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 C
Explanation
A. Provide prophylactic antibiotics for clients who have been exposed to influenza: Antibiotics are not effective against viral infections like influenza. Antiviral medications may be used for prophylaxis in exposed individuals.
B. Assign health care personnel to non-direct care activities for 24 hr after developing influenza symptoms: Healthcare personnel should not provide care while symptomatic. The recommended restriction period is typically longer than 24 hours.
C. Place restrictions on visitation. During an influenza outbreak, limiting visitation can reduce the spread of infection, especially in vulnerable populations like those in long-term care facilities.
D. Implement airborne precautions for clients who have influenza: Influenza is spread through droplets, not airborne particles. Droplet precautions are appropriate.