A nurse observes a nurse assistant bathing a newborn in a drafty room near an open window.
The infant's temperature drops to 97.0°F (36.1°C). Which type of heat loss caused this?
Convection.
Evaporation.
Conduction.
Radiation.
The Correct Answer is A
Choice A rationale
Convection is the heat loss mechanism that involves the transfer of heat from the infant's skin surface to the surrounding cooler air currents. The draft from the open window and the movement of air in the room facilitate this rapid movement of heat away from the infant's body, causing a significant and quick drop in the core temperature, especially when the infant is wet from bathing.
Choice B rationale
Evaporation is the loss of heat that occurs when water (like amniotic fluid or bath water) on the infant's skin surface is converted into vapor. Although this is a significant form of heat loss during and immediately after bathing, the additional factor of a "drafty room near an open window" strongly suggests that convection is the primary or most significant cause of the heat loss in this specific scenario.
Choice C rationale
Conduction involves the transfer of heat from the infant to a cooler object that is in direct contact with the skin, such as a cold scale, mattress, or towel. In this scenario, while the bath setup could involve some conduction, the presence of a drafty room and open window makes heat loss via convection a far more pronounced and likely cause for the significant temperature drop.
Choice D rationale
Radiation is the transfer of heat from the infant's warmer body surface to nearby cooler solid objects that are not in direct contact with the skin, such as cold walls or windowpanes. Although the open window may be a cool object, the draft (moving air) explicitly described in the situation points more directly to heat loss through air currents, which is defined as convection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Frequent, effective milk removal is the principal determinant of milk production because it works on the principle of supply and demand, stimulating prolactin and oxytocin release. The more often the breast is emptied, the more the body signals the glands to synthesize milk, ensuring a robust and sustained supply for the newborn.
Choice B rationale
Breastfeeding only four times in 24 hours is insufficient for establishing and maintaining a full milk supply, as it does not provide enough stimulation or regular milk removal. Most newborns need 8 to 12 feedings in 24 hours, especially in the early weeks, to stimulate adequate milk production.
Choice C rationale
Supplementing with formula can decrease the newborn's demand for breast milk, leading to reduced milk removal from the breast. This reduced stimulation decreases the maternal prolactin levels, which in turn signals the body to decrease milk production, jeopardizing supply.
Choice D rationale
Using an electric pump only once per day is insufficient to maintain a full milk supply, especially if the newborn is not feeding frequently or effectively. Pumping should occur as frequently as the newborn would feed or after each feeding to maximize breast stimulation and milk output.
Correct Answer is C
Explanation
Choice A rationale
Keeping the nipple filled with formula is a correct technique to minimize the amount of air the infant swallows during the feeding. Air ingestion can lead to abdominal distention, gas, and discomfort, so maintaining a constant fluid level in the nipple requires continuous gentle adjustment of the bottle angle.
Choice B rationale
The infant should be held in a semi-upright or upright position (at least a 45-degree angle) for all bottle feedings. This position aids in controlling the flow of formula, reduces the risk of aspiration, and facilitates the passage of milk into the stomach through gravity, promoting a safer and more comfortable feeding experience.
Choice C rationale
Using a pillow to prop the bottle in the infant's mouth is an unsafe feeding practice that indicates a need for further instruction. Propping a bottle increases the risk of choking, aspiration, and ear infections (due to milk pooling in the eustachian tubes) and removes the critical component of parental bonding and monitoring during the feeding.
Choice D rationale
Skin-to-skin contact, although often associated with breastfeeding, is highly beneficial during bottle feeding as well. It promotes bonding, helps regulate the newborn's temperature and heart rate, and can make the feeding experience more calming and pleasant for the infant, reinforcing positive parent-child interaction.
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