# Situation: A nurse on the pediatric ward cares for children with congenital and developmental conditions and supports their families. A 12-month-old has just had a cleft palate repair. Before discharge, which statement by the mother shows the BEST understanding of home care?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=629647  
> language: ko  
> subject: Nursing Practice II — Maternal and Child Health Nursing

## 문제

Situation: A nurse on the pediatric ward cares for children with congenital and developmental conditions and supports their families.

A 12-month-old has just had a cleft palate repair. Before discharge, which statement by the mother shows the BEST understanding of home care?

## 보기

1. "I'll give him water after feeds to rinse his palate." **✔ 정답**
2. "I'll feed him soft porridge with a small, rounded spoon."
3. "I'll let him have his pacifier only when he falls asleep."
4. "I'll give him his drinks through a short, soft straw."

**정답: 1**

## 해설

After palatoplasty nothing is placed in the mouth that can strike the suture line — no straws, spoons, forks, pacifiers, or hard-spouted cups — even if soft or used briefly. Fluids are given from an open cup or by the method the surgeon specifies, and water after feeds rinses food from the palate.

## 심화 해설

The statement that shows good understanding
After cleft palate repair (palatoplasty), the main goal of home care is to protect the suture line on the roof of the mouth while it heals. Food particles left on the palate can promote infection and irritation. Giving water after feeds rinses food from the palate and keeps the repair clean. The mother who says she will give water after feeds to rinse the palate shows the best understanding of home care.

Nothing in the mouth that can strike the repair
After palatoplasty, nothing is placed in the mouth that can hit the suture line. This includes straws, spoons, forks, pacifiers, and hard-spouted cups, even if they are soft or used only briefly. Fluids are given from an open cup or by the method the surgeon specifies. Elbow restraints may be used for a time so the child cannot put hands or toys in the mouth, and the child is given soft toys without sharp edges.

Why the other statements show misunderstanding

| Statement | Problem |
| --- | --- |
| Soft porridge with a small, rounded spoon | Any spoon enters the mouth and can strike the palate repair |
| Pacifier only when he falls asleep | Pacifiers are not allowed at any time after palate repair |
| Drinks through a short, soft straw | A straw enters the mouth, and sucking can damage the repair |
| Water after feeds to rinse the palate | Correct: keeps the suture line clean |

Watch out! The distractors use softening words such as small, rounded, short, soft, and only when he falls asleep. These make the actions sound safe, but the rule is about whether the object enters the mouth, not about how gentle it seems. For cleft lip repair, the concern is different: the external lip suture line is protected from tension and rubbing, and the infant may be fed with special devices. Do not mix the two sets of rules.

Other home care teaching
The nurse teaches the mother to offer soft or blended foods as the surgeon directs, to watch for bleeding, fever, foul breath, or poor intake, and to keep follow-up appointments. Children with cleft palate are at higher risk of middle ear infections and speech problems, so hearing checks and speech therapy are part of long-term care.

Exam takeaway
After cleft palate repair, keep the suture line clean with water after feeds and place nothing in the mouth that can strike it. Key point! Straws, spoons, forks, pacifiers, and hard-spouted cups are all avoided, regardless of size or softness.

## 임상 시나리오

Home Care After Cleft Palate Repair12-month-old after palatoplasty
Rinse the palate with water after feeds to keep the suture line clean.

Place nothing in the mouth that can strike the repair: no straws, spoons, forks, pacifiers, or hard-spouted cups.

Give fluids from an open cup or as the surgeon directs, and watch for bleeding, fever, foul breath, or poor intake.

CautionSoft or small versions of straws, spoons, or pacifiers are still unsafe after palate repair.

## 핵심 개념

- **Palatoplasty** — Surgical repair of a cleft palate, usually done in the first year or so of life.
- **Suture line** — The line of stitches closing a surgical wound, which must be protected while it heals.
- **Cleft palate** — A congenital opening in the roof of the mouth from incomplete fusion of the palate.
- **Elbow restraints** — Soft splints that keep a child's elbows straight so the hands cannot reach the mouth.

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