A nurse is contributing to the plan of care of a 14-month-old toddler who is 24 hours postoperative following a cleft palate repair. Which of the following interventions should the nurse include in the plan?

Choice A rationale Elbow restraints (or 'no-no' restraints) are critical to prevent the toddler from placing their fingers, hands, or foreign objects into their mouth. Postoperative care for a cleft palate repair focuses on protecting the delicate surgical site from trauma, as mechanical stress or contamination can lead to dehiscence (surgical wound separation) or infection, compromising the success of the repair and potentially necessitating further surgery. The restraints must be applied consistently and correctly, with regular neurovascular checks. Choice B rationale Suctioning the nose and mouth can potentially cause trauma to the surgical site, introducing a high risk of damaging the newly repaired palate tissue, which is fragile. Secretions are best managed by positioning (e.g., side-lying or on the abdomen immediately post-op) and gentle wiping of the lips, allowing gravity and gentle oral hygiene to clear secretions. Suctioning should be avoided unless absolutely necessary for an airway obstruction, and then it must be done with extreme caution. Choice C rationale Soft foods still require mastication and may put undue pressure or stress on the newly repaired palate. For a 14-month-old, the plan should typically involve a liquid diet only for the initial postoperative period, often followed by a gradual progression to a pureed diet, and then soft foods, usually several weeks post-surgery, to ensure the surgical site is completely protected during the crucial healing phase. Choice D rationale Hard-tipped sippy cups and straws should be strictly avoided as the rigid plastic tip or the sucking motion can exert direct mechanical force or shearing stress on the incision line. This direct trauma significantly increases the risk of damaging the sutures and causing dehiscence, which would impair healing. Fluids must be administered via a syringe, dropper, or soft-tipped cup to minimize contact and force on the palate.