A nurse is caring for a newborn immediately following birth who has a prescription for erythromycin ophthalmic ointment.
The guardian refuses the medication. Which action should the nurse take?
Document the guardian’s refusal of the medication.
Inform the guardian that the medication can be given after discharge.
Report the guardian’s refusal of the medication to social services.
Notify the facility’s ethics committee about the guardian’s medication refusal.
The Correct Answer is A
Choice A rationale
Erythromycin ophthalmic ointment is administered to newborns to prevent neonatal conjunctivitis, also known as ophthalmia neonatorum, specifically for Neisseria gonorrhoeae infection prevention. If the guardian refuses the administration of erythromycin, the healthcare provider should respect the guardian’s decision and document the refusal. It’s important to note that the refusal should be informed, meaning the guardian should understand the potential risks associated with not administering the medication.
Choice B rationale
Informing the guardian that the medication can be given after discharge may not be the best course of action. The purpose of the ointment is to prevent infection immediately after birth when the risk is highest. Delaying the administration could potentially increase the risk of the newborn developing an infection.
Choice C rationale
Reporting the guardian’s refusal of the medication to social services is not the first step unless there are other concerns about the safety or well-being of the child. The healthcare provider should respect the guardian’s autonomy and their right to make informed decisions about the newborn’s care.
Choice D rationale
Notifying the facility’s ethics committee about the guardian’s medication refusal is not typically necessary unless the refusal puts the newborn at significant risk and other attempts to resolve the situation have failed. In this case, the refusal of erythromycin ophthalmic ointment, while not ideal, is not likely to warrant an ethics consultation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
A thick, white vaginal discharge is more commonly associated with a yeast infection, not trichomoniasis.
Choice B rationale
Vulva lesions are not a typical symptom of trichomoniasis. They can be associated with other conditions such as herpes.
Choice C rationale
Trichomoniasis is a sexually transmitted infection caused by a parasite. One of the common symptoms in women is a foul-smelling vaginal discharge, which can be clear, white, yellowish, or greenish.
Choice D rationale
While urinary frequency can occur with trichomoniasis, it is not as specific or common as malodorous discharge.
Correct Answer is C
Explanation
Choice A rationale
While initiating an infusion of IV fluids for the patient is important, it is not the immediate next step after noticing a protruding umbilical cord.
Choice B rationale
Administering oxygen via a nonrebreather mask at 8L/min is a later step in the management of umbilical cord prolapse.
Choice C rationale
The immediate next step after noticing a protruding umbilical cord is to perform a vaginal examination and apply upward pressure on the presenting part to relieve cord compression.
Choice D rationale
Covering the umbilical cord with a sterile saline-saturated towel is a later step in the management of umbilical cord prolapse.
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