The nurse is assessing newborn patients who are at risk for feeding difficulties. Which patient is at the highest risk?

An infant 6 hours old, 41 weeks and 5 days gestation.

An infant 18 hours old, 36 weeks and 6 days gestation.

An infant 34 hours old, 37 weeks and 3 days gestation.

An infant 27 hours old, 38 weeks and 0 days gestation.

Answer and Explanation

The Correct Answer is B

Choice A reason: A newborn at 41 weeks and 5 days gestation is past full term and, while being older in gestational age, does not typically present increased risk for feeding difficulties as compared to preterm infants. At 6 hours old, this infant would still be adapting, but no additional risk is posed by the gestational age.

Choice B reason: An infant born at 36 weeks and 6 days gestation is considered late preterm. Late preterm infants often have immature suck and swallow reflexes and may experience difficulties with feeding, coordinating breathing with feeding, and maintaining body temperature. These issues place them at a higher risk for feeding difficulties compared to full-term infants.

Choice C reason: A newborn at 37 weeks and 3 days gestation is considered early term and generally faces fewer risks compared to preterm infants. At 34 hours old, feeding patterns are still being established, but there are no significant additional risks related to their gestational age.

Choice D reason: An infant born at 38 weeks gestation is considered full term. At 27 hours old, the baby would still be in the early stages of adapting to feeding, but being full term generally implies a lower risk for feeding difficulties compared to preterm infants.

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Correct Answer is ["B","C","E"]

Explanation

Choice A reason: Obtaining an arterial blood gas is not typically a routine intervention immediately following a caesarean section. Arterial blood gas measurements are usually performed if there is a specific indication or concern about the baby's respiratory status or acid-base balance. Routine care focuses on stabilizing and assessing the baby rather than performing invasive procedures unless clinically indicated.

Choice B reason: Ensuring thermoregulation is a crucial intervention for newborns, especially those delivered by caesarean section. Maintaining an appropriate body temperature is essential to prevent hypothermia, which can lead to complications such as metabolic disturbances and respiratory issues. The nurse should use measures like pre-warmed blankets and radiant warmers to keep the baby warm and stable.

Choice C reason: Administering oxygen as needed is an important intervention to ensure the baby's oxygenation and respiratory stability. Newborns delivered by caesarean section may have transient respiratory difficulties due to the lack of the natural squeeze through the birth canal, which helps clear the lungs of fluid. Monitoring the baby's respiratory status and providing supplemental oxygen if necessary is vital for their well-being.

Choice D reason: Inserting an orogastric tube is not a standard routine intervention immediately after a caesarean section unless there is a specific indication, such as if the baby has difficulty feeding, significant respiratory distress, or gastrointestinal issues. Routine care focuses on more immediate stabilization measures unless clinical signs suggest the need for an orogastric tube.

Choice E reason: Keeping the head in a sniffing position is important for maintaining an open airway and ensuring effective ventilation. The sniffing position aligns the airway and promotes optimal breathing. This position is particularly useful for newborns who may have respiratory difficulties or require resuscitation efforts, ensuring that their airway remains patent and clear.

A. Encourage the parents to home school the child. B. Teach the parents about the need for a high-fibre diet. C. Instruct the parents on the need for yearly dental visits. D. Advise the parents that the child will need monthly thyroid testing.

Correct Answer is D

Explanation

Choice A reason: While some parents may choose to home school their child, this is a personal decision and not a standard recommendation for all children with Trisomy 21. Educational needs should be tailored to the individual child's abilities and preferences, and many children with Trisomy 21 attend public or private schools with appropriate support.

Choice B reason: Teaching the parents about the need for a high-fibre diet is important for overall health but is not specific to Trisomy 21. While children with Trisomy 21 may benefit from a balanced diet, the need for monthly thyroid testing is more directly related to managing their condition.

Choice C reason: Instructing the parents on the need for yearly dental visits is essential for maintaining oral health, but it is not the most critical aspect specific to Trisomy 21. Regular dental check-ups are recommended for all children, regardless of whether they have Trisomy 21.

Choice D reason: Advising the parents that the child will need monthly thyroid testing is crucial because children with Trisomy 21 are at an increased risk for thyroid disorders. Regular monitoring of thyroid function is essential for early detection and management of hypothyroidism or hyperthyroidism, which can significantly impact growth and development.

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The nurse is assessing newborn patients who are at risk for feeding difficulties. Which patient is at the highest risk?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is preparing for the care of a baby about to be delivered by caesarean section. What interventions will the nurse include in the plan of care? Select all that apply.

Correct Answer is ["B","C","E"]

Explanation

The nurse is teaching the parents of a child with Trisomy 21. Which topic will the nurse include in the teaching plan?

Correct Answer is D

Explanation

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