent ductus arteriosus (PDA).
B. Cyanosis with crying can occur in various conditions, but it is not a hallmark of a large PDA; it typically presents with other symptoms.
C. Chronic hypoxemia is more associated with severe heart defects or lung conditions, whereas a large PDA may present with other signs first.
D. A systolic murmur is a classic finding in large PDAs due to the left-to-right shunting of blood, making it the most expected manifestation in this scenario.
Correct Answer is A
Explanation
A. Furosemide is a loop diuretic that can cause potassium loss; therefore, it is essential for the child to eat potassium-rich foods to prevent hypokalemia.
B. Taking furosemide at bedtime is not advisable due to the increased risk of nocturia and sleep disturbances from frequent urination.
C. Aspirin is not recommended without medical guidance, especially for children, as it can increase the risk of Reye's syndrome.
D. Expecting swelling in the hands and feet contradicts the purpose of furosemide, which is to reduce fluid overload; parents should report any unexpected swelling to the healthcare provider.