A mother expresses fear about changing her infant's diaper after he is circumcised with a clamp procedure.
What does the woman need to be taught to take care of the infant when she gets home?
Apply constant firm pressure by squeezing the penis with the fingers for at least 5 minutes if bleeding occurs.
Cleanse the penis gently with water and put petroleum jelly around the glans after each diaper change.
Cleanse the penis with prepackaged diaper wipes every 6 hours.
Wash off the yellow exudate that forms on the glans at least once every day to prevent infection.
The Correct Answer is B
Choice A rationale
Applying constant firm pressure to the penis for five minutes if bleeding occurs is an appropriate initial intervention for bleeding after a circumcision. However, it does not address the routine care needed after each diaper change to promote healing and prevent infection.
Choice B rationale
Cleansing the penis gently with water after each diaper change removes urine and stool, preventing irritation and potential infection. Applying a thin layer of petroleum jelly around the glans helps to keep the diaper from sticking to the healing circumcision site, reducing discomfort and promoting healing.
Choice C rationale
Prepackaged diaper wipes often contain fragrances and alcohol, which can irritate the sensitive skin of a newly circumcised penis and potentially delay healing or cause discomfort. Gentle cleansing with water is preferred.
Choice D rationale
The yellow exudate that forms on the glans after circumcision is a normal part of the healing process, known as granulation tissue. It should not be washed off, as this can disrupt healing and increase the risk of infection. It will typically disappear on its own over a few days.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Avoiding sexual intercourse is recommended in the presence of threatened abortion to prevent further uterine irritation and potential disruption of the pregnancy. Pelvic rest helps to minimize the risk of increased bleeding or complications.
Choice B rationale
Continuing with normal life after discharge is an inappropriate statement. With a threatened abortion, the client needs to understand the importance of rest and avoiding strenuous activities that could potentially exacerbate bleeding or lead to further complications. Activities that increase intra-abdominal pressure or cause physical strain should be limited.
Choice C rationale
Counting perineal pads and noting the amount and color of blood is an important instruction for monitoring the extent of bleeding. This information helps the healthcare provider assess the progression or resolution of the threatened abortion and identify any signs of increased bleeding or passage of tissue.
Choice D rationale
Watching for the evidence of the passage of tissue is crucial as it could indicate a progressing miscarriage. The client should be instructed on how to collect any passed tissue for examination by the healthcare provider to confirm the outcome of the pregnancy. .
Correct Answer is B
Explanation
Choice A rationale
A glucose reading of 58 mg/dL in a newborn is below the normal range (typically 40-60 mg/dL in the first hours of life, rising to 50-90 mg/dL). While this requires intervention to prevent hypoglycemia, other parameters might indicate a more immediate threat to the newborn's well-being.
Choice B rationale
A temperature of 97.4°F (36.3°C) is below the normal range for a newborn (typically 97.7°F to 99.5°F or 36.5°C to 37.5°C). Hypothermia in a newborn can lead to cold stress, increasing oxygen and glucose consumption, potentially leading to respiratory distress and hypoglycemia. Therefore, a low temperature requires immediate assessment and intervention to warm the newborn.
Choice C rationale
A respiratory rate of 48 breaths/minute is within the normal range for a newborn (typically 30-60 breaths/minute). While the respiratory rate should be monitored, it does not indicate an immediate critical issue in this case.
Choice D rationale
A pulse of 134 beats/minute is within the normal range for a newborn (typically 110-160 beats/minute). While the heart rate should be monitored, it does not indicate an immediate critical issue in this case. .
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