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The parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a constant worry. What is the nurses best action?
- A. Encourage the parent to verbalize feelings.
- B. Encourage the parent not to worry so much.
- C. Assess the parent for other signs of inadequate parenting.
- D. Reassure the parent that colic rarely lasts past age 9 months.
Correct Answer: A
Rationale: Colic is multifactorial, and no single treatment is effective for all infants. The parent is verbalizing concern and worry. The nurse should allow the parent to put these feelings into words. An empathetic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parents anxiety. The nurse should reassure the parent that he or she is not doing anything wrong. The infant with colic is experiencing spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does not help him or her through the current situation.
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The nurse is teaching a parent with a 2-month-old infant who has been diagnosed with colic about ways to relieve colic. Which statement by the parent indicates the need for additional teaching?
- A. I should let my infant cry for at least 30 minutes before I respond.
- B. I will swaddle my infant tightly with a soft blanket.
- C. I should massage my infants abdomen whenever possible.
- D. I will place my infant in an upright seat after feeding.
Correct Answer: A
Rationale: Because the infant has been diagnosed with colic, the parent should respond to the infant immediately or any type of interventions to relieve colic may not be effective. Also, the infant may develop a mistrust of the world if his or her needs are not met. The parent should swaddle the baby tightly with a soft blanket, massage the babys abdomen, and place the infant in an upright seat after a feeding to help relieve colic.
What is most descriptive of atopic dermatitis (AD) (eczema) in an infant?
- A. Easily cured
- B. Worse in humid climates
- C. Associated with hereditary allergies
- D. Related to upper respiratory tract infections
Correct Answer: C
Rationale: AD is a type of pruritic eczema that usually begins during infancy and is associated with allergy with a hereditary tendency. Approximately 50% of children with AD develop asthma. AD can be controlled but not cured. Manifestations of the disease are worse when environmental humidity is lower. AD is not associated with respiratory tract infections.
Which term refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation?
- A. Congenital lactase deficiency
- B. Primary lactase deficiency
- C. Secondary lactase deficiency
- D. Developmental lactase deficiency
Correct Answer: D
Rationale: Developmental lactase deficiency refers to the relative lactase deficiency observed in preterm infants of less than 34 weeks of gestation. Congenital lactase deficiency occurs soon after birth after the newborn has consumed lactose-containing milk. Primary lactase deficiency, sometimes referred to as late-onset lactase deficiency, is the most common type of lactose intolerance and is manifested usually after 4 or 5 years of age. Secondary lactase deficiency may occur secondary to damage of the intestinal lumen, which decreases or destroys the enzyme lactase.
A new parent asks the nurse, How can diaper rash be prevented? What should the nurse recommend?
- A. Wash the infant with soap before applying a thin layer of oil.
- B. Clean the infant with soap and water every time diaper is changed.
- C. Wipe stool from the skin using water and a mild cleanser.
- D. When changing the diaper, wipe the buttocks with oil and powder the creases.
Correct Answer: C
Rationale: Change the diaper as soon as it becomes soiled. Gently wipe stool from the skin with water and mild soap. The skin should be thoroughly dried after washing. Applying oil does not create an effective barrier. Over washing the skin should be avoided, especially with perfumed soaps or commercial wipes, which may be irritating. Baby powder should not be used because of the danger of aspiration.
Lactose intolerance is diagnosed in an 11-month-old infant. Which should the nurse recommend as a milk substitute?
- A. Yogurt
- B. Ice cream
- C. Fortified cereal
- D. Cows milk-based formula
Correct Answer: A
Rationale: Yogurt contains the inactive lactase enzyme, which is activated by the temperature and pH of the duodenum. This lactase activity substitutes for the lack of endogenous lactase. Ice cream and cows milk-based formula contain lactose, which will probably not be tolerated by the child. Fortified cereal does not have the nutritional equivalents of milk.