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A nurse is caring for the newborn 1 day after birth

Exhibits
Select 2 orders which the nurse should anticipate that the provider will prescribe

A.

Supplement feedings with dextrose water

B.

Administer intravenous dextrose

C.

Obtain a total serum bilirubin

D.

Encourage breastfeeding every 2 hr

E.

Prepare for an exchange transfusion

F.

Obtain blood cultures

Answer and Explanation

Correct Answer : C,D

A. Supplement feedings with dextrose water – Dextrose water is not appropriate for newborn feeding. It lacks the necessary calories and nutrients and is not recommended for managing hyperbilirubinemia or hydration.

B. Administer intravenous dextrose – There is no evidence of hypoglycemia or need for IV fluids. This is not indicated based on the current assessment.

C. Obtain a total serum bilirubin – The yellow sclera and cephalohematoma (from vacuum-assisted birth) place the newborn at risk for hyperbilirubinemia. A serum bilirubin level is needed to assess severity.

D. Encourage breastfeeding every 2 hr – This promotes bilirubin excretion through stools and urine, which is essential in managing or preventing jaundice in newborns.

E. Prepare for an exchange transfusion – This is a treatment for severe hyperbilirubinemia or hemolytic disease, and is not indicated at this stage without bilirubin results.

F. Obtain blood cultures – The mother received appropriate intrapartum prophylaxis (2 doses of penicillin G) for GBS. The newborn shows no signs of sepsis (vital signs normal, active, feeding), so cultures are not indicated now.


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Related Questions

Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"C"}}

Explanation

  • Administer an iron supplement: The client has low hemoglobin, hematocrit, RBCs, and ferritin, which are consistent with iron deficiency anemia. Iron supplementation is expected to help correct the deficiency and improve oxygen-carrying capacity.
  • Refer for a nutritional consult: A vegan diet, if not properly planned, can lack adequate sources of iron and vitamin B12. A nutritionist can help the client meet dietary needs through fortified foods or supplements, addressing underlying causes of anemia.
  • Place the client on a low sodium diet: The client’s blood pressure is within acceptable range, and there is no history of hypertension or fluid overload. A low sodium diet would not target the client’s current symptoms of anemia and fatigue.
  • Restrict fluid intake: The client shows signs of volume depletion (orthostatic hypotension and low Hct) rather than fluid overload. Restricting fluids could worsen hypotension and contribute to decreased perfusion, making it inappropriate.

Correct Answer is A

Explanation

A. The diaphragm should be inserted after emptying the bladder to reduce the risk of urinary tract infections.
B. Baby powder should not be applied to the diaphragm as it can cause irritation or damage.
C. Oil-based lubricants can degrade latex diaphragms and reduce their effectiveness; only water-based lubricants should be used.
D. The diaphragm should be left in place for at least 6 hours after intercourse, not just 4 hours, to ensure effective contraception.

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