As the nurse caring for an infant who has been prescribed Amoxicillin (Amoxil) orally every 6 hours, you need to calculate the dose.

The recommended dosage is 50 mg/kg/day, divided into multiple doses.

If the infant weighs 6 kg, how much Amoxicillin should you administer per dose?

Choice A rationale

Administering oral glucose for comfort can provide analgesia and soothe a newborn experiencing withdrawal symptoms, which often include irritability and crying. The hyperglycemic solution activates sweet taste receptors and provides a calming effect. It does not alter the newborn's withdrawal process but aids in temporary relief from discomfort caused by neonatal abstinence syndrome. Sweet solutions are commonly used for procedural pain management in neonates.

Choice B rationale

Observing the newborn in a well-lit nursery is inappropriate for managing withdrawal symptoms. Bright lights can overstimulate the newborn and exacerbate symptoms such as irritability and crying. Neonates exposed to heroin in utero often require a low-stimulation environment to prevent sensory overload, as their central nervous system is already compromised by drug exposure. Excessive stimulation can worsen withdrawal effects, increasing stress for the infant.

Choice C rationale

Maintaining a low-stimulation environment is critical for newborns experiencing withdrawal. These infants benefit from dim lighting, minimal noise, and reduced handling, as their central nervous system is hypersensitive. High stimulation may intensify symptoms like tremors and irritability. A controlled, soothing environment helps stabilize the newborn's condition by promoting better neurological regulation and decreasing withdrawal-related distress.

Choice D rationale

Offering the newborn a pacifier helps to satisfy non-nutritive sucking needs, which are often heightened in neonates with withdrawal symptoms. The act of sucking can comfort the infant and reduce irritability associated with neonatal abstinence syndrome. Non-nutritive sucking is a self-soothing behavior that has been proven to decrease stress responses and stabilize physiological parameters in affected infants.

Choice E rationale

Feeding the infant half-strength formula is inappropriate as it can lead to nutritional deficiencies, which are harmful to a newborn already at risk due to prenatal drug exposure. Newborns require adequate caloric intake to support growth and recovery. Half-strength formula lacks sufficient nutrients necessary for healthy weight gain and organ development. Full-strength, nutrient-rich feeding is advised for optimal neonatal care.

Choice F rationale

Swaddling the newborn with legs flexed mimics the intrauterine environment and provides a sense of security to a neonate undergoing withdrawal symptoms. This method reduces sensory stimulation and decreases distress, helping stabilize the infant's condition. Swaddling promotes calming and decreases excessive movements such as tremors, which are characteristic of neonatal abstinence syndrome. It is a widely accepted comfort measure.

Choice A rationale

A positive rubella serum antibody titer indicates immunity to rubella infection, which is protective during pregnancy. It is not an abnormal finding and does not require immediate reporting. Rubella immunity is important to prevent congenital rubella syndrome in the fetus, a severe condition causing defects such as deafness or cardiac anomalies.

Choice B rationale

Blood pressure of 144/94 mmHg is elevated and indicates gestational hypertension, which could progress to preeclampsia if not managed. Preeclampsia can lead to complications such as eclampsia, placental abruption, or maternal and fetal mortality. Normal blood pressure during pregnancy is less than 140/90 mmHg, making this finding critical to report.

Choice C rationale

Copious leukorrhea is a common physiological change in pregnancy due to increased estrogen levels and vascularity. It is usually benign and protective, preventing infections by maintaining a mildly acidic environment in the vagina. This finding does not warrant immediate concern unless associated with infection symptoms.

Choice D rationale

An O-negative blood type requires administration of Rh immunoglobulin to prevent Rh isoimmunization, but this is routinely managed in pregnancy. It is not an urgent issue unless there are concerns about fetomaternal hemorrhage or alloimmunization, which could harm an Rh-positive fetus.