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    Obstetricspediatrics proctored exam

    The nurse is discussing discharge instructions with the parents of a 6-year-old who had a tonsillectomy. What is the most important thing to stress?

    Explanation & Rationale

    A. Administer analgesics: Pain control is essential after a tonsillectomy to promote oral intake and comfort. Analgesics reduce throat discomfort and help the child maintain hydration and nutrition, but they do not directly prevent life-threatening complications such as postoperative hemorrhage. B. Encourage the child to drink liquids: Hydration supports mucosal healing and prevents dehydration, which is a common postoperative concern. However, while encouraging fluid intake is important, it does not directly address the risk of sudden, severe bleeding that can occur after tonsillectomy. C. Inspect the throat for bleeding: Post-tonsillectomy hemorrhage is the most serious complication, especially within the first 24 hours and around 5–10 days post-surgery when the scabs begin to slough. Careful observation for signs of active bleeding, such as frequent swallowing, vomiting blood, or fresh blood in the mouth, is critical to detect hemorrhage early. D. Apply an ice collar: Ice collars can reduce local swelling and provide comfort by constricting blood vessels, helping with pain control. Although beneficial, this intervention does not address the immediate danger posed by postoperative bleeding and is secondary to monitoring for hemorrhage.

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