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A nurse is reviewing the laboratory results of a newborn. Which of the following findings should the nurse report to the provider?
- A. Blood glucose 58 mg / DL
- B. Hematocrit 48%
- C. Platelets 100,000/ mm 3
- D. Hemoglobin 16 G / DL
Correct Answer: C
Rationale: The correct answer is C: Platelets 100,000/mm3. This finding is abnormal in a newborn and could indicate a potential bleeding disorder or thrombocytopenia, which requires immediate attention from the provider to assess and manage appropriately. Choice A (Blood glucose 58 mg/dL) is within normal range for a newborn. Choice B (Hematocrit 48%) and D (Hemoglobin 16 g/dL) are also within normal limits for a newborn and do not require immediate reporting.
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A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client which of the following vaccinations? Select all the apply
- A. Varicella
- B. human papillomavirus
- C. Diphtheria - acellular pertussis
- D. inactivated influenza
- E. measles, mumps, and rubella
Correct Answer: C,D
Rationale: The correct answers are C (Diphtheria - acellular pertussis) and D (inactivated influenza) for a client at 30 weeks gestation. These vaccines are safe during pregnancy and provide protection to both the mother and the developing fetus. Diphtheria and pertussis can cause severe complications for newborns, so vaccinating the mother during pregnancy helps pass on immunity. Influenza vaccination is recommended to reduce the risk of severe illness in pregnant women and their babies. Choices A, B, and E are contraindicated during pregnancy due to potential harm to the fetus.
A client who is 16 weeks of gestation asks the nurse how to prepare her father to a younger sibling. Statements should the nurse make?
- A. You should hold your newborn in your arms when you introduce him to your toddler
- B. You should give your toddler a gift from the baby when she visits
- C. You should move your toddler out of her crib 2 weeks prior to your due date
- D. You should place your toddler in timeout if she exhibits regressive Behavior after the baby is born
Correct Answer: B
Rationale: Correct Answer: B - You should give your toddler a gift from the baby when she visits.
Rationale: Giving a gift from the baby to the toddler helps create a positive association and bond between the siblings from the beginning. It can also help the toddler feel special and included in the new family dynamic. This gesture can promote a sense of love and acceptance, easing the transition for both the toddler and the newborn.
Incorrect Choices:
A: Holding the newborn when introducing to the toddler may cause the toddler to feel overwhelmed or jealous.
C: Moving the toddler out of her crib close to the due date may disrupt her routine and lead to feelings of insecurity.
D: Placing the toddler in timeout for regressive behavior can create negative associations with the new sibling and cause emotional distress.
A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?
- A. Expect 2 to 4 wet diapers every 24 hours
- B. Allow the baby to feed at least every 3 hours
- C. Offer the newborn 30 ml (1 oz.) a water between feedings
- D. Feed the newborn 5 to 10 minutes per breast
Correct Answer: B
Rationale: Correct Answer: B - Allow the baby to feed at least every 3 hours.
Rationale:
1. Breastfeeding frequency is crucial for establishing a good milk supply and ensuring the baby receives adequate nutrition.
2. Newborns typically need to breastfeed at least 8-12 times in 24 hours to meet their nutritional needs.
3. Feeding every 3 hours helps maintain the baby's hydration, energy levels, and growth.
4. Regular feeding also helps prevent issues like engorgement for the mother and ensures the baby gets enough hindmilk for proper growth.
Summary of Incorrect Choices:
A: Wet diapers may vary, but newborns should ideally have 8-12 wet diapers a day.
C: Offering water between feedings is unnecessary and may fill up the baby's stomach, reducing milk intake.
D: Limiting feeding time per breast may not allow the baby to get enough hindmilk, essential for growth and development.
A nurse is assessing a newborn whose mother had a primary cytomegalovirus (CMV) infection during pregnancy. The newborn acquired CMV trans placenta Lee. Which of the following findings should the nurse expect the newborn to exhibit?
- A. Urinary tract infection
- B. Hearing loss
- C. Macrosomia
- D. Cataracts
Correct Answer: B
Rationale: The correct answer is B: Hearing loss. CMV infection during pregnancy can lead to congenital CMV in the newborn, causing sensorineural hearing loss. This occurs as the virus affects the inner ear structures. Urinary tract infection (A), macrosomia (C), and cataracts (D) are not typically associated with congenital CMV infection. The nurse should monitor the newborn's hearing closely and consider early intervention if hearing loss is detected.
A nurse is planning care for a newborn who is scheduled to start phototherapy using a lap. Which of the following actions should the nurse include?
- A. Apply a thin layer lotion to the newborn skin every 8 hours
- B. Trust in you born in a thin layer clothing during the therapy
- C. Ensure the newborn's eyes are closed beneath the shield
- D. Give the newborn 1 oz of glucose water every 4 hours
Correct Answer: C
Rationale: The correct answer is C: Ensure the newborn's eyes are closed beneath the shield. This is crucial during phototherapy to protect the newborn's eyes from potential damage caused by the bright lights. Newborns undergoing phototherapy should have their eyes shielded with protective eye coverings to prevent eye damage. Choice A is incorrect as lotion can intensify the effects of phototherapy. Choice B is incorrect as the newborn should be undressed to maximize skin exposure. Choice D is incorrect as glucose water is not indicated for phototherapy and may interfere with treatment.