Nokea
A premature infant has been admitted to the NICU for both respiratory and nutritional support. When should the nurse begin discharge teaching to the family?
- A. after the infant has met goals of a mature breathing pattern and their percentile on the growth chart
- B. as the infant is extubated and transitioned to nasal cannula
- C. when the family shows interest in caring for their neonate independently
- D. as early as possible and throughout the admission
Correct Answer: D
Rationale: The correct answer is D because discharge teaching should start as early as possible and continue throughout the admission to ensure the family receives adequate education and support. Starting early allows for more time to address any concerns, teach necessary skills, and build confidence in caring for the premature infant. This approach promotes better outcomes for both the infant and the family.
Choice A is incorrect because waiting for the infant to meet specific goals may delay essential education and support for the family. Choice B is incorrect as it focuses on a specific medical intervention rather than comprehensive teaching. Choice C is incorrect because interest alone may not indicate readiness or understanding of the care required for a premature infant.
You may also like to solve these questions
The nurse is providing support to parents of a premature neonate in NICU. Which actions by the nurse will best provide psychosocial support to the parents? Select all that apply.
- A. Assess the parents’ ability to care for their neonate.
- B. Ask the parents how they are coping with the experience.
- C. Provide equipment for breast pumping and storage of milk.
- D. Provide equipment for breast pumping and storage of milk.
Correct Answer: B
Rationale: The correct answer is B. Asking the parents how they are coping with the experience is crucial for providing psychosocial support. This action shows empathy, encourages open communication, and helps the nurse understand the parents' emotional state. By actively listening, the nurse can offer appropriate support and resources.
Assessing the parents' ability to care for their neonate (Choice A) is important but does not directly address their psychosocial needs. Providing equipment for breast pumping and storage of milk (Choices C and D) is more focused on the physical aspects of care rather than the emotional support needed by the parents.
The nurse is present in the delivery room when a mother is told her neonate was stillborn. The mother begins to wail loudly and pull at her hair. Which action does the nurse take?
- A. Allow the mother to express grief in her own way.
- B. Attempt to calm the mother and prevent self-harm.
- C. Ask for a sedative to calm the mother’s reaction.
- D. Ask a family member to comfort the mother.
Correct Answer: A
Rationale: The correct answer is A: Allow the mother to express grief in her own way. The nurse should prioritize the mother's emotional needs by providing a safe space for her to express her grief. This can help the mother process her emotions and begin the grieving process. Option B may come across as dismissive of the mother's feelings and could hinder her emotional healing. Option C with sedatives may suppress the mother's natural grieving process and is not recommended unless absolutely necessary. Option D is not appropriate as the nurse should be present to support the mother directly.
Which patient should be assessed first?
- A. Infant with a blood glucose level of 45 mg/dL, maternal history of gestational diabetes
- B. Infant who is plotted on the growth chart between the 75th and 85th percentile for weight and length and the 50th percentile for head circumference
- C. Infant born at 42 weeks gestation to 40-year-old mother who was otherwise healthy during pregnancy and at the time of delivery
- D. Infant born at 38 weeks gestation with a green stain and bruising noted on initial assessment at delivery
Correct Answer: A
Rationale: The correct answer is A. An infant with a blood glucose level of 45 mg/dL and a maternal history of gestational diabetes should be assessed first to rule out hypoglycemia, which can be life-threatening in newborns. Hypoglycemia can lead to seizures, brain damage, or even death if not promptly treated. Infants born to mothers with gestational diabetes are at higher risk for hypoglycemia due to their own insulin production in response to high maternal glucose levels. Therefore, immediate assessment and intervention are crucial.
Choice B is incorrect because growth parameters within normal ranges do not indicate an immediate need for assessment. Choice C is also incorrect as the mother's age and gestational age do not necessarily indicate an urgent need for assessment. Choice D is incorrect as the presence of a green stain and bruising may indicate meconium aspiration syndrome, but hypoglycemia poses a more immediate threat to the infant's health.
If the neonatal nurse is suspicious of necrotizing enterocolitis in the infant, which intervention should take place first?
- A. Stop feeds
- B. Obtain a blood gas
- C. Call the practitioner
- D. Check electrolytes
Correct Answer: A
Rationale: The correct answer is A: Stop feeds. This is the first intervention because neonatal necrotizing enterocolitis is a serious condition that requires immediate action to prevent further complications. Stopping feeds helps reduce intestinal inflammation and allows the bowel to rest. This step is crucial in managing NEC and preventing perforation. Obtaining a blood gas or checking electrolytes can provide valuable information but are not as urgent as stopping feeds. Calling the practitioner is important but should come after initiating the immediate intervention of stopping feeds.
A 3-month-old has pulled out their NG tube at home, and the mother is now speaking with the on-call nurse. What recommendation should the nurse provide her?
- A. drive the infant to the nearest ER
- B. Call 911 and wait for EMS to arrive
- C. attempt to replace the NG tube yourself following discharge training
- D. feed the infant by mouth as there is not an NG tube to use
Correct Answer: C
Rationale: The correct answer is C because the mother was trained on NG tube replacement. This knowledge ensures proper technique and reduces the risk of injury. Driving to the ER or calling 911 may waste time, and feeding by mouth without the NG tube is not safe. Replacing the NG tube at home is the most efficient and appropriate course of action in this scenario.