A nurse is teaching a client who is postpartum about caring for their newborn's umbilical cord. Which of the following instructions should the nurse include?
Cover the cord with the upper edge of the diaper.
Apply petroleum jelly around the cord with every diaper change.
Report minor bleeding when the cord's stump falls off.
Wash the area around the base of the cord with water.
The Correct Answer is D
A. Cover the cord with the upper edge of the diaper: Placing the diaper below the umbilical cord stump allows air to circulate around the area, promoting drying and preventing irritation. Covering the cord stump with the upper edge of the diaper may trap moisture and increase the risk of infection.
B. Apply petroleum jelly around the cord with every diaper change: Applying petroleum jelly or any other substance to the umbilical cord stump is not recommended as it can interfere with the natural drying process. Keeping the area dry promotes quicker healing and reduces the risk of infection.
C. Report minor bleeding when the cord's stump falls off: It is normal for a small amount of bleeding to occur when the umbilical cord stump falls off. However, ongoing bleeding or excessive bleeding should be reported to the healthcare provider. Reporting minor bleeding when the stump falls off is unnecessary as it is considered a normal part of the healing process.
D. Wash the area around the base of the cord with water: Cleaning the area around the base of the cord with water helps to prevent infection and promotes healing. It is essential to keep the area clean and dry to avoid bacterial growth. Using water alone is sufficient for cleansing, and there is no need to use soap or other products that may irritate the delicate skin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "I'll replace the batteries every 2 weeks." - This statement is incorrect. While it's essential to replace hearing aid batteries regularly, the frequency of battery replacement depends on factors such as battery type, usage, and the specific needs of the individual. Providing a specific timeframe like "every 2 weeks" may not be accurate for all clients.
B. "I'll use isopropyl alcohol to clean my hearing aids." - This statement is incorrect. Isopropyl alcohol can damage hearing aids as it may degrade plastic components or affect the adhesives used in their construction. Instead, clients should use a soft, dry cloth or a specialized hearing aid cleaning tool recommended by their audiologist.
C. "I'll clean my ear with cotton swabs before I insert my hearing aids." - This statement is incorrect. Using cotton swabs to clean the ear canal can push earwax deeper into the ear canal, potentially impacting it and interfering with hearing aid function. Clients should avoid inserting anything into their ear canal and consult with their healthcare provider if earwax buildup is a concern.
D. "It will disconnect the battery when I remove my hearing aids." - This statement is correct. Many behind-the-ear (BTE) hearing aids are designed to disconnect the battery when removed from the ear, helping to conserve battery life when not in use. This understanding indicates that the client grasps an essential aspect of caring for their hearing aids.
Correct Answer is B
Explanation
Answer: B. Turn on the faucets in the client's sink.
Rationale:
A. Tell the client to gently stroke their lower abdomen:
Stroking the abdomen may promote some sensory stimulation, but it is not a well-supported or commonly used intervention to stimulate voiding reflexes in clients having difficulty urinating on bed rest.
B. Turn on the faucets in the client's sink:
The sound of running water is a non-invasive, evidence-based method known to trigger the urge to urinate by stimulating the micturition reflex. This auditory cue can help relax pelvic muscles and facilitate urination, especially in clients struggling to void while in bed.
C. Pour cool water over the client's perineum:
Pouring cool water may not effectively stimulate urination and may cause discomfort. If water is used to promote voiding, it should be warm, not cool, to relax the perineal muscles and increase the likelihood of voiding.
D. Instruct the client to lean slightly backward:
Leaning backward can misalign the urethra and bladder, making voiding more difficult, especially for a female client in a supine or semi-recumbent position. A forward-leaning posture, if possible, is more anatomically favorable to aid urination.
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