A nurse is caring for a newborn immediately following birth.
For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?

The newborn weighs less than 2.5 kg (5.5 lb).

The newborn was delivered via cesarean birth.

To allow manifestations of infection to be identified.

To facilitate bonding between the newborn and parent.

Answer and Explanation

The Correct Answer is D

Choice A rationale
The weight of the newborn is not a factor in the decision to delay the instillation of antibiotic ophthalmic ointment. The ointment is used to prevent eye infections caused by bacteria present in the mother’s birth canal, and this risk is not related to the newborn’s weight.
Choice B rationale
Whether the newborn was delivered via cesarean birth or vaginal birth does not affect the decision to delay the instillation of antibiotic ophthalmic ointment. The ointment is used to prevent eye infections that can occur regardless of the method of delivery.
Choice C rationale

While it is important to monitor newborns for signs of infection, delaying the instillation of antibiotic ophthalmic ointment would not aid in identifying manifestations of infection. The ointment is a preventative measure and does not interfere with the observation of symptoms.
Choice D rationale
Correct answer. The instillation of antibiotic ophthalmic ointment can cause blurred vision in the newborn. Delaying the instillation of the ointment facilitates immediate bonding between the newborn and parent, as the newborn will be able to see more clearly.

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Correct Answer is ["A","C","F"]

Explanation

Choice A rationale: Swaddling the newborn with flexed extremities can provide a sense of security and help soothe the newborn. This is a common practice in managing neonates with Neonatal Abstinence Syndrome (NAS) as it can help reduce irritability and promote sleep.

Choice B rationale: Naloxone is not typically used in the treatment of NAS. Naloxone is an opioid antagonist and can precipitate withdrawal symptoms in opioid-dependent individuals. In a neonate with NAS due to maternal opioid use, naloxone can cause severe and immediate withdrawal.

Choice C rationale: Maintaining a low stimulation environment is crucial in managing neonates with NAS. These neonates are often hypersensitive to stimuli, and a quiet, dimly lit environment can help reduce irritability and promote sleep.

Choice D rationale: Breastfeeding is usually encouraged in mothers who are stable on their opioid replacement therapy, are not using illicit drugs, and have no other contraindications for breastfeeding. The benefits of breastfeeding include the passage of maternal antibodies and the promotion of mother-infant bonding.

Choice E rationale: The Ballard newborn screening is a tool used to estimate gestational age using physical and neuromuscular characteristics. It is typically performed shortly after birth and may not need to be performed each shift in a neonate with NAS.

Choice F rationale: Weighing the newborn daily is important in the management of NAS. Weight can provide information about feeding and hydration status, and any significant or sudden changes in weight can indicate a need for further evaluation.

Choice G rationale: Eye contact during feeding can promote bonding between the parent and the newborn. There is no need to avoid eye contact during feeding in a neonate with NAS.

A. Place a bumper pad in your baby’s crib. B. Bathe your baby immediately after a feeding. C. Wash your baby’s face with plain water. D. Put a soft mattress in your baby’s crib.

Correct Answer is C

Explanation

Choice A rationale
Bumper pads are not recommended for use in a baby’s crib. They pose a risk of suffocation, strangulation, and entrapment.
Choice B rationale
Bathing a baby immediately after a feeding is not recommended. It can cause discomfort and increase the likelihood of spitting up. It’s better to wait at least 30 minutes after a feeding before bathing the baby.
Choice C rationale
Washing a baby’s face with plain water is recommended. Babies have sensitive skin, and plain water is the gentlest option. Soap can dry out their skin and cause irritation.
Choice D rationale
A soft mattress in a baby’s crib is not recommended. It increases the risk of sudden infant death syndrome (SIDS). A firm mattress is safer.

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A nurse is caring for a newborn immediately following birth. For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?

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A nurse is caring for a newborn immediately following birth.
For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?