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A nurse is caring for a newborn who has neonatal abstinence syndrome. Which of the following actions should the nurse take?

A.

Swaddle the newborn with his legs extended.

B.

Schedule larger volume feedings at less frequent intervals.

C.

Maintain eye contact with the newborn during feedings.

D.

Plan care to minimize handling of the newborn.

Answer and Explanation

The Correct Answer is D

Choice A rationale: 
Swaddling the newborn with his legs extended is not the appropriate action for a newborn with neonatal abstinence syndrome (NAS). NAS occurs when a baby is born dependent on drugs, usually because the mother used opioids during pregnancy. Swaddling may provide some comfort, but extending the legs could increase discomfort and agitation. 

Choice B rationale: 
Scheduling larger volume feedings at less frequent intervals is not the correct approach for a  newborn with NAS. These infants often have feeding difficulties and may require smaller,  more frequent feedings to reduce the risk of aspiration. 

Choice C rationale: 
Maintaining eye contact with the newborn during feedings may not be well-tolerated by a  baby with NAS. They can be irritable and easily overstimulated, and eye contact during feeding may exacerbate their agitation. 

Choice D rationale:
Planning care to minimize handling of the newborn is the most appropriate action for a baby with NAS. These infants are sensitive to stimuli and can become agitated easily, so minimizing unnecessary handling helps reduce their distress. 

The correct answer is D. Plan care to minimize handling of the newborn.

Here's why:

  • Swaddling with legs extended: This is not recommended as it can be uncomfortable for the newborn and may exacerbate withdrawal symptoms.
  • Larger volume feedings at less frequent intervals: This can be difficult for newborns with NAS due to their increased metabolic rate and may lead to overfeeding.
  • Maintaining eye contact during feedings: While this is important for bonding, it can be overwhelming for newborns with NAS, who often prefer a calm environment.

Minimizing handling is a key intervention in caring for newborns with NAS. Excessive handling can trigger withdrawal symptoms and make the newborn more irritable. Instead, focus on gentle, soothing techniques like swaddling with arms tucked in, rocking, and providing a quiet, dimly lit environment.


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Related Questions

Correct Answer is C

Explanation

Listeriosis is a foodborne illness that can have severe consequences during pregnancy. To minimize the risk of listeriosis, a pregnant client should avoid certain foods that are more likely to be contaminated with the bacteria Listeria. The correct statement that indicates an understanding of the teaching is:

C) "I can eat grilled chicken on a bun at lunchtime."

Grilled chicken is a safe option, and as long as it's properly cooked, it's a suitable choice during pregnancy. The other options are not recommended during pregnancy:

A) Soft cheeses, like Brie or feta, can carry a risk of Listeria contamination, so they should be avoided.

B) Seafood salad from the grocery store may not be safe as it could contain seafood that's been sitting at improper temperatures, which can increase the risk of foodborne illness.

D) Hot dogs can also be a risk as they are often not served steaming hot, which is necessary to kill any potential Listeria contamination.

Correct Answer is B

Explanation

Choice A rationale:

Swaddling the baby tightly with his legs extended before laying him down to sleep is not a recommended practice, as it can increase the risk of hip dysplasia. Instead, the baby should be placed on their back in a safe sleep environment.

Choice B rationale:

This statement is correct because monitoring the baby's urinary output is essential in ensuring adequate hydration and proper kidney function. Less than six wet diapers a day could be a sign of dehydration and should be promptly reported to the pediatrician.

Choice C rationale:

It is not necessary to retract the foreskin to clean the baby's penis during each bath. The foreskin should be left alone and not forcibly retracted until it naturally loosens, usually around the age of 3 to 5 years.

Choice D rationale:

Applying triple antibiotic ointment on the baby's umbilical cord is not recommended, as the standard practice is to keep the umbilical cord clean and dry. This helps it to fall off naturally within a week or two after birth, reducing the risk of infection.

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