A mother asks whether or not she should be concerned that her baby never opens his mouth to breathe when his nose is so small. Which of the following is the nurse's best response?

"Babies usually breathe in and out through their noses so they can feed without choking."

"You are right. I will report the baby's small nasal openings to the pediatrician right away.*

*Everything about babies is small. It truly is amazing how everything works so well."

"The baby does rarely open his mouth but you can see that he isn't in any distress.

Answer and Explanation

The Correct Answer is A

A) "Babies usually breathe in and out through their noses so they can feed without choking.":
Newborns are obligate nasal breathers, meaning they primarily breathe through their noses rather than their mouths, which helps coordinate breathing with feeding. This nasal breathing mechanism helps prevent aspiration and ensures that babies can feed while still breathing. It is perfectly normal for a baby to primarily use their nose for breathing, especially in the early days of life, and no cause for concern should be raised about small nasal openings unless the baby is showing signs of respiratory distress.

B) "You are right. I will report the baby's small nasal openings to the pediatrician right away.":
A small nasal opening is common in newborns and is not usually a cause for alarm unless it interferes with breathing, feeding, or shows signs of a more significant anatomical issue. There is no immediate need to report it unless the baby is having trouble breathing or feeding. The nurse should offer reassurance instead.

C) "Everything about babies is small. It truly is amazing how everything works so well.":
While this response may seem comforting, it is not very informative. It dismisses the mother’s concern rather than providing a clear and educational explanation. Reassuring the mother with factual information about why babies breathe through their noses and how this works effectively for them would be more helpful.

D) "The baby does rarely open his mouth but you can see that he isn't in any distress.":
This response minimizes the importance of the mother’s question and doesn’t fully address her concern. While it’s true that babies rarely open their mouths to breathe, the explanation needs to focus on the physiological reasoning behind it. The nurse should also reassure the mother that nasal breathing is normal in newborns and not typically a concern unless signs of distress are present.

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Correct Answer is A

Explanation

A) Skin to Skin contact:
Skin-to-skin contact, also known as "kangaroo care," is a highly beneficial practice for both the mother and the infant in the immediate postpartum period. It promotes bonding by enhancing emotional connections, helps the infant maintain their body temperature through the transfer of warmth from the mother’s chest, and supports the initiation of breastfeeding, which is essential for the infant's nourishment. Additionally, skin-to-skin contact stimulates the release of oxytocin, which can aid in uterine contractions and promote involution of the uterus.

B) Swaddling the infant:
While swaddling the infant can provide comfort and a sense of security, it does not directly promote bonding or help with temperature regulation as effectively as skin-to-skin contact does. Swaddling can help the infant feel secure and prevent the startle reflex but does not have the same physiological benefits in terms of promoting involution or maintaining body temperature.

C) Allowing family members to hold the infant:
While allowing family members to hold the infant can help with bonding, it does not offer the same immediate physical benefits as skin-to-skin contact between the mother and infant. Skin-to-skin contact is particularly beneficial in terms of temperature regulation and promoting the early stages of breastfeeding, which can help with the involution of the uterus.

D) None of the above:
This option is incorrect because skin-to-skin contact has been shown to promote bonding, help regulate the infant's temperature, and support postpartum recovery processes, including uterine involution.

A. Abdominal with synchronous chest movements. B. Chest breathing with nasal flaring. C. Diaphragmatic with chest retraction. D. Deep with a regular rhythm.

Correct Answer is A

Explanation

A) Abdominal with synchronous chest movements:
Newborns primarily exhibit abdominal breathing, meaning that the diaphragm does most of the work while the chest movements are less pronounced. This is normal for full-term neonates, and the chest and abdomen move in a synchronous manner as the baby breathes. This pattern is indicative of an immature respiratory system that is still developing, but it is completely normal in the early stages of life.

B) Chest breathing with nasal flaring:
While some chest movement is observed in newborns, the primary pattern of breathing is abdominal. Nasal flaring is generally an abnormal sign in newborns and may indicate respiratory distress, such as when there is an obstruction in the airway or a need for increased oxygen intake. It is not considered a normal, healthy breathing pattern in newborns.

C) Diaphragmatic with chest retraction:
Diaphragmatic breathing is normal, but chest retraction is not. Retractions occur when there is increased effort to breathe, and they typically indicate respiratory distress or obstruction. In a healthy, full-term newborn, retractions should not be present. This type of breathing would require further investigation to rule out conditions like respiratory distress syndrome or infection.

D) Deep with a regular rhythm:
Newborns may have irregular breathing patterns, including periods of apnea (a few seconds without breathing) and slight irregularity in rhythm, especially during sleep. Deep, regular breathing without any irregularities is not typical in a newborn, and any consistent deep breathing would require further observation to rule out any potential underlying issues.

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A mother asks whether or not she should be concerned that her baby never opens his mouth to breathe when his nose is so small. Which of the following is the nurse's best response?

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Correct Answer is A

Explanation

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