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A nurse is discharging parents and their new infant. When assisting the family to place the infant in a car seat, which observation leads the nurse to reinforce teaching?
- A. The baby is wearing a sack-type sleeper.
- B. The baby is wearing a single layer of clothes.
- C. The parent checks the temperature of the car seat.
- D. A rear-facing car seat is in the back seat.
Correct Answer: A
Rationale: Sack-type sleepers are not recommended for wearing in a child safety seat because the straps may not fit properly. The other observations are appropriate.
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The nurse is caring for a patient who has been diagnosed as having a fetal death. The nurse is aware of the possible causes of intrapartum fetal death. How can the nurse explain the potential causes of IPFD to the patient?
- A. We will always find the cause of fetal death with an autopsy.
- B. Infection is never a cause of fetal death.
- C. Umbilical cord entanglement can cause fetal death.
- D. Congenital anomalies cause growth restriction, not fetal death.
Correct Answer: C
Rationale: Umbilical cord entanglement is a recognized cause of intrapartum fetal death (IPFD). While congenital anomalies may lead to complications, they are not typically direct causes of IPFD. Infections can also contribute to fetal death, making option B incorrect. Autopsies help identify causes but do not guarantee definitive answers, so A is incorrect.
The nurse is receiving shift report on her mother-baby couplet assignment. Which infant should the nurse evaluate first?
- A. 38-weeks' gestation female newborn with a blood sugar level of 60 mg/dL
- B. Term male newborn with a noted axillary temperature of 37.2°C (99°F)
- C. 40-weeks' gestation female newborn with reported poor feed at last attempt
- D. 39-weeks' gestation male newborn who has been crying prior to initial bath
Correct Answer: C
Rationale: The correct answer is C, to evaluate the 40-weeks' gestation female newborn with reported poor feed at the last attempt first. This choice should be prioritized as poor feeding in a newborn can be a sign of potential serious issues such as inadequate nutrition, dehydration, or underlying medical conditions. Addressing this concern promptly is crucial for the infant's well-being.
Option A can be considered as the blood sugar level of 60 mg/dL in the 38-weeks' gestation female newborn is slightly low, but it is not an immediate priority compared to poor feeding. Option B's axillary temperature of 37.2°C is within the normal range for a newborn, so it can be assessed after addressing the concern of poor feeding. Option D, a 39-weeks' gestation male newborn crying prior to the initial bath, can also be evaluated after addressing the more urgent issue of poor feed.
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.
A nurse has just been asked to be the baby nurse for a coworker who is working with a birthing woman at 35 weeks, 3 days. The patient has preeclampsia, has had a very hard labor with multiple decelerations on her fetal heart monitor, and her amniotic fluid had meconium when her water was broken earlier in the day. In anticipation of this birth, what resources will the nurse need to gather? Select all that apply.
- A. another baby nurse to help
- B. Neonatal Intensive Care team
- C. radiant warmer for the newborn
- D. intubation kit
Correct Answer: B
Rationale: Given the complications, additional support, NICU readiness, warming equipment, and airway management tools are necessary.
The most effective time to initiate breast-feeding is in which stage of reactivity for the neonate?
- A. period of decreased reactivity
- B. first period of reactivity
- C. second period of reactivity
- D. after the end of the second period of reactivity
Correct Answer: B
Rationale: The first period of reactivity is optimal for initiating breastfeeding due to the newborn's alertness.