RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Child Health Nursing (Pediatrics)
Medium
When feeding an 18-month-old child two days after he underwent a cleft palates repair, a nurse would offer liquid nutrition using a?
Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Explanation
- An open cup is the safest method for providing liquids after cleft palate surgery.
- This method prevents the creation of suction (negative pressure) in the mouth, which could stress and damage the fresh suture line on the palate.
- Using a cup avoids inserting any foreign objects like spoons or straws that could cause direct physical trauma to the surgical site.
- An 18-month-old child is developmentally able to drink from an open cup, making it a practical and safe choice.
Why Other Options Were Wrong
- Option B: A nasogastric tube is an invasive feeding method and is not the standard of care for routine post-operative feeding. It is reserved for infants or children who are unable to take adequate nutrition orally.
- Option C: Using a straw is strictly contraindicated after cleft palate repair. The sucking action required to use a straw creates negative pressure in the oral cavity, which can pull on the sutures and cause the repair to fail.
- Option D: Any type of spoon, even if rubber-coated, should be avoided. It can cause accidental trauma to the delicate suture line if the child moves suddenly or bites down. Post-operative care instructions explicitly state to keep spoons away from the child.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing Postoperative feeding techniques following cleft palate repair (palatoplasty) in a toddler in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- The primary nursing responsibility after cleft palate repair is to protect the integrity of the surgical site to ensure a successful outcome and prevent complications like an oronasal fistula (a hole between the mouth and nose).
- Patient and family education is critical. The nurse must clearly instruct caregivers on proper feeding techniques and what to avoid (suction, hard objects) to ensure compliance at home.
- What if the patient was a 3-month-old infant instead of an 18-month-old? The principle of avoiding suction remains, but the method would change. A 3-month-old cannot use an open cup. A specialized feeder, like a Haberman feeder or a syringe with a soft extension, which does not require suction, would be used.
How to Approach the Question
- First, identify the core of the question: selecting a safe feeding method after a specific surgery (cleft palate repair).
- Recall the anatomy and physiology of the procedure. The palate has a fresh suture line that is fragile.
- Identify the primary risks to this suture line: suction (negative pressure) and direct trauma from foreign objects.
- Evaluate each option against these two risks:
- Does it create suction? (Straws, bottles do).
- Does it risk physical trauma? (Spoons, hard objects do).
Concept Tested & Keywords
- Concept Tested: Postoperative feeding techniques following cleft palate repair (palatoplasty) in a toddler.
- Stem keywords: 18-month-old child, cleft palate repair, feeding, liquid nutrition
- Lead-in keywords: offer liquid nutrition using a
- Clinical cues: The patient is 2 days post-op from a cleft palate repair, a critical period for suture line healing.
Question ID
QOCnFfPvz77ivYpsIyt-OL
Reference Book
E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 2 (pp 239-476 of 713) p. 156-158
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 480-482
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 203-205
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