The position contraindicated for a child after cleft lip surgery is?

Appeared in: KPSC Staff Nurse - 2015

Explanation

The primary goal after cleft lip surgery is to protect the suture line from pressure and trauma.
The prone (on the stomach) position causes the infant's repaired lip to rub against the bedding.
This friction can lead to suture dehiscence (opening of the wound), bleeding, and infection.
This position also makes it difficult to monitor the infant for respiratory distress or bleeding from the surgical site.
General guidelines for patient positioning list maxillofacial surgery as a contraindication for the prone position.

Option A: The supine (on the back) position is a recommended and safe position after cleft lip surgery.
Option C: The right lateral (side-lying) position is an acceptable position after cleft lip surgery.
Option D: The left lateral (side-lying) position is also an acceptable position after cleft lip surgery.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Postoperative positioning following cleft lip repair (cheiloplasty) as background academic context rather than a clinical decision trigger.
The cornerstone of post-cheiloplasty nursing care is protecting the integrity of the suture line to ensure the best cosmetic and functional outcome.
Nurses must also focus on maintaining a patent airway, providing adequate pain relief, and ensuring proper nutrition while avoiding stress on the repair.
Elbow restraints are a critical safety measure to prevent the infant from inadvertently touching or scratching the surgical site.

How to Approach the Question

First, identify the key procedure in the question: cleft lip surgery.
Next, determine the primary goal of postoperative care for this procedure. The main priority is to protect the fresh suture line on the lip.
Evaluate each position based on this goal. Ask yourself: 'Does this position put pressure on or risk trauma to the lip?'
The supine and lateral positions keep the lip away from the bed surface.
The prone position places the infant's face directly on the mattress, causing pressure and friction on the lip.
Therefore, the prone position is the one that is contraindicated (forbidden).

Concept Tested & Keywords

Concept Tested: Postoperative positioning following cleft lip repair (cheiloplasty).
Stem keywords: cleft lip surgery, child, position, contraindicated
Lead-in keywords: contraindicated
Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Negative lead-in flag: false

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E6 Nursing Fundamentals Potter Perry 12e Part 4 p. 155-157

Practise the full KPSC Staff Nurse - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.