A one-day-old newborn, at 32 weeks' gestation, is under the radiant warmer.
The nurse assesses the axillary temperature and notes it is 97.3 degrees F (36.3 degrees C). Which of the following would explain this assessment finding?
This is a normal temperature for a preterm neonate.
The supply of brown adipose tissue is incomplete.
Conduction heat loss is pronounced in the neonate.
Axillary temperatures are not valid for the preterm neonate.
The Correct Answer is B
Choice A rationale
A temperature of 97.3 degrees F (36.3 degrees C) is considered mildly hypothermic for a neonate, as the normal axillary temperature range is typically 97.7 to 99.5 degrees F (36.5 to 37.5 degrees C). This slightly low temperature indicates inadequate thermoregulation or heat loss, even while under a radiant warmer, and requires intervention.
Choice B rationale
Preterm neonates, especially those at 32 weeks' gestation, have an incomplete development and limited supply of brown adipose tissue, which is the primary non-shivering thermogenesis mechanism in newborns. This lack of available brown fat reserves significantly impairs their ability to generate heat metabolically, making them highly susceptible to cold stress and hypothermia.
Choice C rationale
While conduction heat loss is a factor where heat transfers from the infant's body to a cooler surface, it is minimized by the use of a radiant warmer and proper bedding. The primary cause of the preterm infant's hypothermia is their physiological immaturity in heat production, rather than a single mode of heat loss.
Choice D rationale
Axillary temperatures are considered a valid and safe method for assessing temperature in both term and preterm neonates, providing a reliable measure of core body temperature. Rectal temperatures, while sometimes used, carry a small risk of perforation and are not routinely preferred for initial or frequent checks in this population.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Determining the child's specific vocabulary for body functions and feelings is essential to facilitate effective communication and reduce anxiety during hospitalization. Children with Down syndrome may have delayed or limited expressive language skills, and understanding their individual communication patterns is a foundational nursing action.
Choice B rationale
Assessing hearing and visual capabilities is a critical step because children with Down syndrome have an increased incidence of sensory deficits, such as conductive hearing loss and refractive errors. Identifying these deficits allows the nurse to tailor communication and safety measures to the child's specific sensory needs.
Choice C rationale
Encouraging parents to leave the child alone is contraindicated because children with Down syndrome, like most hospitalized children, benefit greatly from the presence of their primary caregivers to feel secure and reduce separation anxiety. Parental presence promotes emotional well-being and facilitates communication.
Choice D rationale
Maintaining the child's usual meal times is an appropriate and supportive action that promotes a sense of normalcy and control for the child in the unfamiliar hospital setting. Consistency in routines, including feeding schedules, helps minimize anxiety and encourages adequate nutritional intake.
Correct Answer is C
Explanation
Choice A rationale
Although finishing the entire course of antibiotics is crucial for preventing antibiotic resistance and ensuring the complete eradication of the bacteria, it is not the standard criterion for determining when a child can return to school. The infectious period is generally considered to end much sooner after initiating topical treatment.
Choice B rationale
The cessation of eye drainage, or purulent discharge, is a sign of improving infection but is not the sole, definitive indicator for returning to school. The child is generally considered non-infectious and can return to school after a specified period of effective topical antibiotic treatment has been completed.
Choice C rationale
Bacterial conjunctivitis is highly contagious, but contagiousness is rapidly reduced upon starting topical antibiotic treatment. Most school and public health guidelines permit a child to return to school 24 hours after the initiation of topical antibiotic therapy because the risk of transmission is significantly decreased within this timeframe.
Choice D rationale
Requiring a child to be symptom-free for 72 hours is an overly restrictive and generally unnecessary measure for bacterial conjunctivitis managed with topical antibiotics. The standard public health recommendation focuses on the duration of appropriate antibiotic treatment to minimize infectious risk, which is typically 24 hours.
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