Nokea
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.
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Why is the Dubowitz/Ballard assessment tool used on newborns following delivery?
- A. To determine whether the infant is transitioning to extrauterine life
- B. To predict any growth and development problems that the infant may have
- C. To determine the neuromuscular and physical maturity of the infant
- D. To compare the newborn with other newborns born at the same gestational age
Correct Answer: C
Rationale: The Dubowitz/Ballard assessment tool is used to determine the neuromuscular and physical maturity of the newborn. This tool assesses various physical and neuromuscular characteristics to estimate the gestational age of the infant accurately. By evaluating factors such as skin texture, lanugo, ear formation, and posture, healthcare providers can assess the infant's developmental stage. This assessment helps in determining if the infant is born prematurely or post-term, guiding appropriate care and interventions. The other choices are incorrect because the tool is not primarily used for those purposes.
Which baby is at highest risk of skin infection upon discharge?
- A. Newborn with scabs forming over heels where blood has been drawn
- B. Newborn with a new circumcision
- C. Newborn with jaundice
- D. Newborn with milia
Correct Answer: B
Rationale: The correct answer is B, a newborn with a new circumcision, as this procedure involves an incision, making the baby more susceptible to skin infections. Circumcision wounds need proper care to prevent infection.
Choice A is incorrect because scabs forming over heels where blood has been drawn do not necessarily indicate a higher risk of skin infection. Choice C, a newborn with jaundice, is incorrect as jaundice affects the liver and does not directly increase the risk of skin infection. Choice D, a newborn with milia, is incorrect because milia are harmless and do not increase the risk of skin infection.
At birth, a newborn weighed 6 pounds, 12 ounces. Three days later, the newborn weighs 5 pounds, 10 ounces. What conclusion should the nurse draw regarding this newborn’s weight?
- A. This weight loss is within normal limits.
- B. This weight gain is within normal limits.
- C. This weight loss is excessive.
- D. This weight gain is excessive.
Correct Answer: A
Rationale: A weight loss of up to 10% in the first few days is considered normal.
What is acrocyanosis in the newborn?
- A. a mildly blue or purple color of the hands and feet when the newborn is cold
- B. a common occurrence in the first few weeks of life
- C. a bluish-gray coloring around the nose and mouth in the first few hours of life as the newborn adjusts to extrauterine circulation.
- D. a bluish color to the infant’s face when the infant is resting quietly, which lasts throughout most of the first day after birth
Correct Answer: A
Rationale: Acrocyanosis refers to mild bluish discoloration of the extremities due to immature circulatory adaptation.
The nurse must administer erythromycin ophthalmic ointment to a newborn after birth. The nurse should:
- A. instill within 15 minutes of birth for maximum effectiveness
- B. cleanse eyes from inner to outer canthus before administration
- C. apply directly over the cornea.
- D. flush eyes 10 minutes after instillation to reduce irritation
Correct Answer: B
Rationale: Cleansing the eyes from inner to outer canthus ensures that any debris or contaminants are removed before administration, which helps prevent infection and ensures the medication's effectiveness.