The nurse is caring for a newly delivered breast-feeding infant. Which nursing intervention would best prevent jaundice in this infant?
Encouraging the mother to supplement breast-feeding with formula.
Keeping the infant NPO until the second period of reactivity.
Encouraging the mother to breastfeed the infant every 2 to 3 hours.
Placing the infant under phototherapy.
The Correct Answer is C
Choice A Reason:
Encouraging the mother to supplement breast-feeding with formula is not the best intervention to prevent jaundice. Frequent breastfeeding helps to increase the infant’s fluid intake and promotes the excretion of bilirubin through stools. Supplementing with formula may interfere with the establishment of breastfeeding and is not necessary unless the infant is not feeding well.
Choice B Reason:
Keeping the infant NPO (nothing by mouth) until the second period of reactivity is not recommended. Early and frequent breastfeeding is crucial in preventing jaundice as it helps to establish milk supply and promotes the passage of meconium, which contains bilirubin.
Choice C Reason:
Encouraging the mother to breastfeed the infant every 2 to 3 hours is the best intervention to prevent jaundice. Frequent breastfeeding ensures that the infant receives adequate nutrition and hydration, which helps to lower bilirubin levels by promoting regular bowel movements.
Choice D Reason:
Placing the infant under phototherapy is a treatment for jaundice, not a preventive measure. Phototherapy is used when bilirubin levels are already elevated. The goal is to prevent jaundice from developing in the first place through frequent breastfeeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Allowing the grandmother to push the baby to the room in a wheeled bassinet is not advisable. Hospitals have strict protocols to prevent infant abduction, and only authorized personnel should transport newborns. This ensures the safety and security of the infant.
Choice B Reason:
Requiring photo identification from the grandmother before allowing her to take the infant is not a standard practice. While identification is crucial, it is typically the responsibility of the hospital staff to transport the newborn to ensure proper security measures are followed.
Choice C Reason:
Having the mother call and the nurse taking the baby to the room is the most appropriate response. This ensures that the newborn is transported safely by authorized personnel, adhering to hospital protocols designed to prevent infant abduction and ensure the baby’s safety.
Choice D Reason:
Allowing the grandmother to carry the grandchild to the room is not recommended. Similar to choice A, this does not align with hospital security protocols. Only authorized personnel should handle the transportation of newborns within the hospital to maintain safety and security.
Correct Answer is A
Explanation
Choice A Reason:
The primary reason for performing an ultrasound before an amniocentesis is to identify the location of the placenta and fetus. This ensures that the needle used for the procedure can be safely inserted into the amniotic sac without harming the fetus or placenta12. The ultrasound helps guide the healthcare provider to a safe location for the needle insertion, minimizing risks associated with the procedure.
Choice B Reason:
While an ultrasound can be useful for estimating fetal age, this is not the primary reason for performing it before an amniocentesis. The main goal is to ensure the safety of the procedure by accurately locating the fetus and placenta.
Choice C Reason:
An ultrasound is not primarily a screening tool for spina bifida. Although it can help detect certain congenital anomalies, the main purpose of the ultrasound before an amniocentesis is to guide the needle insertion safely.
Choice D Reason:
Determining if there is more than one fetus can be an incidental finding during an ultrasound, but it is not the primary reason for performing the ultrasound before an amniocentesis. The main objective is to ensure the safe placement of the needle by identifying the exact location of the fetus and placenta.
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