A nurse is caring for a newborn who is 5 days old in the neonatal intensive care unit (NICU).
Exhibits
Which of the following actions should the nurse take? (Select all that apply)
Swaddle the newborn with flexed extremities.
Plan to administer naloxone.
Maintain a low stimulation environment.
Instruct the parent to avoid breastfeeding.
Perform Ballard newborn screening each shift.
Weigh the newborn daily.
Instruct the parent to avoid eye contact with the newborn during feeding.
Correct Answer : A,C,F
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While taking a Vitamin C supplement can be beneficial for overall health, it is not specific to assessing the dietary intake of a vegan client at 6 weeks of gestation.
Choice B rationale
Asking when the client last ate meat is not relevant for a vegan, as vegans do not consume meat.
Choice C rationale
Asking about the client’s daily protein intake is important. Vegans need to ensure they are getting enough protein from plant-based sources, as they do not consume animal products.
Choice D rationale
Asking if the client has considered eating shellfish is not appropriate for a vegan, as vegans do not consume any animal products, including shellfish.
Correct Answer is C
Explanation
Choice A rationale
Vaginal candidiasis is not a contraindication for the use of a suppository. Candidiasis is a fungal infection that can cause itching and discomfort in the vaginal area. While it may require treatment, it does not prevent the use of a suppository for constipation.
Choice B rationale
Afterpains are not a contraindication for the use of a suppository. Afterpains are cramping pains that some women experience after childbirth as the uterus contracts back to its pre- pregnancy size. While they can be uncomfortable, they do not prevent the use of a suppository for constipation.
Choice C rationale
A third-degree perineal laceration is a contraindication for the use of a suppository. A third- degree laceration extends through the vaginal wall, perineal skin, and perineal muscles to the anal sphincter. Inserting a suppository could potentially cause further damage or introduce bacteria into the healing wound.
Choice D rationale
Abdominal distention is not a contraindication for the use of a suppository. While abdominal distention can be uncomfortable, it does not prevent the use of a suppository for constipation.
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