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.
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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 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.
Which characteristics are typically found in a patient diagnosed with Down syndrome? Select all that apply.
- A. Low-set ears
- B. Broad nasal bridge
- C. Round occiput
- D. Small tongue
Correct Answer: C
Rationale: The correct answer is C: Round occiput. In Down syndrome, individuals often exhibit a round-shaped head at the back (occiput) due to the abnormal growth patterns of the skull bones. This characteristic is a common physical feature seen in individuals with Down syndrome.
A: Low-set ears - While low-set ears can be a feature in some cases of Down syndrome, it is not a defining characteristic and not always present.
B: Broad nasal bridge - Broad nasal bridge is a common feature in Down syndrome, but it is not specific enough to be a defining characteristic.
D: Small tongue - While individuals with Down syndrome may have slightly smaller tongues compared to the general population, it is not a prominent characteristic and not typically used for diagnosis.
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: C
Rationale: The correct answer is C: The newborn is experiencing respiratory distress. Gasping respirations, low heart rate, cyanotic skin, and poor muscle tone are indicative of respiratory distress in a newborn. Gasping is an abnormal breathing pattern seen in severe respiratory distress. A low heart rate is a compensatory response to decreased oxygen levels. Cyanotic skin color indicates poor oxygenation. Poor muscle tone can be a sign of inadequate oxygen delivery to tissues.
Explanation for other choices:
A: The newborn may be hypothermic due to poor temperature regulation, but the primary concern in this scenario is respiratory distress.
B: Being full term does not directly explain the newborn's clinical presentation, so it is not a likely cause.
D: Anemia could contribute to poor oxygen delivery, but the clinical presentation suggests a more acute issue related to respiratory distress.
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.