The nurse is assessing a 40-week-gestation infant. What action by the nurse prevents heat loss through conduction?

Warm the stethoscope before use.

Move the infant away from a drafty vent.

Dry the infant with a towel.

Close the doors to the isolate.

Answer and Explanation

The Correct Answer is A

Choice A reason: Warming the stethoscope before use prevents heat loss through conduction. Conduction is the transfer of heat from the infant's body to a cooler surface or object that comes in direct contact with them. By warming the stethoscope, the nurse ensures that the infant does not lose heat to the cold surface of the stethoscope, thereby helping to maintain the infant's body temperature.

Choice B reason: Moving the infant away from a drafty vent helps prevent heat loss through convection, not conduction. Convection is the transfer of heat through air currents, and keeping the infant away from drafts helps minimize this type of heat loss.

Choice C reason: Drying the infant with a towel prevents heat loss through evaporation. When a wet infant is dried, it helps reduce the loss of heat that occurs as moisture evaporates from the skin.

Choice D reason: Closing the doors to the isolate helps prevent heat loss through radiation. Radiation is the transfer of heat from the infant's body to cooler surrounding surfaces. By closing the doors, the nurse helps maintain a warm environment, reducing heat loss.

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Correct Answer is ["A","C","D"]

Explanation

Choice A reason: Lethargy and hypotonia are critical findings in a child who was left in a closed car. These symptoms can indicate severe dehydration, heat stroke, or other serious conditions that require immediate medical attention.

Choice B reason: Elastic skin turgor generally indicates good hydration status and is not an immediate concern that needs to be reported urgently in this context.

Choice C reason: An apical heart rate of 64 beats per minute is significantly low for a 14-month-old child, indicating bradycardia, which can be a sign of severe heat stress or dehydration. This finding needs immediate reporting.

Choice D reason: A blood pressure of 100/54 mmHg is within the normal range for many paediatric patients, but in the context of being left in a hot car, it can suggest potential complications and should be monitored closely. However, it is not as critical as the heart rate and mental status findings.

Choice E reason: A flat anterior fontanel is a normal finding in infants and does not require urgent intervention in this context.

A. Begin formula supplementation B. Cleanse the breast with soap and water C. Reposition the baby D. Administer ibuprofen

Correct Answer is C

Explanation

Choice A reason: Beginning formula supplementation is not the first step in addressing issues with breastfeeding. Introducing formula might reduce the infant’s breastfeeding efficiency and disrupt milk supply. The focus should initially be on correcting the breastfeeding technique to ensure successful and comfortable breastfeeding for both mother and baby.

Choice B reason: Cleansing the breast with soap and water is not recommended as it can dry out the nipples and exacerbate cracking. It is more appropriate to clean the breasts with warm water and avoid harsh soaps that could strip natural oils and worsen nipple damage.

Choice C reason: Repositioning the baby is a crucial step in addressing breastfeeding issues such as cracked nipples and a painful latch. Ensuring a proper latch can significantly reduce nipple trauma and improve comfort during breastfeeding. Techniques like ensuring the baby’s mouth covers more areola and changing breastfeeding positions can help achieve a better latch.

Choice D reason: Administering ibuprofen may help relieve pain temporarily, but it does not address the root cause of the breastfeeding issue. The primary focus should be on correcting the baby's latch and positioning to prevent ongoing nipple damage and pain during breastfeeding. Pain management should be considered alongside addressing the underlying problems.

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The nurse is assessing a 40-week-gestation infant. What action by the nurse prevents heat loss through conduction?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The emergency department nurse is assessing a 14-month-old child who was left inside a closed car for an hour. The outside temperature was 88 degrees Fahrenheit. Which assessment findings will the nurse report immediately to the health care provider? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

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Correct Answer is C

Explanation

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