A nurse is caring for an infant who has a prescription for continuous pulse oximetry. Which of the following actions should the nurse take?
Warm the infant's extremity for 1 min prior to placing the sensor probe.
Keep the infant's foot immobilized while the sensor is in place.
Place a sensor on the infant's index finger.
Place a sock over the infant's foot to secure the sensor.
The Correct Answer is B
A. Warm the infant's extremity for 1 min prior to placing the sensor probe: While cold extremities can affect pulse oximetry readings, brief warming alone may not reliably improve accuracy. Proper probe placement and minimizing movement are more critical to obtaining consistent readings.
B. Keep the infant's foot immobilized while the sensor is in place: Immobilizing the extremity prevents motion artifact, which can interfere with pulse oximetry accuracy. This is a recommended action for continuous monitoring in infants, as movement can cause false low or fluctuating readings.
C. Place a sensor on the infant's index finger: In infants, the fingers are often too small for standard pulse oximetry probes. Preferred sites include the foot or wrist, which accommodate the sensor without compromising accuracy.
D. Place a sock over the infant's foot to secure the sensor: Covering the sensor with a sock may create pressure or interfere with proper probe function, and it can trap moisture, which affects readings. Securing the probe with gentle adhesive or specialized wraps is safer.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["6.2"]
Explanation
Rationale:
- Identify the ordered dose and client weight
Ordered Dose: 0.15 mg/kg
Client Weight: 41 kg
- Calculate the dose to administer
Dose to administer = Ordered Dose × Client Weight
Dose to administer = 0.15 × 41
Dose to administer = 6.15 mg
Correct Answer is B
Explanation
A. "Yes, you will have to discontinue breastfeeding.": Stopping breastfeeding is not necessary with mastitis unless the mother is severely ill or the provider specifically advises it. Continuing to nurse helps relieve milk stasis and promotes healing.
B. "No, you can continue to nurse from both your breasts.": Continuing to breastfeed or pump from both breasts is recommended. Frequent emptying of the affected breast reduces engorgement, clears infection, and maintains milk supply while ensuring the infant receives safe breast milk.
C. "No, but you should alternate between the right breast and the bottle.": Alternating with bottles is unnecessary unless the mother cannot feed directly. Encouraging breastfeeding from both breasts helps resolve the infection more efficiently.
D. "Yes, but you can resume nursing when you are done with your antibiotics.": Delaying breastfeeding is not required; continuing to nurse while on antibiotics that are safe for lactation is standard practice and helps resolve mastitis faster.
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