A nurse is caring for a preterm newborn who is in an incubator to maintain a neutral thermal environment. The father of the newborn asks the nurse why this is necessary.
Which of the following responses should the nurse make?
“Preterm newborns have a smaller body surface area than normal newborns”
“Preterm newborns lack adequate temperature control mechanisms”
“The heat in the incubator rapidly dries the sweat of preterm newborns”
“The added brown fat layer in preterm newborn reduces his ability to generate heat” .
The Correct Answer is B
Choice A rationale
While it is true that preterm newborns have a smaller body surface area than full-term newborns, this is not the primary reason for using an incubator. A smaller body surface area can contribute to heat loss, but the main issue is the lack of adequate temperature control mechanisms.
Choice B rationale
Preterm newborns lack the adequate temperature control mechanisms that full-term newborns have. They have less subcutaneous fat to insulate them and a higher surface area to volume ratio, which increases heat loss. They also lack the ability to shiver to generate heat.
Therefore, an incubator is used to maintain a neutral thermal environment.
Choice C rationale
The heat in the incubator does not rapidly dry the sweat of preterm newborns. In fact, preterm newborns do not sweat as efficiently as full-term newborns or adults, so they are less likely to lose heat through sweating.
Choice D rationale
The statement that the added brown fat layer in preterm newborn reduces his ability to generate heat is incorrect. In fact, preterm newborns have less brown fat than full-term newborns. Brown fat is a type of fat that generates heat when metabolized, and it is an important source of heat for newborns.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The nurse’s response, “You seem scared to talk to your parents,” is an empathetic response that validates the client’s feelings and encourages further communication. It’s important for the nurse to provide emotional support and help the client explore her feelings about the situation. The nurse can also provide information about confidentiality laws and discuss potential outcomes of various decisions.
Choice B rationale
Telling the client that her parents will have to be told why she is being admitted may not be accurate depending on the age of the client and local laws regarding minor’s rights to privacy in healthcare. It’s crucial to respect the client’s autonomy and privacy.
Choice C rationale
While it’s possible that the parents might understand, suggesting this puts pressure on the client to disclose her condition to her parents. The nurse should instead focus on supporting the client in making her own decision about disclosure.
Choice D rationale
Offering to tell the parents for the client could undermine the client’s autonomy and may not be legally permissible without the client’s consent. The nurse should instead focus on helping the client explore her options and come to her own decision.
Correct Answer is A
Explanation
Choice A rationale
Postpartum hemorrhage is a serious condition characterized by heavy bleeding after childbirth. In the scenario described, the nurse’s notes indicate that the client’s fundus is boggy and located 1 cm above the umbilicus, which becomes firm with massage. This could be a sign of uterine atony, a leading cause of postpartum hemorrhage. Additionally, the client reports abdominal cramping and rates the pain as 8 on a scale of 0 to 10, and the perineal pad shows a moderate amount of lochia rubra. These are all signs that could indicate a postpartum hemorrhage.
Choice B rationale
While infection is a possible postpartum complication, the symptoms provided do not strongly indicate an infection. Symptoms of a postpartum infection typically include soreness, tenderness, or swelling of the belly or abdomen, chills, pain while urinating or during sex, abnormal vaginal discharge that has a bad smell or blood in it, and a general feeling of discomfort or unwellness.
Choice C rationale
Thrombophlebitis is a condition where an inflammation in a vein is caused by a blood clot, affecting normal blood flow. It commonly occurs in the legs but can occur elsewhere in the body. The symptoms include swelling of the affected area, redness of the affected area, tenderness of the affected area, warmth around the affected area, and pain. However, the symptoms provided do not strongly indicate thrombophlebitis.
Choice D rationale
Pulmonary embolism is a serious condition that occurs when a blood clot gets lodged in an artery in the lung, blocking blood flow to part of the lung. Symptoms can include shortness of breath or chest pain. However, the symptoms provided do not strongly indicate a pulmonary embolism.
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