The nurse is providing discharge teaching to a postpartum patient. Which information will the nurse include when teaching the parent about the difference between pathologic and physiologic jaundice?
Pathologic jaundice appears within 24 hours after birth.
Both are treated with exchange transfusions of maternal O-negative blood.
Physiologic jaundice results in kernicterus.
Physiologic jaundice requires transfer to the neonatal intensive care unit.
The Correct Answer is A
Choice A reason: Pathologic jaundice is an abnormal condition that typically appears within the first 24 hours of life. It often indicates an underlying health problem and requires prompt medical evaluation and intervention.
Choice B reason: Both pathologic and physiologic jaundice are not treated with exchange transfusions of maternal O-negative blood. Exchange transfusions are only considered in severe cases of jaundice, typically for pathologic jaundice when other treatments are ineffective.
Choice C reason: Physiologic jaundice is a common and usually harmless condition that occurs in many newborns, peaking around the second or third day of life. It does not result in kernicterus, a rare but severe form of brain damage caused by very high levels of bilirubin. Pathologic jaundice, if untreated, may lead to kernicterus.
Choice D reason: Physiologic jaundice generally does not require transfer to the neonatal intensive care unit. It is usually managed with simple interventions, such as phototherapy, and often resolves on its own as the newborn's liver matures and becomes more efficient at processing bilirubin.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Encouraging the patient to ambulate intermittently and change positions can help alleviate early decelerations by improving uteroplacental blood flow and promoting fatal oxygenation. Movement and position changes can reduce compression on the umbilical cord and facilitate Labor progression.
Choice B reason: Placing the patient in the left lateral position can improve uteroplacental blood flow, but increasing the oxytocin rate is not indicated based on the current findings. Early decelerations are typically not a sign of Labor dystocia requiring oxytocin augmentation.
Choice C reason: Administering oxygen via a non-rebreather mask is generally reserved for situations where there is significant fatal distress or non-reassuring fatal heart rate patterns. Early decelerations are usually benign and do not necessitate supplemental oxygen.
Choice D reason: Teaching the patient to push when she feels the urge during contractions is appropriate during the second stage of Labor. However, the current findings with early decelerations do not indicate the need for this intervention at this time. The focus should be on monitoring and managing the fatal heart rate.
Correct Answer is A
Explanation
Choice A reason: This statement indicates the parent's understanding that vacuum-assisted deliveries can sometimes lead to an increased risk of jaundice. The use of a vacuum can cause bruising on the baby's scalp, which can lead to the breakdown of red blood cells, thereby increasing bilirubin levels. Elevated bilirubin levels can cause jaundice in newborns. Recognizing this potential risk and monitoring the baby for signs of jaundice is an essential aspect of post-delivery care.
Choice B reason: Stating that the procedure was required because the baby was breech is incorrect. Vacuum-assisted delivery is typically used in cases where the baby is in a cephalic (head-first) position and there are difficulties in progressing through the birth canal, such as when the mother is exhausted, or the baby needs to be delivered quickly due to fatal distress. Breech presentations often necessitate a caesarean section instead of a vacuum-assisted delivery.
Choice C reason: The assertion that the vacuum was required because the mother did not dilate past 6 centimetres is inaccurate. Vacuum-assisted delivery is not related to cervical dilation but rather to difficulties encountered during the second stage of Labor (pushing phase). The decision to use a vacuum is made when the baby is in the birth canal, and additional assistance is needed to facilitate delivery.
Choice D reason: Stating that the baby’s head will be cone-shaped for about 2 months is also incorrect. While a vacuum-assisted delivery can result in a temporary cone-shaped head (known as "caput succedaneum" or melding), this typically resolves within a few days to weeks after birth. It is not expected to last for two months. Proper education should clarify the temporary nature of the head shape changes.
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