A nurse is reinforcing discharge instructions with a parent of a 6-year-old child who has just had a tonsillectomy. Which of the following statements by the parent indicates an understanding of postoperative care?
"It's okay for my child to have plenty of ice cream."
“I’ll help my child gargle with salt water a few times a day."
"I'll call the doctor if my child is swallowing continuously."
"It's okay for my child to ride his bike in a few days.”
The Correct Answer is C
A. "It's okay for my child to have plenty of ice cream.": Cold, soft foods like ice cream are typically allowed, but dairy products like ice cream may increase mucus production, which could irritate the throat.
B. “I’ll help my child gargle with salt water a few times a day.": Gargling is contraindicated after a tonsillectomy as it can irritate the surgical site and potentially cause bleeding.
C. "I'll call the doctor if my child is swallowing continuously." Continuous swallowing can be a sign of bleeding after a tonsillectomy, which is a medical emergency. It is important for parents to recognize this as an early sign of hemorrhage.
D. "It's okay for my child to ride his bike in a few days.": Strenuous activities, including riding a bike, should be avoided for at least 1-2 weeks to reduce the risk of bleeding.
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Correct Answer is A
Explanation
A. Continuous bubbling in the water-seal chamber: Continuous bubbling in the water-seal chamber indicates a possible air leak in the system, which needs to be assessed and potentially reported to the charge nurse for further evaluation.
B. Patient respiratory status is stable and denies pain to chest tube site: This is a normal finding and does not require reporting.
C. Tidalling, fluctuations in the fluid level in the water-seal chamber: This is a normal finding, indicating that the chest tube is functioning properly and that the lungs are expanding.
D. Occasional bubbling in the water-seal chamber: This may be acceptable, especially with respiratory movements, as it could indicate that the patient is exhaling, but continuous bubbling is concerning.
Correct Answer is D
Explanation
A. Case manager: A case manager can help coordinate care but is not responsible for the specific education on BiPAP use.
B. Occupational therapist: Occupational therapists focus on daily living activities, not respiratory therapy.
C. Physical therapist: Physical therapists work on mobility and musculoskeletal issues, not respiratory support or BiPAP education.
D. Respiratory therapist: A respiratory therapist is responsible for providing education on the use of BiPAP, as they are specialists in respiratory equipment and therapy. They ensure that the client knows how to use the machine properly at home.