A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH).

Which of the following interventions should the nurse include in the plan?

Monitor vital signs and neurological status frequently

Administer antibiotics as prescribed

Elevate the head of the bed to 30 degrees

Provide supplemental oxygen as needed

Answer and Explanation

The Correct Answer is A

Monitor vital signs and neurological status frequently.

This is because intraventricular hemorrhage (IVH) is a common and serious complication of prematurity that can lead to hydrocephalus, cerebral palsy, and developmental delays. Monitoring vital signs and neurological status can help detect changes in intracranial pressure, bleeding, and infection.

Choice B is wrong because antibiotics are not indicated for IVH unless there is evidence of infection.

Choice C is wrong because elevating the head of the bed to 30 degrees can increase the risk of IVH by reducing cerebral perfusion pressure and causing venous congestion.

Choice D is wrong because supplemental oxygen is not recommended for IVH unless there is hypoxia or respiratory distress. Excessive oxygen can cause oxidative stress and vasoconstriction, which can worsen IVH.

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Correct Answer is D

Explanation

“I will call my doctor if I have more than four contractions in an hour.” This statement indicates that the client understands the signs of preterm labor and when to seek medical attention.Preterm labor is defined as having regular contractions and cervical changes before 37 weeks of gestation.More than four contractions in an hour may indicate that preterm labor is occurring and requires prompt evaluation.

Choice A is wrong because drinking at least eight glasses of water every day is not a specific instruction for preventing preterm labor.However, dehydration can trigger contractions and should be avoided.

Choice B is wrong because lying on the back with a pillow under the knees can reduce blood flow to the uterus and the baby.This position can also increase the risk of blood clots in the legs.A better position is lying on the left side, which improves circulation and reduces pressure on the cervix.

Choice C is wrong because avoiding sexual intercourse until reaching term is not necessary for most women with a history of preterm labor.Sexual activity does not cause preterm labor or premature rupture of membranes (PROM).However, some women may be advised to abstain from sex if they have certain conditions, such as placenta previa or a short cervix.

A. Tachypnea and grunting B. Bradycardia and cyanosis C. Apnea and nasal flaring D. All of the above

Correct Answer is D

Explanation

All of the above.

Respiratory distress syndrome (RDS) is a condition that affects preterm newborns who have immature lungs and lack sufficient surfactant.

Surfactant is a substance that helps keep the alveoli open and prevents them from collapsing.

Without enough surfactant, the newborn has difficulty breathing and may develop hypoxia and acidosis.

Choice A is wrong because tachypnea and grunting are signs of respiratory distress, but they are not specific to RDS.

They can also be caused by other conditions such as transient tachypnea of the newborn, pneumonia, or congenital heart defects.

Choice B is wrong because bradycardia and cyanosis are also signs of respiratory distress, but they are not specific to RDS.

They can also be caused by other conditions such as hypothermia, hypoglycemia, or sepsis.

Choice C is wrong because apnea and nasal flaring are also signs of respiratory distress, but they are not specific to RDS.

They can also be caused by other conditions such as intracranial ...

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A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH). Which of the following interventions should the nurse include in the plan?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing discharge instructions to a client who had pre-term labor at 32 weeks of gestation and was prescribed bed rest at home. Which of the following statements by the client indicates an understanding of the teaching?

Correct Answer is D

Explanation

A nurse is assessing a pre-term newborn who was born at 28 weeks of gestation. Which of the following findings indicates a possible diagnosis of respiratory distress syndrome (RDS)?

Correct Answer is D

Explanation

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A nurse is planning care for a pre-term newborn who has a diagnosis of intraventricular hemorrhage (IVH).

Which of the following interventions should the nurse include in the plan?