Author Question: A child is going home with a distractor in place after surgery to repair syndactyly. Which discharge ... (Read 43 times)

viki · **on:** Jun 28, 2018

A child is going home with a distractor in place after surgery to repair syndactyly. Which discharge teaching is most important?

A.
Clean around the pin sites twice a day with soap and water.
B.
Don't pull the pins; they will gradually fall out on their own.
C.
Perform range-of-motion exercises to the affected fingers daily.
D.
Turn the screw with the Allen wrench twice a day for a week.

Question 2

A 4-year-old child is recovering from a modified Nuss procedure. Which is the priority intervention by the nurse?

A.
Ambulating the child as soon as allowed
B.
Encouraging food and fluids postoperatively
C.
Monitoring vital signs and wound drainage
D.
Playing with the child using pinwheels or bubbles

Athena23 · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

ANS: A
The distractor uses pins placed in the bone fragments that extend through the skin. The parents need to care for the pins using soap and water to clean around the exit sites. The pins need to be removed surgically; they will not fall out on their own. Because the bones are pinned, range of motion is not possible. The Allen wrench is used to turn the screw on the distractor twice a week.

Answer to Question 2

ANS: D
The modified Nuss procedure is an open chest reconstruction for severe cases of pectus excavatum. Preventing pneumonia is a critical nursing action. Because this child is too young to use an incentive spirometer, playing with him or her using bubbles, pinwheels, or paper triangles the child can blow across the table accomplishes pulmonary hygiene. The other activities are important postoperative nursing interventions, but are not specific to this operation.