The nurse is caring for a 26-week-gestation infant diagnosed with periventricular hemorrhage and currently intubated. What is the most appropriate nursing action(s) for this infant?

Do not disturb the infant until the diaper is visibly soiled.

Frequent repositioning and use of a musical mobile.

Provide boundaries and dim the lights.

Administer morphine sulfate and gradually increase the gavage feeding amount.

Answer and Explanation

The Correct Answer is C

A. Delayed diaper changes can increase the risk of skin breakdown and infection.
B. Frequent repositioning and stimulation with a mobile may increase stress and intracranial pressure.
C. Minimizing stimulation, providing boundaries, and maintaining a calm environment (e.g., dim lighting) help reduce intracranial pressure and prevent further bleeding in infants with periventricular hemorrhage.
D. While pain management is important, feeding increases may exacerbate intracranial pressure and are not the priority.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

Respiratory Status: The newborn is exhibiting signs of respiratory distress, including a respiratory rate of 100/min, grunting, nasal flaring, and substernal retractions. These findings indicate compromised respiratory function, which requires immediate attention to prevent hypoxemia or respiratory failure. The diffuse radiopaque areas on the chest x-ray suggest a condition like transient tachypnea of the newborn (TTN) or respiratory distress syndrome (RDS), common in low-birth-weight infants.

Temperature: After stabilizing the respiratory status, addressing the newborn’s temperature is important. The temperature of 36.3°C (97.3°F) indicates mild hypothermia, which can further compromise respiratory function and glucose metabolism if not corrected. Warming the infant with skin-to-skin contact or using a radiant warmer is necessary to maintain thermoregulation.

A. Insulating the body against lowered environmental temperatures. B. Protection for the infant from birth injuries. C. Being available to be metabolized by body when heat is needed. D. Providing a ready source of calories for the newborn.

Correct Answer is C

Explanation

A. BAT does not primarily act as insulation but as a heat source.

B. BAT is unrelated to protection from birth injuries.

C. Brown adipose tissue (BAT) is metabolized to generate heat through non-shivering thermogenesis, which is critical for newborns as they cannot shiver effectively.

D. While BAT does provide some energy, its main purpose is heat production, not calorie storage.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is caring for a 26-week-gestation infant diagnosed with periventricular hemorrhage and currently intubated. What is the most appropriate nursing action(s) for this infant?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn who was born at 38 weeks of gestation. Exhibits A nurse is initiating the newborn's plan of care. Complete he following sentence by using the list of options. The nurse should first address the client's dropdown followed by the client's dropdown

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}

Explanation

The nurse caring for an infant at risk for hypothermia knows that the function of brown adipose tissue (BAT) in a newborn is what?

Correct Answer is C

Explanation

A nurse places a newborn under a radiant heat warmer after birth. The purpose of this action is to prevent which of the following in the newborn?

The nurse is providing education to a mother of an uncircumcised male infant. What hygiene education would be the most appropriate for the nurse to provide?

The nurse is assessing a 4-hour old newborn. The nurse's findings include an irregular respiratory rate at 58, heart rate of 138 with a regular rhythm, and axillary temperature of 97.4 °F. Based on these assessments which intervention(s) should the nurse perform first?

A nurse is assisting a healthcare provider during an infant's circumcision. Which action by the nurse demonstrates the nurse is acting as the infant's client care advocate?

A client delivers a term neonate and expresses concern about the reason for giving the neonate a Vitamin K injection. Which information from the nurse is accurate?

Complete the following sentence by using the list of options. Clinical management strategies for prevention of retinopathy of prematurity (ROP) focus on targeting appropriate ______ for infants at risk.

The nurse is caring for a preterm formula fed infant. What finding would be most important to report to the healthcare provider?

A 3-day-old infant is slightly jaundiced and has an elevated bilirubin level. What is the most probable cause for these changes?