The nurse is caring for a newborn with a cleft lip and palate. The mother states, 'I will not be able to breastfeed my baby.' Select the nurse's best response.

Correct Answer: C

Rationale: The best response for the nurse in this scenario is option C: "Although breastfeeding may be challenging, some mothers are able to breastfeed their infants with a cleft lip and palate. Let's discuss your options." This response is the most supportive and informative. It acknowledges the mother's concerns while also providing hope and encouragement. Option A is not the best response because it focuses more on the emotional aspect and does not provide accurate information or support. Option B is not ideal as it lacks reassurance and guidance, simply offering more information without addressing the mother's feelings. Option D is incorrect because it provides misleading information. While breastfeeding a baby with a cleft lip and palate can be challenging, it is still a viable option with proper support and guidance. In an educational context, it is crucial for nurses to provide accurate information, support, and encouragement to parents facing challenges such as caring for a newborn with a cleft lip and palate. Understanding the nuances of breastfeeding in this situation and being able to guide parents effectively can make a significant difference in their confidence and ability to care for their child.

Correct Answer: B

Rationale: The correct answer is B) "I will flush the GT with 2 ounces of water after each feeding to prevent it from clogging." This answer is correct because flushing the gastrostomy tube (GT) with water after feedings helps prevent clogging and ensures proper functioning of the tube, which is essential for delivering nutrition to the infant. Option A is incorrect because liquid medications should be administered through the GT to ensure proper delivery and absorption, rather than placing them in the corner of the mouth. Option C is incorrect as cleaning the area around the GT with soap and water every day may increase the risk of infection. The focus should be on maintaining cleanliness and proper care of the GT itself. Option D is incorrect because petroleum jelly should not be used around the GT if redness develops. It is important to consult healthcare providers for proper assessment and management of any skin issues around the GT. In an educational context, understanding the correct care and maintenance of a gastrostomy tube is crucial for parents and caregivers of infants with tracheoesophageal fistula. Proper education and demonstration of these care techniques by healthcare providers can help ensure the well-being and safety of the infant.

Correct Answer: D

Rationale: The correct answer is option D: "Your child will be very sleepy and have an intravenous line in the hand. If your child needs pain medication, we will give it intravenously." The correct response reflects the common postoperative experience for a child following an appendectomy. It accurately describes the expected state of the child in terms of being sleepy due to the effects of anesthesia and having an intravenous line for necessary medications. Option A is incorrect because it incorrectly mentions a nasal tube to drain the stomach, which is not typically part of post-appendectomy care in children. Option B is incorrect because it mentions white stockings to prevent blood clots, which are not typically used in pediatric patients after an appendectomy. Option C is incorrect because it states that the child will be wide awake, which is unlikely immediately after surgery due to the effects of anesthesia. In an educational context, it is crucial for nurses to accurately inform parents about what to expect postoperatively to alleviate their anxiety and ensure they understand the care their child is receiving. Providing clear and accurate information helps build trust between healthcare providers and families, leading to better outcomes for the child.

Correct Answer: C

Rationale: The correct response is C) Pedialyte is best. You might offer it in a spoon, medicine cup, or syringe to give your child a choice, which may help him take it. This response is the most appropriate because Pedialyte is specifically formulated to help replace lost fluids and electrolytes in cases of diarrhea and vomiting, which are common in pediatric gastrointestinal disorders. Offering it in different ways allows the child some autonomy in choosing how to take it, increasing the likelihood of compliance. Option A is incorrect because clear diet sodas like Sprite and ginger ale do not contain the necessary electrolytes and may even worsen dehydration due to their sugar content. Option B is incorrect because waiting for the child to drink Pedialyte when severely dehydrated is not a safe approach. Option D is incorrect as it overlooks the importance of using Pedialyte specifically in cases of dehydration. In an educational context, it is crucial for nurses to understand the appropriate management of pediatric gastrointestinal disorders, including dehydration. Providing parents with accurate information on the best fluids to offer their child can prevent further complications and promote optimal recovery. Nurses must prioritize evidence-based practices to ensure the best outcomes for pediatric patients.

Correct Answer: D

Rationale: The correct answer is D) The lip is repaired in the first few weeks of life, but the palate is not usually repaired until the child is about 18 months old. This answer is correct because cleft lip repair is typically done early on to promote proper feeding, while cleft palate repair is delayed to allow for more growth and development of the palate. Option A is incorrect because repairing both the lip and palate in the first few weeks of life is not the standard practice due to the need for allowing adequate growth before palate repair. Option B is incorrect as waiting until the baby is approximately 6 months old for both repairs is not typical and delays the lip repair, which is usually done earlier. Option C is incorrect as the lip repair usually occurs earlier than a few months, and waiting until the child is 3 years old for palate repair is too late and may impact speech development. In an educational context, it is important for nurses to understand the timing and rationale behind surgical interventions for cleft lip and palate to provide accurate information and support to families of affected newborns. Timely and appropriate interventions are crucial for optimal outcomes in these cases.