The nurse is caring for a 37-weeks gestation infant born to a parent with hepatitis B. Which intervention will the nurse include in the plan of care?

Immune globulin given as soon as possible after delivery

Hepatitis B immune globulin and hepatitis B vaccine given within 12 hours of birth

Hepatitis B immune globulin given within 20 hours after birth

Hepatitis B vaccine given 24 hours after birth

Answer and Explanation

The Correct Answer is B

Choice A reason: Administering immune globulin as soon as possible after delivery is a correct step but does not include the critical combination of both immune globulin and the hepatitis B vaccine, which provides optimal protection for the newborn against hepatitis B.

Choice B reason: The combination of hepatitis B immune globulin and hepatitis B vaccine given within 12 hours of birth is the most effective intervention for preventing hepatitis B transmission from the parent to the infant. This approach ensures immediate passive immunity through the immune globulin and active immunity through the vaccine, significantly reducing the risk of the newborn developing hepatitis B.

Choice C reason: Administering hepatitis B immune globulin within 20 hours after birth delays the initiation of protective measures compared to the 12-hour window. It is essential to provide both immune globulin and the vaccine as early as possible to maximize the protective effect against hepatitis B.

Choice D reason: Administering the hepatitis B vaccine 24 hours after birth is too late for immediate protection against the virus. The combination of immune globulin and vaccine should be provided within the first 12 hours to ensure the highest level of protection for the newborn. Delaying the vaccination could increase the risk of hepatitis B transmission and infection.

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Correct Answer is C

Explanation

Choice A reason: Burping the baby on their shoulder is a common and effective method to help release air that the baby may have swallowed during feeding. It does not require further teaching.

Choice B reason: Swaddling the baby in the bassinet can help the baby feel secure and sleep better. However, it is important to ensure that the swaddle is not too tight and that the baby's hips can move freely to prevent hip dysplasia.

Choice C reason: Placing the baby on their side for sleep is not recommended due to the increased risk of sudden infant death syndrome (SIDS). The safest sleep position for babies is on their back, on a firm mattress, without any loose bedding or soft toys.

Choice D reason: Waking the baby for feedings is often necessary, especially in the early weeks, to ensure that the baby gets enough nutrition and maintains an adequate weight gain. It does not require further teaching.

A. Observing for mental confusion or hallucinations. B. Assessing motor function. C. Monitoring for a decrease in spasticity. D. Performing a follow-up MRI.

Correct Answer is C

Explanation

Choice A reason: Observing for mental confusion or hallucinations is important, but it is not the priority action following myelography. While these symptoms can occur due to complications, they are less common than changes in muscle tone or motor function.

Choice B reason: Assessing motor function is crucial, but the priority is specifically monitoring for changes in muscle tone, such as a decrease in spasticity. Myelography can affect the spinal cord and nerve roots, potentially leading to changes in muscle tone and motor function.

Choice C reason: Monitoring for a decrease in spasticity is the priority nursing action. Myelography involves injecting contrast material into the spinal canal, which can affect the spinal cord and nerve roots. Monitoring for changes in muscle tone, such as a decrease in spasticity, helps detect potential complications early and allows for timely intervention.

Choice D reason: Performing a follow-up MRI is not the immediate priority nursing action. While follow-up imaging may be necessary to assess the results of the myelography, the immediate focus is on monitoring the patient's neurological status and ensuring their safety.

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The nurse is caring for a 37-weeks gestation infant born to a parent with hepatitis B. Which intervention will the nurse include in the plan of care?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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