Nokea
A new mother is preparing for discharge. She plans on bottle feeding her baby. Which statement indicates to the nurse that the mom needs more information about bottle feeding?
- A. I should encourage my baby to consume the entire amount of formula prepared for each feeding.'
- B. I can make up a 24-hour supply of formula and refrigerate the bottles so I am ready to feed my baby.'
- C. I will hold my baby in a cradle hold and alternate sides from left to right when I feed my baby.'
- D. I will generally feed my baby every 3 to 4 hours or more often as signs of hunger are displayed.'
Correct Answer: A
Rationale: The correct answer is A because it indicates a lack of understanding about infant feeding cues and responsive feeding. Encouraging a baby to consume the entire prepared amount can lead to overfeeding and disregards the baby's hunger and satiety cues. This approach may result in the baby being forced to finish the bottle, leading to potential issues such as obesity or feeding difficulties.
Choice B may seem convenient but is not recommended as formula should be prepared fresh to avoid bacterial contamination. Choice C describes a suitable feeding position but is not a crucial indicator of needing more information. Choice D reflects a good understanding of feeding frequency based on hunger cues, which aligns with responsive feeding practices.
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Developing a plan to achieve patient outcomes is included in which step of the CJMM?
- A. prioritizing hypotheses
- B. generating solutions
- C. taking action
- D. evaluating outcomes
Correct Answer: B
Rationale: Generating solutions involves creating strategies to address identified problems, which includes developing plans to achieve desired patient outcomes.
Upon assessment, the RN notices that the newborn remains red at rest. Which laboratory value is most important for the nurse to evaluate?
- A. Glucose
- B. Bilirubin
- C. Sodium
- D. Hematocrit
Correct Answer: D
Rationale: The correct answer is D: Hematocrit. A red newborn at rest may indicate polycythemia, which increases the risk of hyperviscosity and complications. Hematocrit measures the percentage of red blood cells in the blood, so evaluating it can help determine if the newborn has polycythemia. Glucose (A) is important but not directly related to the newborn's redness. Bilirubin (B) is crucial for evaluating jaundice, not redness. Sodium (C) levels are not typically associated with a red newborn at rest.
A woman who has just delivered has decided to bottle feed her full term infant. Which of the following should be included in the patient teaching?
- A. It is best to heat the baby’s bottle in the microwave before feeding.
- B. You should prepare enough bottles for 24 hours of feedings.
- C. The bottle nipples should be enlarged to ease the baby’s sucking.
- D. The baby’s stools will appear bright yellow and will have a smell similar to sour milk.
Correct Answer: B
Rationale: Preparing enough bottles for 24 hours ensures convenience and hygiene. Microwaving can create hot spots, and enlarged nipples are unnecessary.
Postnatal nurses expressed concern about neonatal pain management during painful interventions. Using evidence-based practice from research performed by Thakkar, Arora, Das, Javadekar, and Panigrahi (2016), which method of pain control will be used for heel sticks?
- A. An anesthetic gel will be applied 20 minutes before the stick.
- B. The stick will be administered while the neonate is breastfeeding.
- C. A combination of stimulated sucking and receiving sucrose orally.
- D. The neonate is stuck while the mother and neonate are en face.
Correct Answer: C
Rationale: The correct answer is C, a combination of stimulated sucking and receiving sucrose orally. Thakkar et al. (2016) found that this method effectively reduced pain response during heel sticks in neonates. Stimulated sucking triggers the release of endorphins, providing natural pain relief, while sucrose activates sweet taste receptors, further reducing pain perception. This dual approach addresses both physiological and psychological aspects of pain management in neonates.
Choice A (anesthetic gel) may not be as effective for heel sticks as it takes time to work and may not provide comprehensive pain relief. Choice B (breastfeeding) may distract the neonate but does not directly address pain management. Choice D (en face positioning) may promote bonding but does not offer a specific pain management strategy. Overall, choice C is supported by research and provides a holistic approach to neonatal pain control during heel sticks.
The nurse is assigned to the room of a 15-year-old person who gave birth to a newborn 72 hours ago. Why is this newborn a perfect candidate for the Brazelton assessment?
- A. This parent-newborn couplet is at risk for delayed attachment.
- B. The newborn is likely going home soon.
- C. The EHR is prompting her to do so.
- D. The infant is likely withdrawing from a substance.
Correct Answer: A
Rationale: The correct answer is A because the Brazelton assessment is used to evaluate the newborn's neurobehavioral development and ability to interact with the environment. In this case, the 15-year-old parent may be at risk for delayed attachment due to her age and the circumstances of giving birth. The assessment can help identify any issues early on and provide appropriate interventions.
Choice B is incorrect because the timing of when the newborn is going home is not relevant to the Brazelton assessment. Choice C is incorrect as the Electronic Health Record (EHR) prompting is not a valid reason to conduct the assessment. Choice D is incorrect as there is no indication that the infant is withdrawing from a substance.