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 A
Explanation
Choice A rationale
This is the correct answer. Sore nipples are a common issue for breastfeeding women, often due to the baby not latching well. Assessing the newborn’s latch can help identify and correct any issues, potentially alleviating the mother’s discomfort.
Choice B rationale
Limiting the length of breastfeeding to 5 minutes per breast is not typically recommended as it may not provide enough feeding time for the baby and could potentially exacerbate nipple soreness.
Choice C rationale
Waiting 4 hours between daytime feedings is not typically recommended. Newborns typically need to feed every 2-3 hours.
Choice D rationale
Offering supplemental formula between the newborn’s feedings is not typically the first step in addressing sore nipples in a breastfeeding mother. It’s more important to address the underlying issue, such as improving the baby’s latch.
Correct Answer is D
Explanation
Choice A rationale
While surgical closure is a common treatment for myelomeningocele, it is not typically performed immediately after birth.
Choice B rationale
Cleansing the site with povidone-iodine is not typically the first step in caring for a newborn with a myelomeningocele.
Choice C rationale
Monitoring the rectal temperature every 4 hours is not specifically related to the care of a newborn with a myelomeningocele.
Choice D rationale
This is the correct answer. Administering broad-spectrum antibiotics can help prevent infection in a newborn with a myelomeningocele.
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