A nurse is educating a parent about how to care for a newborn who has hyperbilirubinemia at home.
Which of the following statements by the parent indicates an understanding of the teaching?
“I will call the doctor if my baby has a high-pitched cry or seizures.”
“I will keep my baby fully clothed and wrapped in blankets.”
“I will limit breastfeeding to no more than 10 minutes per session.”
“I will avoid exposing my baby to sunlight or artificial light.”.
The Correct Answer is A
This statement indicates that the parent understands the signs of acute bilirubin encephalopathy, a serious complication of hyperbilirubinemia that can cause brain damage.
The parent should seek immediate medical attention if these symptoms occur.
Choice B is wrong because “I will keep my baby fully clothed and wrapped in blankets.” This statement indicates that the parent does not understand the role of phototherapy in treating hyperbilirubinemia. Phototherapy is a treatment wherein a baby is placed under a special blue spectrum light to reduce the bilirubin levels. The baby should be exposed to as much light as possible, with only the eyes and genitals covered.
Choice C is wrong because “I will limit breastfeeding to no more than 10 minutes per session.” This statement indicates that the parent does not understand the importance of adequate hydration and nutrition in preventing and treating hyperbilirubinemia. Breastfeeding should not be interrupted or limited, as it provides fluids and calories that help the baby excrete bilirubin through urine and stool. The American Academy of Pediatrics recommends breastfeeding at least 8 to 12 times per day for newborns.
Choice D is wrong because “I will avoid exposing my baby to sunlight or artificial light.” This statement indicates that the parent does not understand the difference between natural and artificial light sources for phototherapy. Sunlight or artificial light from lamps or windows are not effective or safe for treating hyperbilirubinemia, as they do not emit the right wavelength or intensity of light, and they can cause overheating, dehydration, sunburn, or eye damage.
The baby should receive phot
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Correct Answer is C
Explanation
The baby is at risk for hemolytic jaundice if the mother has a different blood type that is incompatible with the baby’s blood type.This can cause the mother’s immune system to produce antibodies that attack the baby’s red blood cells, leading to hemolysis or excessive destruction of red blood cells.Hemolysis can cause bilirubin, a yellowish pigment, to accumulate in the baby’s blood, tissues, and fluids, causing jaundice.It can also cause anemia, a condition where the blood does not have enough healthy red blood cells.
Choice A is wrong because O positive is compatible with B negative.
O positive is the universal donor, meaning it can donate blood to any other blood type without causing a reaction.
Choice B is wrong because AB negative is compatible with B negative.
AB negative is the universal recipient, meaning it can receive blood from any other blood type without causing a reaction.
Choice D is wrong because A negative is incompatible with B negative.
A negative and B negative are different blood types that can cause a reaction if mixed together.
Correct Answer is B
Explanation
Transcutaneous bilirubin measurement is a useful screening tool for neonatal hyperbilirubinemia, but it has some limitations and sources of variability.Therefore, any bilirubin screening result obtained must be confirmed by a diagnostic method before treatment.
Choice A is wrong because initiating phototherapy without confirming the bilirubin level could expose the newborn to unnecessary treatment and potential adverse effects.
Choice C is wrong because increasing hydration by feeding more frequently may not be sufficient to lower the bilirubin level if it is too high or if there are other causes of jaundice.
Choice D is wrong because reassuring the parent that this is a normal finding could delay the diagnosis and treatment of severe neonatal hyperbilirubinemia, which can lead to serious complications such as kernicterus spectrum disorders.
Normal ranges for transcutaneous bilirubin measurement vary depending on the device used, the skin pigmentation, and the postnatal age of the newborn.However, a general guideline is that a measurement of 16 mg/dL at 48 hours of age is above the 95th percentile and warrants further investigation.
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