A 23-week gestation neonate weighing 1100 grams in the NICU is having respiratory difficulties. Due to his size, which interventions are appropriate? (Select all that apply)
Provide support and teaching to family members.
Maintain handwashing and sterile technique.
Keep the neonate in as close to a womb-like state as possible.
Monitor vital signs and change diapers every hour.
Correct Answer : A,B,C
Choice A rationale
Providing family support is crucial as preterm birth can cause significant emotional distress. Education and involvement aid understanding of interventions and foster a supportive environment for both the neonate and family.
Choice B rationale
Strict handwashing and sterile technique prevent infection in preterm neonates, whose immature immune systems make them highly susceptible to sepsis, a leading cause of morbidity in NICUs.
Choice C rationale
Creating a womb-like state through dim lighting, limited noise, and careful positioning supports neurodevelopment and mimics the intrauterine environment, promoting growth and stability.
Choice D rationale
Frequent diaper changes may disturb thermoregulation and disrupt the neonate's limited energy reserves, as preterm infants require an environment that minimizes stress and conserves energy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Tone refers to uterine atony, the leading cause of postpartum hemorrhage. Tissue refers to retained placental fragments. Trauma includes lacerations or uterine rupture. Thrombin relates to coagulation disorders impacting clotting.
Choice B rationale
TOLAC (Trial of Labor After Cesarean) and thrombosis are unrelated to immediate hemorrhage management. Thrombosis generally involves venous clots, differing from thrombin, which concerns clotting factor deficiencies causing bleeding.
Choice C rationale
Tear and tolerance are non-specific terms lacking relevance to postpartum hemorrhage management. Time to search is impractical and unrelated to immediate intervention for hemorrhage or its causes.
Choice D rationale
"None of the above" is incorrect as the Four Ts (Tone, Tissue, Trauma, Thrombin) specifically address the primary causes of postpartum hemorrhage and are universally accepted in clinical guidelines.
Correct Answer is B
Explanation
Choice A rationale
Tight swaddling does not address hypoglycemia but may increase the infant’s stress. Hypoglycemia requires immediate correction through feeding or IV glucose, as low glucose levels can impair neonatal neurologic function.
Choice B rationale
Feeding provides immediate glucose replenishment, correcting hypoglycemia, which manifests as trembling. Rechecking glucose ensures effective correction. Normal neonatal glucose levels are 45–65 g/dL, with intervention needed below 40 g/dL.
Choice C rationale
Monitoring urinary output is insufficient for managing neonatal hypoglycemia. Trembling indicates an acute need for glucose, requiring prompt feeding or IV glucose rather than passive observation of output.
Choice D rationale
Immediate NICU transfer is unnecessary unless hypoglycemia remains uncorrected or other complications arise. Prompt feeding and glucose recheck are adequate to stabilize the neonate in most cases.
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