A nurse is performing a head-to-toe assessment on a newborn. Which of the following actions should the nurse take to prevent heat loss through conduction?
Conduct the assessment before drying the newborn.
Check the newborn's rectal temperature every hr.
Place the newborn in an open crib for the initial assessment.
Cover scale with warm blankets when weighing the newborn.
The Correct Answer is D
Rationale:
A. Conduct the assessment before drying the newborn: Performing the assessment before drying exposes the newborn’s wet skin to cooler air and surfaces, increasing heat loss through evaporation, not conduction. The newborn should always be thoroughly dried immediately after birth to conserve body heat.
B. Check the newborn's rectal temperature every hr: Frequent temperature monitoring does not prevent heat loss; it only identifies hypothermia after it occurs. Additionally, rectal temperature measurement may cause mucosal injury and is not routinely recommended for newborns.
C. Place the newborn in an open crib for the initial assessment: Placing the newborn in an open crib exposes the infant to cooler air and surfaces, increasing heat loss through convection and conduction. The initial assessment should occur under a radiant warmer to maintain thermal stability.
D. Cover scale with warm blankets when weighing the newborn: Covering the scale prevents conduction heat loss, which occurs when the newborn’s skin comes into contact with cold surfaces. Using a warm blanket or pad ensures the infant’s body heat is preserved during weighing or handling.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Advise the client to wait 1 hr before showering or swimming: Testosterone gel should be allowed to fully absorb into the skin before washing or swimming, typically waiting at least 1 hour. This ensures optimal absorption and therapeutic effect.
B. Instruct the client to have his testosterone checked in 1 week: Testosterone levels are generally evaluated after several weeks of therapy to assess effectiveness, not after just one week.
C. Wear clean gloves to apply the gel: The client should apply the medication themselves using clean, dry hands. The nurse should wear gloves only if assisting to prevent unintentional hormone absorption.
D. Apply the gel to the client's genital region: Testosterone gel should not be applied to the genitals due to increased absorption risk and skin irritation. Recommended sites include shoulders, upper arms, or abdomen.
Correct Answer is D
Explanation
Rationale:
A. Call in additional medical-surgical unit nursing care staff: Calling in staff may be part of the overall disaster plan but is typically coordinated by administration or the incident command team, not by individual unit nurses.
B. Act as a liaison between the facility and the media: Communication with the media is the responsibility of the facility’s public information officer or designated spokesperson, not bedside nurses.
C. Determine the medical needs of incoming clients through the emergency department: Triage and assessment of incoming clients occur in the emergency department by the triage nurse or emergency staff, not on the medical-surgical unit.
D. Recommend to the provider specific acute care clients for discharge: In a mass casualty event, medical-surgical nurses help identify stable clients who can be safely discharged or transferred to make room for incoming critical clients. This is an essential role in surge capacity management.
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