Nokea
An infant who was stable for a day after birth now demonstrates pallor tachycardia tachypnea and circumoral cyanosis. The parent asks how the child might have a heart problem when he was stable yesterday. What information by the nurse is most accurate?
- A. Blood incompatibilities can cause this problem so we will test the mothers blood.
- B. Symptoms may not appear until fetal circulation routes begin to close after birth.
- C. The extra blood from the umbilical cord may have kept the baby stable for a while.
- D. Your baby may have gotten an infection during birth that now is causing problems.
Correct Answer: B
Rationale: This baby has clinical manifestations of tetralogy of Fallot. While the ductus arteriosus remains patent the infant remains stable. However when the ductus begins closing after the first 24 hours of life the infants cardiovascular system becomes unstable and manifestations appear. The other statements are inaccurate.
You may also like to solve these questions
The mother-baby nurse is providing care to a patient and her newborn 2 hours after delivery. On review of the newborn's chart, the nurse sees a notation of caput succedaneum. What will the nurse expect to find in the mother's chart?
- A. Race: non-White
- B. A longer than usual labor
- C. Administration of an epidural
- D. Delivery by cesarean birth
Correct Answer: B
Rationale: The correct answer is B: A longer than usual labor. Caput succedaneum is swelling of the baby's scalp due to pressure during labor. This indicates a longer labor duration.
A: Race is not a factor in the development of caput succedaneum.
C: Administration of an epidural does not directly cause caput succedaneum.
D: Delivery by cesarean birth is not associated with caput succedaneum.
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.
Which of the following is an important consideration in positioning a newborn for breastfeeding?
- A. Placing the infant at nipple level facing the breast.
- B. Keeping the infant's head slightly lower than the body.
- C. Using the forefinger and middle finger to support the breast.
- D. Limiting the amount of areola the infant takes into the mouth.
Correct Answer: A
Rationale: The correct answer, A, is important because it ensures proper alignment for effective breastfeeding. Placing the infant at nipple level facing the breast helps the baby latch on correctly, promoting optimal milk transfer. Choice B is incorrect as the infant's head should be in line with the body to prevent swallowing issues. Choice C is incorrect because the fingers should support the breast underneath, not on top. Choice D is also incorrect as the baby should take in a sufficient amount of areola for a deep latch.
A new mother asks why she has to open a new bottle of formula for each feeding. What is the nurse's best response?
- A. Formula may turn sour after it is opened.'
- B. Bacteria can grow rapidly in warm milk.'
- C. Formula loses some nutritional value once it is opened.'
- D. This makes it easier to keep track of how much the baby is taking.'
Correct Answer: B
Rationale: The correct answer is B because bacteria can grow rapidly in warm milk, increasing the risk of contamination and illness for the baby. Opening a new bottle for each feeding ensures the formula is fresh and safe for consumption. Choice A is incorrect because formula does not necessarily turn sour immediately after opening. Choice C is incorrect because nutritional value does not significantly decrease after opening. Choice D is incorrect as it does not address the health and safety concerns associated with bacteria growth in opened formula.
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.