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A nurse is caring for a newborn who is 5 days old.

Exhibits
Which of the following actions should the nurse take? Select all that apply.

Instruct the parent to avoid eye contact with the newborn during feeding.

Weigh the newborn daily.

Plan to administer naloxone.

Instruct the parent to avoid breastfeeding

Maintain a low stimulation environment

Swaddle the newborn with flexed extremities.

Perform Ballard newborn screening each shift.

Answer and Explanation

Correct Answer : B,E,F

A. Instruct the parent to avoid eye contact with the newborn during feeding – This is not recommended. While overstimulation should be minimized, gentle eye contact and bonding are still encouraged during feeding to promote attachment.

B. Weigh the newborn daily – Weight loss and feeding difficulties are common in NAS. Daily weight monitoring is essential to evaluate nutritional status and fluid balance.

C. Plan to administer naloxone – Naloxone is contraindicated in opioid-exposed neonates because it can precipitate acute withdrawal and seizures.

D. Instruct the parent to avoid breastfeeding – Breastfeeding is generally encouraged unless the mother is using illicit substances or is HIV-positive. Methadone is not a contraindication for breastfeeding.

E. Maintain a low stimulation environment – NAS newborns are easily overstimulated. A quiet, dimly lit environment helps reduce symptoms like irritability and tremors.

F. Swaddle the newborn with flexed extremities – Swaddling provides comfort and containment, helping to reduce stress responses in NAS infants.

G. Perform Ballard newborn screening each shift – The Ballard score is used once to assess gestational age and is not repeated every shift.

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Correct Answer is A

Explanation

A. Changing a perineal pad only every 4 hours may indicate excessive bleeding or hemorrhage, which requires immediate assessment.
B. A urine output of 750 mL in 6 hours is within normal limits (about 125 mL/hr).
C. 1+ deep tendon reflexes indicate decreased reflexes, which is expected during magnesium sulfate therapy and generally not an immediate concern.
D. Abdominal cramping during breastfeeding is common due to uterine contractions and is usually not urgent.

A. Fentanyl citrate B. Meperidine C. Aspirin D. Ibuprofen

Correct Answer is D

Explanation

A. Fentanyl citrate is a potent opioid, typically reserved for severe pain and usually administered in controlled settings, not first-line postpartum analgesia.
B. Meperidine is less commonly used due to side effects and safety concerns.
C. Aspirin is generally avoided postpartum due to bleeding risks.
D. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) commonly used postpartum for pain relief and inflammation control with a safer profile for breastfeeding mothers.

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A nurse is caring for a newborn who is 5 days old. Exhibits Which of the following actions should the nurse take? Select all that apply.

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A nurse is caring for a newborn who is 5 days old.

Exhibits
Which of the following actions should the nurse take? Select all that apply.