Nokea
A postpartum nurse is giving guidance to a mother whose breast-fed newborn is experiencing hyperbilirubinemia. What are the best instructions for the nurse to give the mother in this case?
- A. It is best for the infant if she stops breast-feeding and switches to bottle-feeding permanently.
- B. The mother should switch to bottle-feeding until the baby’s bilirubin returns to normal range.
- C. The mother should alternate breast-feeding and bottle-feeding to ensure adequate fluid intake, until the baby’s bilirubin returns to normal range.
- D. The mother should continue to breast-feed the infant every 2 to 3 hours or more frequently as tolerated (every 2 hours if under phototherapy).
Correct Answer: D
Rationale: Continued frequent breastfeeding helps reduce bilirubin levels effectively.
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How can the nurse be culturally sensitive after a neonatal death?
- A. Call a priest for all families during this time of grief.
- B. Recognize that most religions have traditions surrounding death.
- C. Encourage families to have an open casket to help them deal with the death.
- D. Discuss cremation, as it is the best process for a neonatal death.
Correct Answer: B
Rationale: Recognizing religious traditions acknowledges cultural diversity and respects individual beliefs. Imposing specific practices, such as calling a priest or promoting cremation, disregards personal preferences and cultural norms.
A neonate has difficulty maintaining a normal temperature. A student nurse prepares to place the infant under a radiant warmer. What action by the student leads the faculty member to intervene?
- A. Assesses the surrounding area for drafts
- B. Ensures the infant is dried off completely
- C. Observes the respiratory rate at the same time
- D. Wraps the baby in a warmed blanket
Correct Answer: D
Rationale: Radiant heater units warm only the outer surface of objects in them so it is counterproductive to dress the baby or cover the baby with blankets. The other actions are appropriate.
The newborn is having occasional gasping respirations with a heart rate of 90 beats per minute. Skin color is cyanotic with poor muscle tone. Interpreting relevant clinical data in this scenario, what problems are possible? Select all that apply.
- A. The newborn is hypothermic.
- B. The newborn is full term.
- C. The newborn is experiencing respiratory distress.
- D. The newborn is anemic.
Correct Answer: A
Rationale: Gasping respirations, cyanosis, and poor tone suggest respiratory distress and potential hypothermia.
What characteristics are directly related to the newborn's decreased ability to maintain thermal stability?
- A. A neonate has decreased subcutaneous fat and a large body surface-to-weight ratio.
- B. The blood vessels in the neonate are farther from the skin than those of an adult.
- C. Newborns are unable to rely on brown adipose tissue for heat production.
- D. The newborn prefers to be in constant motion, increasing the surface area exposed to the environment.
Correct Answer: A
Rationale: Step-by-step rationale:
1. Subcutaneous fat provides insulation, so decreased fat leads to heat loss.
2. A larger body surface-to-weight ratio means more heat loss through the skin.
3. Both factors contribute to the newborn's decreased ability to maintain thermal stability.
4. Blood vessels being farther from the skin (choice B) does not impact thermal stability directly.
5. Brown adipose tissue (choice C) is actually important for heat production in newborns.
6. Constant motion (choice D) may increase heat loss but is not a primary factor in thermal stability for newborns.
What is the proper method for cleaning the bulb syringe?
- A. Boil the syringe after each use
- B. Microwave in warm water for 1 minute after use
- C. Wash in warm soapy water daily or after each use
- D. Wipe with alcohol prep each day and after each use
Correct Answer: C
Rationale: The correct answer is C: Wash in warm soapy water daily or after each use. This method is recommended as it effectively removes any residue, dirt, or bacteria from the bulb syringe. Cleaning the syringe daily or after each use helps prevent the growth of harmful bacteria and ensures it remains hygienic for future use. Boiling the syringe (choice A) may damage the materials and is not necessary after every use. Microwaving in warm water (choice B) may not effectively clean the syringe. Wiping with alcohol prep (choice D) may not be sufficient to remove all contaminants.