A nurse is caring for a preterm newborn who has a nasogastric tube and who recently began intermittent gavage feedings of formula. The nurse notes increased abdominal distention, lethargy, bloody stools, and increasing gastric residuals before feedings. The nurse should suspect which of the following?
Intraventricular hemorrhage
Need for placement of a gastrostomy tube
Overstimulation
Necrotizing enterocolitis
The Correct Answer is D
A. Intraventricular hemorrhage presents with neurological signs like apnea or seizures, not primarily gastrointestinal symptoms.
B. Increased gastric residuals alone may indicate a need for tube placement, but the full symptom set suggests NEC.
C. Overstimulation may cause irritability but does not typically result in bloody stools or abdominal distension.
D. NEC is a life-threatening gastrointestinal disorder in preterm infants characterized by intestinal inflammation, abdominal distension, lethargy, bloody stools, and increased gastric residuals. Immediate intervention is necessary.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Delayed diaper changes can increase the risk of skin breakdown and infection.
B. Frequent repositioning and stimulation with a mobile may increase stress and intracranial pressure.
C. Minimizing stimulation, providing boundaries, and maintaining a calm environment (e.g., dim lighting) help reduce intracranial pressure and prevent further bleeding in infants with periventricular hemorrhage.
D. While pain management is important, feeding increases may exacerbate intracranial pressure and are not the priority.
Correct Answer is ["A","B","C","E"]
Explanation
A. Bottle-feeding formula is associated with a higher risk of childhood obesity compared to breastfeeding, due to differences in nutrient composition and feeding regulation.
B. Formula feeding is more expensive than breastfeeding, requiring the purchase of formula, bottles, and other supplies.
C. Formula feeding increases the risk of infections such as gastroenteritis, especially if bottles and nipples are not properly sterilized.
D. Bottle-feeding may reduce the opportunity for maternal-infant bonding compared to breastfeeding, which promotes skin-to-skin contact and the release of oxytocin.
E. This is a neutral factor and not a disadvantage; the ability for others to feed the infant can provide flexibility and support for the mother.
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