Certified Pediatric Nurse (CPN)

What is the highest priority intervention for an infant scheduled for cleft lip repair postoperatively?

1. A. Comforting the child as quickly as possible

2. B. Maintaining the child in a prone position

3. C. Restraining the child's arms using elbow restraints or swaddling

4. D. Avoiding disturbing any crusts that form on the suture line

The correct answer is: C. Restraining the child's arms using elbow restraints or swaddling

The highest priority intervention for an infant scheduled for cleft lip repair postoperatively is the need to restrain the child's arms using elbow restraints or swaddling. This measure is crucial to prevent the infant from inadvertently disrupting the surgical site. After a cleft lip repair, it is vital for the healing process that the suture line remains undisturbed to ensure proper healing and minimize complications such as dehiscence or infection. While comforting the child is important for emotional support, it does not address the immediate physical risk to the surgical site. Maintaining the child in a prone position may not be appropriate since this could compromise the surgical area and lead to injury, as the lip may need to be protected from contact with surfaces. Additionally, while avoiding disturbance of crusts is necessary for healing, it is secondary to the more urgent need to keep the infant’s arms restrained to prevent movements that could risk the integrity of the sutures. Thus, the priority focuses on physical protection of the surgical site, making the use of restraints essential in the postoperative care of infants following cleft lip repair.