A nurse is caring for a 1-day-old newborn who has jaundice and is receiving phototherapy. Which of the following actions should the nurse take?
Keep the infant's head covered with a cap.
Apply lotion to the newborn every 4 hr.
Give the infant 30 mL (1 oz) of glucose water every 2 hr.
Ensure that the newborn wears a diaper.
The Correct Answer is D
A. The infants’s head should not be covered while receiving phototherapy, as the skin needs to be exposed to the therapy. However, it is essential to ensure that the infant's eyes are protected from the light.
B. Applying lotion may interfere with the effectiveness of phototherapy by blocking the light’s effects and is unnecessary for managing jaundice in newborns.
C. Giving glucose water is unnecessary and may interfere with the infant's hydration and nutritional needs during phototherapy.
D. Ensuring that the newborn wears a diaper to prevent soiling of the phototherapy equipment and to allow for the monitoring of urinary output, which is an important indicator of the newborn's health during treatment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Positioning the client in reverse Trendelenburg can increase the risk of maternal aspiration.
B. The lithotomy position is not appropriate for cesarean birth and may compromise blood flow to the placenta.
C. This position could increase pressure on the vena cava and compromise placental blood flow.
D. This lateral tilt relieves pressure on the inferior vena cava, preventing decreased placental blood flow.
Correct Answer is C
Explanation
A. This type of play usually begins around ages 3 to 4.
B. While possible, this is more typical in slightly older children who engage in more complex forms of pretend play.
C. At 30 months (2.5 years old), children are typically engaged in simple pretend play and enjoy playing with larger, more manipulable toys like plastic trucks. Their motor skills and cognitive development at this stage support this type of play.
D. Coordination for jumping rope generally develops later, closer to school age.
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