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    Ati pn paediatrics nursing proctored exam 2023

    A nurse is caring for an infant who is postoperative following repair of a cleft palate. Which of the following is an appropriate action by the nurse?

    Explanation & Rationale

    A. Apply elbow immobilizers to both arms is correct. Elbow immobilizers are used to prevent the infant from putting their hands to their mouth, which could disrupt the healing of the surgical site. This is a common practice following cleft palate surgery. B. Offer a pacifier with glucose syrup is incorrect. Offering a pacifier with glucose syrup is not appropriate, as it could cause harm to the surgical site. The infant should not be allowed to suck on objects that could interfere with healing. C. Gently cleanse the surgical site with sterile gauze is incorrect. The surgical site should not be cleansed immediately postoperatively unless directed by the provider. Typically, the area is left to heal undisturbed, and cleaning is done with specific guidelines. D. Place the infant in a supine position is incorrect. While supine positioning is important for infants to prevent sudden infant death syndrome (SIDS), following cleft palate surgery, the infant may need to be placed in an upright position to avoid putting pressure on the surgical site and to reduce the risk of aspiration.

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