A nurse is caring for a 1-week-old newborn who has hyperbilirubinemia and is being treated with phototherapy. Which of the following actions should the nurse take?
Check the newborn's eyes every 8 hr.
Place mittens on the newborn's hands.
Monitor the newborn's temperature every 2 hr.
Apply lotion to the newborn's skin.
The Correct Answer is C
Rationale:
A. Checking the newborn's eyes every 8 hours is not necessary for the management of hyperbilirubinemia or phototherapy.
B. Placing mittens on the newborn's hands is unrelated to the management of hyperbilirubinemia or phototherapy.
C. Monitoring the newborn's temperature every 2 hours is essential during phototherapy because infants are at risk of hypothermia due to increased heat loss from the lights.
D. Applying lotion to the newborn's skin is not recommended during phototherapy as it can interfere with the effectiveness of the lights.
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Related Questions
Correct Answer is D
Explanation
A. Stevens-Johnson syndrome is a severe, rare, and potentially life-threatening reaction that can occur as a hypersensitivity reaction to certain medications. However, it is not typically associated with morphine use.
B. Morphine is more commonly associated with hypotension rather than hypertension. Therefore, while monitoring for changes in blood pressure is important, hypertension is not a primary concern with morphine administration.
C. Morphine use is not typically associated with prolonged wound healing. However, it can cause respiratory depression, which can indirectly affect wound healing by reducing tissue oxygenation.
D. Morphine is a potent opioid analgesic that can cause respiratory depression, leading to bradypnea (slow breathing) or even respiratory arrest. Monitoring respiratory rate is crucial when administering morphine to detect signs of respiratory depression early and intervene promptly.
Correct Answer is B
Explanation
D. Renal failure Correct Answer: B Rationale:
A. Stevens-Johnson syndrome is a severe allergic reaction that can occur with various medications, but it is not a common adverse effect of prednisolone.
B. Prolonged wound healing is a potential adverse effect of corticosteroids like prednisolone due to their immunosuppressive effects.
C. Hypotension is not a common adverse effect of prednisolone; rather, it can cause fluid retention and hypertension.
D. Renal failure is a rare adverse effect of prednisolone and is not typically monitored for in school-age children unless there are preexisting renal issues.
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