A nurse is caring for a newborn in the delivery room. Which of the following nursing actions is most effective in preventing heat loss via conduction?
Drying the newborn thoroughly and removing wet linens
Placing the newborn under a radiant warmer immediately after birth
Placing the newborn directly on the scale to obtain weight
Placing the newborn on a prewarmed blanket over the scale
The Correct Answer is D
A. Drying the newborn thoroughly and removing wet linens helps prevent evaporative heat loss, not conductive heat loss. While important for thermoregulation, this action does not directly address conduction, which occurs when the newborn comes into direct contact with a cooler surface.
B. Placing the newborn under a radiant warmer prevents heat loss through radiation, as the newborn absorbs heat from a warmer source without direct contact. This does not prevent conductive heat loss caused by touching cold surfaces.
C. Placing the newborn directly on the scale exposes the infant to cold, hard surfaces, which increases heat loss via conduction. This action would actually exacerbate conductive heat loss rather than prevent it.
D. Placing the newborn on a prewarmed blanket over the scale is the most effective way to prevent heat loss via conduction. Conduction occurs when heat is transferred from the newborn’s body to a cooler surface in direct contact. Using a prewarmed blanket provides insulation and prevents heat from transferring away from the infant, maintaining body temperature during initial assessments and procedures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Shivering is rare in newborns because they lack mature skeletal muscle activity for heat generation. Newborns primarily produce heat through nonshivering thermogenesis by metabolizing brown fat. Preventing shivering is not the purpose of a radiant warmer.
B. Reducing basal metabolic rate is not the goal of using a radiant warmer. In fact, cold stress increases basal metabolic rate as the newborn attempts to maintain body temperature. The warmer helps prevent this increase by maintaining a neutral thermal environment.
C. Hyperthermia is an elevated body temperature. A radiant warmer is carefully regulated to maintain normal body temperature, not to induce hyperthermia. Overheating can occur if the warmer is set too high, so preventing hyperthermia is not the primary purpose, though monitoring is required.
D. Cold stress occurs when a newborn loses heat faster than it can produce it, leading to hypothermia, increased oxygen consumption, metabolic acidosis, and hypoglycemia. Placing the newborn under a radiant heat warmer provides external heat to maintain normothermia immediately after birth, preventing cold stress and its associated complications. This is the primary reason for using a radiant warmer in the delivery room.
Correct Answer is A
Explanation
A. Melasma, also called the “mask of pregnancy,” is characterized by irregular, blotchy, brownish patches on the face, typically over the cheeks, nose, forehead, and upper lip. It occurs in response to hormonal changes during pregnancy, specifically elevated estrogen and progesterone, which increase melanocyte activity and melanin production in sun-exposed areas. Melasma is more common in women with darker skin tones and those with a family history of hyperpigmentation. It is considered a benign and reversible condition, often improving several months postpartum, though it may persist in some cases. Preventive strategies include limiting sun exposure, using broad-spectrum sunscreen, and wearing protective clothing, as ultraviolet light can worsen pigmentation.
B. Palmar erythema refers to reddening of the palms due to increased estrogen levels and enhanced peripheral vasodilation. While it is a normal pregnancy change, it does not affect the face and therefore does not describe the blotchy facial pigmentation observed in melasma.
C. Linea nigra is a dark vertical line that appears along the midline of the abdomen, extending from the pubic area to the umbilicus or higher. It develops from hormonal stimulation of melanocytes in the abdominal midline and is unrelated to facial hyperpigmentation.
D. Striae gravidarum, commonly called stretch marks, appear as reddish-purple streaks on the abdomen, breasts, hips, or thighs due to rapid skin stretching combined with hormonal effects on connective tissue. They are not blotchy brown patches on the face.
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