A nurse is caring for a neonate in the neonatal intensive care unit.

Exhibits

The nurse is reviewing the neonate's electronic medical record.

Drag words from the choices below to fill in each blank in the following sentence.

Following discontinuation of feedings, the nurse should monitor for

______

and

______

A. The client takes furosemide twice daily: There is no direct contraindication between furosemide and lavender oil.

B. Lavender oil, especially in aromatherapy, can trigger respiratory issues in some individuals, particularly those with asthma. Essential oils can act as irritants and exacerbate bronchospasms, potentially leading to wheezing, coughing, or an asthma attack. Therefore, the nurse should advise caution when using lavender oil in clients with a history of asthma.

C. The client takes vitamin C daily: There is no significant interaction between lavender oil and vitamin C.

D. While lavender has mild sedative properties, it is not a direct contraindication for clients with a history of alcohol use disorder. However, excessive use of lavender could enhance CNS depression when combined with alcohol, so it should be used with caution.

Rationale:

Keep neonate prone: Contraindicated. Placing the neonate in a prone position may increase the risk of aspiration, especially in the context of respiratory distress or abdominal issues, so it is generally avoided unless clinically necessary in a controlled environment.

Administer total parenteral nutrition (TPN): Anticipated. TPN may be required if the neonate is unable to tolerate oral or enteral feeding due to gastrointestinal distress, as seen with abdominal distention and blood in stool.

Encourage parent bonding: Anticipated. Parent bonding is important for the emotional and developmental support of the neonate, even in critical care settings. However, it must be done in a manner that does not compromise the neonate’s health (e.g., ensuring sterile technique).

Obtain an arterial blood gas: Anticipated. Given the neonate's respiratory status and potential infection, obtaining an ABG is appropriate to assess acid-base balance and oxygenation status.

Attach OG tube to low intermittent suction: Anticipated. Suctioning through the OG tube may be necessary if the neonate has signs of gastrointestinal distress, such as abdominal distention, to remove excess gastric contents or air.

Repeat abdominal x-ray every 24 hr: Contraindicated. Repeating an x-ray every 24 hours may not be necessary unless there are significant changes in the neonate’s condition. Continuous monitoring with clinical assessments is typically prioritized.

Obtain a CBC and blood culture: Anticipated. Given the neonate's lethargy, hypotonia, and other concerning signs, a CBC and blood cultures are necessary to evaluate for infection, which is a common complication in critically ill neonates.

Administer IV antibiotics: Anticipated. Administration of IV antibiotics is essential, especially with signs of possible infection such as lethargy, distended abdomen, and blood in the stool, which may indicate sepsis or necrotizing enterocolitis.