Nokea
A nurse is planning discharge needs to a family whose baby has just been born. Which statement is the most accurate regarding care of the umbilical cord?
- A. Wash the newborn every day in a shallow tub of water.
- B. Rinse the umbilical cord with water and soap until it falls off.
- C. Notify the practitioner if the umbilical cord is still in place after 1 week.
- D. Swab the umbilical cord with alcohol or water daily until it falls off.
Correct Answer: D
Rationale: The correct answer is D. Swabbing the umbilical cord with alcohol or water daily until it falls off is the recommended care to prevent infection. Alcohol helps dry out the cord stump, promoting faster healing.
- A: Washing the newborn every day in water can introduce bacteria and moisture to the cord, increasing infection risk.
- B: Using soap on the umbilical cord can irritate the skin and delay healing.
- C: It's normal for the umbilical cord to fall off within 1-2 weeks, so there's no need to notify the practitioner unless there are signs of infection.
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The nurse is assessing a newborn girl born at 40 weeks of gestation based on the parent’s LMP. What assessment finding of the genitalia confirms this gestational age?
- A. labia majora covering clitoris and labia minora
- B. clitoris prominent, labia minora enlarged
- C. small labia minora, clitoris enlarged
- D. labia majora enlarged, labia minora small
Correct Answer: A
Rationale: In full-term female infants, the labia majora typically cover the clitoris and labia minora.
The nurse is assisting a newborn's primary care provider with the performance of a circumcision. Which intervention is used to manage the neonate's pain?
- A. A Velcro tourniquet is loosely wrapped around the penis.
- B. The neonate is breastfed first to promote a sense of calmness.
- C. A sucrose-dipped pacifier is offered during the nerve block.
- D. The foreskin is numbed with ice before the nerve block.
Correct Answer: C
Rationale: The correct answer is C because offering a sucrose-dipped pacifier during the nerve block procedure can help manage the newborn's pain by providing comfort and distraction through the sweet taste and sucking motion. Sucrose has been shown to have analgesic effects in newborns. Choice A is incorrect as a tourniquet is not recommended for circumcision. Choice B may help with calming but not specifically with pain management. Choice D is incorrect as numbing with ice before the nerve block may not be effective in providing adequate pain relief during the procedure.
A maculopapular rash with a red base and a small white papule in the center is commonly known as
- A. milia.
- B. Mongolian spots.
- C. erythema toxicum.
- D. CafÃ-au-lait spots.
Correct Answer: C
Rationale: The correct answer is C: erythema toxicum. This rash is characterized by red macules with small white papules in the center. Erythema toxicum is a common benign rash in newborns, usually appearing in the first few days of life. Milia (A) are tiny white bumps on the skin, Mongolian spots (B) are blue-gray birthmarks, and Café-au-lait spots (D) are flat, light brown spots. In this case, the description of a maculopapular rash with a red base and a small white papule matches the characteristics of erythema toxicum, making it the correct choice.
The labor and delivery nurse understands that some neonates spontaneously take a breath once the head and chest is delivered. Which understanding does the nurse have for the neonate that requires chemical stimuli to breathe?
- A. Oxygen is applied immediately to start respirations.
- B. Carbon dioxide is administered in small doses.
- C. Mild hypoxia and decreased pH stimulates the brain.
- D. Suctioning is used to stimulate breathing efforts.
Correct Answer: C
Rationale: Step 1: Mild hypoxia and decreased pH stimulate the brain to initiate breathing in neonates.
Step 2: This chemical stimuli trigger the respiratory centers in the brainstem.
Step 3: Oxygen administration may not be necessary as the neonate's own respiratory drive is initiated by chemical stimuli.
Step 4: Carbon dioxide administration is not needed as high levels can be harmful.
Step 5: Suctioning is not used to stimulate breathing but to clear airways if necessary.
Summary: Choice C is correct as it aligns with the physiological response of neonates to chemical stimuli for breathing, while the other choices are not relevant or could be potentially harmful.
What steps are included in the QSEN steps for rewarming a neonate at risk for cold stress? Select all that apply.
- A. placing the neonate under the radiant warmer
- B. putting a pulse oximeter on the neonate
- C. assessing a blood glucose level
- D. calling the NICU team for assessment
Correct Answer: A
Rationale: Steps include placing the neonate under a radiant warmer and assessing blood glucose levels.