Name 3 nursing interventions that promote stabilization of the newborn immediately after birth:

A) It could make respiratory distress syndrome worse:
The most critical reason to protect a preterm infant from cold stress is that hypothermia can exacerbate respiratory distress syndrome (RDS). Cold stress leads to an increased oxygen demand, which can worsen the infant’s already compromised respiratory function. In preterm infants, the immature lungs and underdeveloped surfactant production contribute to RDS, and hypothermia worsens the situation by increasing metabolic demands and impairing pulmonary function. Maintaining a stable body temperature is crucial for minimizing respiratory complications.

B) Shivering to produce heat may use up too many calories:
While it is true that preterm infants may not have the metabolic reserves to generate heat via shivering (as they lack significant brown fat), the primary concern is not shivering. Preterm infants generally do not shiver, and cold stress does not trigger this response. Instead, their body tries to conserve heat through vasoconstriction and increased metabolism, which can lead to hypoxia and worsening respiratory distress.

C) A low temperature may make the infant less able to digest nutrients:
Cold stress can affect a preterm infant’s gastrointestinal function by reducing blood flow to the digestive organs, which can impair nutrient absorption and digestion. However, the most immediate and serious consequence of cold stress is the increased metabolic demand and worsening of respiratory distress, rather than a direct impact on digestion. Protecting the infant from hypothermia helps prevent these secondary complications.

D) Cold decreases circulation to the extremities:
While cold stress can indeed lead to vasoconstriction and decreased circulation to the extremities, this is not the most significant concern. The primary issue with cold stress in preterm infants is the overall increase in metabolic demands, oxygen consumption, and exacerbation of respiratory problems, which can lead to more severe respiratory distress syndrome. The loss of peripheral circulation is a secondary concern.

A) Bulb syringe in crib:
While a bulb syringe can be useful for clearing the infant’s airway in case of respiratory distress, keeping it in the crib is not an optimal safety practice. The syringe should be readily available but not within reach of the infant, as it could be a choking hazard if mishandled. Ideally, it should be stored in an easily accessible area but not within the crib.

B) Secure hugs tag on and alarms activated:
Ensuring that the infant has a security tag (often referred to as a "Hugs" tag) that is properly placed and that alarms are activated is an important safety measure to prevent infant abductions. Hospitals typically use electronic security systems that alert staff if the infant is removed from the designated area without proper authorization. This intervention is essential for maintaining safety in the hospital setting.

C) ID bands match with mom's ID bands:
It is critical that the infant's ID band matches the mother's ID band. This helps prevent any mix-up or baby swap and ensures that the infant is properly identified at all times. Regular checks should be made to verify that the bands match and remain secure throughout the hospital stay.

D) Infant on their back to sleep:
Placing the infant on their back to sleep is a key guideline for reducing the risk of Sudden Infant Death Syndrome (SIDS). This position has been proven to be the safest for infants and is a crucial practice for their well-being. Educating parents and caregivers about safe sleep practices is vital for infant safety.

E) All of the above:
All of these practices are part of a comprehensive safety plan for the infant. Ensuring that the infant is safely secured with proper identification, preventing any risk of abduction, promoting safe sleep practices, and ensuring that airway equipment is available are all essential measures in maintaining the safety of the newborn. Therefore, the correct response is "All of the above."