The nurse is giving discharge instructions to the parent of a 1-month-old infant with tracheoesophageal fistula and a gastrostomy tube (GT). The nurse knows the mother understands the discharge teaching when she states:

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: 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.

Correct Answer: A

Rationale: The correct answer is A) A palliative procedure in which the bile duct is attached to a loop of bowel to assist with bile drainage. In pediatric patients with biliary atresia, the Kasai procedure is performed to establish bile flow by connecting the liver directly to the intestine. This is a palliative procedure, not curative, as it helps improve bile drainage but does not completely resolve the underlying issue. Option B is incorrect because the Kasai procedure is not curative; it is performed to improve bile drainage but does not completely fix the underlying problem. Option C is incorrect as the procedure does not involve banding the bile duct but rather attaching it to a loop of bowel. Option D is also incorrect as banding is not part of the Kasai procedure. Educationally, understanding the purpose and limitations of the Kasai procedure is crucial for nursing students and healthcare providers caring for pediatric patients with biliary atresia. Knowing the correct description of the procedure helps in providing accurate patient education and support to families undergoing this intervention.

Correct Answer: A

Rationale: The correct answer is A) Allow the infant to have familiar items of comfort (e.g., favorite stuffed animal) and a 'sippy' cup. Rationale: After cleft palate repair, it is essential to provide comfort to the child as they may be irritable due to postoperative pain and discomfort. Allowing familiar items like a stuffed animal and a 'sippy' cup can provide emotional support and familiarity, which can help in reducing anxiety and promoting healing. Option B is incorrect because immediately after cleft palate repair, the child should not be given solid foods like soup, Jell-O, or saltine crackers. It is crucial to start with clear fluids and gradually progress to soft, easily digestible foods as tolerated. Option C is incorrect as elbow restraints are typically used postoperatively to prevent the child from touching or traumatizing the surgical site. They should only be removed as per the surgeon's instructions. Option D is incorrect because using a Yankauer suction catheter in the mouth can disrupt the healing process and increase the risk of trauma to the surgical site. Suctioning should be done cautiously and as per the healthcare provider's orders to prevent complications. Educational Context: Understanding the specific care needs of a child after cleft palate repair is crucial for pediatric nurses. Providing appropriate postoperative care, including comfort measures and diet modifications, is essential to ensure optimal recovery and prevent complications. Nurses must be knowledgeable about the correct interventions to promote the child's comfort and well-being during the postoperative period.