Nokea
The nurse is providing support to a mother whose newborn is diagnosed with a life-threatening defect. The mother states, “I just want to go home and never come back.” Which reaction by the mother does the nurse recognize?
- A. Guilty feelings by the mother
- B. Delay of attachment process
- C. Maternal emotional distancing
- D. Disruption of family life
Correct Answer: C
Rationale: The correct answer is C: Maternal emotional distancing. The mother's statement of wanting to go home and never come back indicates a desire to emotionally distance herself from the situation. This reaction is a common coping mechanism when faced with overwhelming emotions. Guilty feelings (choice A) typically involve a sense of responsibility or remorse, which is not evident in the mother's statement. Delay of attachment process (choice B) refers to difficulties in forming an emotional bond with the newborn, which is not explicitly mentioned in the scenario. Disruption of family life (choice D) implies changes in family dynamics, which are not directly related to the mother's expressed desire to distance herself emotionally.
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The NICU nurse encourages the mother of a premature neonate to bring breast milk to the unit for enteral feedings to her baby. For which reason does the nurse make this suggestion?
- A. The baby will be more likely to breastfeed later.
- B. The mother will feel more involved with the baby.
- C. The neonate will gain weight faster on breast milk.
- D. Breast milk helps prevent necrotizing enterocolitis.
Correct Answer: D
Rationale: The correct answer is D because breast milk helps prevent necrotizing enterocolitis (NEC) in premature neonates. Breast milk contains protective factors that reduce the risk of NEC, a serious gastrointestinal condition common in preterm infants. Other choices are incorrect: A is not directly related to feeding breast milk, B focuses on emotional involvement rather than physiological benefits, and C does not address the specific health benefits of breast milk in preventing NEC.
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.
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.
Which nursing action is especially important for an SGA newborn?
- A. Promote bonding.
- B. Observe for and prevent dehydration.
- C. Observe for respiratory distress syndrom
- D. Prevent hypoglycemia with early and frequent feedings.
Correct Answer: D
Rationale: The correct answer is D because preventing hypoglycemia is crucial for Small for Gestational Age (SGA) newborns due to their decreased glycogen stores. Early and frequent feedings help maintain stable blood sugar levels. Option A, promoting bonding, is important for all newborns but not particularly crucial for SGA babies. Option B, preventing dehydration, is essential for all newborns but not specific to SGA. Option C, observing for respiratory distress syndrome, is important but not the most critical concern for SGA newborns.
Which data should alert the nurse caring for an SGA infant that additional calories may be needed?
- A. The latest hematocrit was 53%.
- B. The infant's weight gain is 40 g/day.
- C. The infant is taking 120 mL/kg every 24 hours.
- D. Three successive temperature measurements were 36.1ï‚°C, 35.5ï‚°C, and 36.1ï‚°C (97, 96, and 97ï‚°F).
Correct Answer: B
Rationale: The correct answer is B because weight gain is a direct indicator of nutritional status. A weight gain of 40 g/day may indicate inadequate caloric intake for an SGA (small for gestational age) infant, necessitating additional calories.
A: Hematocrit level might indicate dehydration or polycythemia, not necessarily inadequate caloric intake.
C: The volume of intake alone does not indicate the adequacy of caloric intake; concentration and composition of the feed are also essential.
D: Temperature measurements are not directly related to the need for additional calories in an SGA infant.