The nurse is caring for a newly delivered breast-feeding infant. Which nursing intervention would best prevent jaundice in this infant?

Choice A reason:

Drying the newborn with a warm blanket is an effective method to prevent heat loss through evaporation, not conduction. Evaporation occurs when moisture on the baby’s skin turns into vapor, which can cool the baby down. Using a warm blanket to dry the newborn helps to remove this moisture and keep the baby warm, but it does not specifically address heat loss via conduction.

Choice B reason:

Closing the doors to the delivery room helps to maintain a warm environment and prevent drafts, which can reduce heat loss through convection. Convection is the transfer of heat through air currents, and keeping the room warm can help to minimize this type of heat loss. However, this action does not directly address heat loss via conduction.

Choice C reason:

Wrapping the newborn in a blanket is another method to prevent heat loss through radiation and convection. By wrapping the baby, you create a barrier that helps to retain the baby’s body heat and protect against cooler air temperatures. While this is important for overall warmth, it does not specifically target heat loss via conduction.

Choice D reason:

Placing the newborn on a warm crib pad is the most effective method to prevent heat loss via conduction. Conduction is the transfer of heat from the baby’s body to a cooler surface. By using a warm crib pad, you ensure that the surface in contact with the baby is warm, thereby reducing the amount of heat lost through conduction. This method directly addresses the issue of heat loss via conduction and helps to keep the newborn warm.

Choice A reason:

Observing for meconium in respiratory secretions is crucial for newborns who are small for gestational age (SGA). Meconium aspiration syndrome (MAS) is a significant risk for these infants. Meconium, the first stool of an infant, can be passed into the amniotic fluid before or during labor, especially in cases of fetal distress. If the newborn inhales this meconium-stained fluid, it can lead to severe respiratory issues, including airway obstruction, inflammation, and infection. Therefore, careful monitoring and immediate intervention are necessary to prevent complications associated with MAS.

Choice B reason:

Monitoring for hyperthermia is not typically a primary concern for SGA infants. These infants are more prone to hypothermia due to their lower body fat and reduced ability to regulate body temperature. While maintaining a stable temperature is essential, the risk of hyperthermia is less common compared to hypothermia. Therefore, this intervention is not as critical as others for SGA infants.

Choice C reason:

Identifying manifestations of anemia is important but not the most immediate concern for SGA infants. Anemia can occur in these infants due to various factors, including intrauterine growth restriction and maternal conditions. However, the immediate postnatal period requires more urgent interventions, such as monitoring for respiratory distress and hypoglycemia. Anemia can be assessed and managed as part of the ongoing care plan.

Choice D reason:

Monitoring for hyperglycemia is not a primary concern for SGA infants. In fact, these infants are at a higher risk of hypoglycemia due to their limited glycogen stores and increased metabolic demands. Hypoglycemia can lead to serious complications, including neurological damage if not promptly addressed. Therefore, monitoring blood glucose levels and ensuring adequate nutrition are critical interventions for SGA infants.