A postpartum woman telephones about her 4-day-old infant.
She is not scheduled for a weight check until the infant is 10 days old, and she is worried about whether breastfeeding is going well.
Effective breastfeeding is indicated by the newborn who:
Has at least 4 wet diapers per day with the number increasing for each day of life during the first week.
Gains 1 to 2 ounces per week.
Sleeps for 6 hours at a time between feedings.
Has at least one breast milk stool every 24 hours.
The Correct Answer is A
Choice A rationale
The number of wet diapers is a reliable indicator of sufficient fluid intake and renal perfusion, directly reflecting adequate milk transfer during breastfeeding. During the first week, an increase in wet diapers, reaching at least 6 to 8 wet diapers per day by day five, signifies successful hydration and effective latch and suck, ensuring the newborn receives necessary volume.
Choice B rationale
A newborn is expected to lose 5.
Choice C rationale
Newborns should feed on demand, typically 8 to 12 times in 24 hours or approximately every 2 to 3 hours initially, not sleeping for 6 hours between feedings. Prolonged periods of sleep, especially in the early weeks, can lead to hypoglycemia and insufficient milk intake, hindering effective weight gain and establishing milk supply.
Choice D rationale
In the first month, a breastfed newborn should typically have at least 3 to 4 breast milk stools per day, not just one, after the meconium phase is complete. Stools should transition from black (meconium) to green to a yellow, seedy consistency. One stool per 24 hours suggests inadequate intake or volume.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The regression in habits and behaviors, like a return to thumb-sucking or wetting the bed, is a common manifestation of sibling rivalry and is the older child's unconscious attempt to regain parental attention by acting like the infant. The best approach is to affirm the older child's need for extra love and attention and acknowledge that these feelings are typical, validating his emotional response to the newborn's presence and minimizing punitive reactions.
Choice B rationale
Telling the older child he is a "big boy" and instructing him to "love his new sister" invalidates his complex emotional response to the change, which often includes feelings of resentment or displacement. This statement creates an unrealistic expectation and can intensify feelings of inadequacy or hostility toward the newborn, rather than alleviating the underlying causes of sibling rivalry which require emotional support.
Choice C rationale
Asking friends and relatives not to bring gifts for the older sibling removes a crucial opportunity to help the older child feel included and valued amidst the focus on the newborn. Bringing the older child gifts, especially those "from the baby," helps mitigate feelings of being overlooked and reinforces the message that he is still important to the family, thereby reducing rivalry.
Choice D rationale
Allowing the older child to stay away from the home for 6 weeks during the newborn period may intensify the child's feeling of being displaced or abandoned by the parents. Rather than promoting adjustment, this absence can create further distance and difficulty reintegrating the older child into the new family dynamic, increasing the risk of more severe sibling rivalry upon return. —.
Correct Answer is A
Explanation
Choice A rationale
Heat loss by convection occurs when body heat is transferred to cooler ambient air that is moving across the newborn's body surface. The fan blowing directly on the unwrapped infant creates a flow of cooler air, which accelerates heat loss from the infant's skin to the surrounding air. Keeping the baby wrapped and preventing air currents minimizes this mechanism to help maintain a neutral thermal environment.
Choice B rationale
Heat loss by conduction involves the transfer of heat from the newborn's body to a cooler solid surface with which the infant is in direct contact, such as a cold mattress or scale. The situation described (fan blowing on the unwrapped baby) does not involve direct contact with a cooler surface, so conduction is not the primary mechanism of heat loss here.
Choice C rationale
Heat loss by evaporation involves the vaporization of water from the newborn's moist skin or respiratory tract, such as from amniotic fluid immediately after birth or from sweat or insensible water loss. While some insensible loss occurs, the fan's action is primarily convection, as it moves cooler air over the infant, making evaporation an indirect or secondary concern.
Choice D rationale
While it is true that a newborn needs to be bundled to maintain a neutral thermal environment (NTE), stating this general fact does not answer the mother's "why" question regarding the specific mechanism of heat loss caused by the fan. The NTE is the range of ambient temperatures where metabolic rate and oxygen consumption are minimal to maintain a normal body temperature (36.5°C to 37.5°C). —.
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