A nurse is providing discharge teaching to a client who delivered a pre-term newborn at 34 weeks of gestation.
Which of the following instructions should the nurse include in the teaching?
Avoid breastfeeding until the newborn reaches term gestation
Use an apnea monitor at home as prescribed
Keep the newborn in a warm environment at all times
Delay immunizations until the newborn reaches term gestation.
The Correct Answer is B
Pre-term newborns are at risk of apnea of prematurity, which is a pause in breathing for more than 20 seconds or less than 20 seconds with bradycardia or cyanosis. An apnea monitor can detect and alert the parents of any episodes of apnea and help them intervene promptly.
Choice A is wrong because breastfeeding is beneficial for pre-term newborns and can provide them with antibodies, nutrients, and bonding with the mother. Breastfeeding should be encouraged as soon as the newborn is medically stable and able to suck and swallow.
Choice C is wrong because keeping the newborn in a warm environment at all times can lead to overheating, dehydration, and increased metabolic rate. Pre-term newborns have difficulty regulating their body temperature and need to be dressed appropriately for the ambient temperature. They should also be monitored for signs of cold stress or heat stress.
Choice D is wrong because delaying immunizations until the newborn reaches term gestation can expose the newborn to preventable infections that ...
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Correct Answer is C
Explanation
To promote fetal lung maturity.Betamethasone (Celestone) is a type of corticosteroid that can help reduce the risk of respiratory distress syndrome and other complications in preterm infants by accelerating the development of their lungs.It is recommended for pregnant women between 24 0/7 weeks and 36 6/7 weeks of gestation who are at risk of preterm delivery within 7 days.
Choice A is wrong because betamethasone does not suppress uterine contractions.
It has no effect on the cause of preterm labor.
Choice B is wrong because betamethasone does not prevent infection.
It may actually increase the risk of infection by suppressing the immune system.
Choice D is wrong because betamethasone does not reduce maternal blood pressure.
It may actually cause hypertension and hyperglycemia as side effects.
Correct Answer is A
Explanation
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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