A nurse is caring for a newborn immediately following birth and notes a large amount of mucus in the newborn's mouth and nose. Identify the sequence the nurse should follow when performing suction with a bulb syringe.

(Arrange the steps, placing them in the selected order of performance. Use all the steps.)

Compress the bulb syringe.

Place the bulb syringe in the newborn's mouth.

Assess the newborn for reﬂex bradycardia.

Use the bulb syringe to suction the newborns nose.

Answer and Explanation

The Correct Answer is A, B, D, C

Compressing the bulb syringe before placing it in the newborn's mouth or nose creates a vacuum that allows the suctioning of the mucus¹².
Placing the bulb syringe in the newborn's mouth first helps clear the oral airway and prevent aspiration of mucus into the lungs¹². The nozzle of the bulb syringe should be gently inserted into the corner of the mouth, not the center, to avoid stimulating the gag reﬂex¹².
Using the bulb syringe to suction the newborns nose helps clear the nasal airway and improve breathing¹². The nozzle of the bulb syringe should be gently inserted into one nostril at a time, and not too far, to avoid injuring the nasal mucosa¹².
Assessing the newborn for reﬂex bradycardia helps monitor for any adverse eﬀects of suctioning, such as a decrease in heart rate due to vagal stimulation¹³. Reﬂex bradycardia can cause hypoxia and acidosis in newborns, and may require oxygen administration or resuscitation³. The normal heart rate for a newborn is 120 to 160 beats per minute³.

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Correct Answer is C

Explanation

A. Platelets 170,000/mm³ is a normal platelet count in pregnancy. The normal range for platelets in pregnancy is 150,000 to 450,000/mm³⁷⁸.

B. This HbA1c level indicates good control of blood glucose levels over the past 2-3 months. For a pregnant woman with type 1 diabetes, a target HbA1c of less than 6-7% is often recommended to reduce the risk of complications.

C. This blood urea nitrogen (BUN) level is elevated. Normal BUN levels typically range from 7 to 20 mg/dL. Elevated BUN may indicate renal impairment, which can be a concern for a pregnant woman with type 1 diabetes, as it could suggest developing diabetic nephropathy or other kidney-related issues.
D. Hct 34% is a normal hematocrit level in pregnancy. The normal range for hematocrit in pregnancy is 30% to 36%.

A. Maintain airborne precautions in the nursery. B. Place the newborn's foot on a sterile field during a heelstick. C. Place newborn bassinets at least 3 feet apart. D. Allow parents to enter the nursery if they are wearing a mask.

Correct Answer is C

Explanation

When reviewing infection control procedures in a newborn nursery, the nurse manager should instruct the newly hired nurses to place newborn bassinets at least 3 feet apart. This practice helps prevent the spread of infections between infants by minimizing close contact and reducing the risk of droplet transmission.

Option a) Maintaining airborne precautions in the nursery is not necessary unless there is a specific airborne infectious disease outbreak or a newborn with a known airborne infection. Standard precautions, including hand hygiene and proper use of personal protective equipment, are generally sufficient to prevent the spread of infections in a newborn nursery.

Option b) Placing the newborn's foot on a sterile field during a heelstick is not necessary for routine procedures. However, a clean and disinfected surface should be used to perform the heelstick to minimize the risk of introducing pathogens. Sterile fields are typically reserved for sterile procedures in an operating room or other controlled environments.

Option d) Allowing parents to enter the nursery if they are wearing a mask is not a standard infection control practice. In general, only authorized personnel should enter the nursery, and parents or visitors should follow any specific visiting policies in place. If there are concerns about respiratory infections or outbreaks, additional visitor restrictions or requirements may be implemented.

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Naxlex Comprehensive Predictor Exams

A nurse is reviewing the laboratory results of a client who is at 20 weeks of gestation and has type 1 diabetes mellitus. Which of the following findings should the nurse report to the provider?

Correct Answer is C

Explanation

A nurse manager in a newborn nursery is reviewing infection control procedures with a group of newly hired nurses. Which of the following instructions should the nurse manager include in the teaching?

Correct Answer is C

Explanation

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