The nurse is teaching a newborn care class to parents who are about to give birth to their first babies. Which statement indicates that teaching was effective?

Keep umbilical cord dry and above the level of the diaper.

Baby will need to breast feed every hour

Be sure to always wrap baby in 2 blankets when going outside

Limit the amount of time baby is skin to skin with parents

Answer and Explanation

The Correct Answer is A

A) "Keep umbilical cord dry and above the level of the diaper."
The umbilical cord stump should be kept clean, dry, and exposed to air as much as possible to prevent infection. The diaper should be folded below the stump to ensure that it remains dry and doesn’t rub against it, which can lead to irritation or infection.

B) "Baby will need to breastfeed every hour."
Newborns typically breastfeed every 2 to 3 hours, not necessarily every hour. The exact frequency may vary based on the baby's hunger cues. Overstating the frequency of feedings may cause undue anxiety for parents, as newborns may not feed this frequently.

C) "Be sure to always wrap baby in 2 blankets when going outside."
Overbundling can lead to overheating. Newborns should be dressed in appropriate layers for the weather, with one layer more than an adult would wear. The use of two blankets may not be necessary unless it is extremely cold. The key is ensuring the baby is comfortably warm, not overheated.

D) "Limit the amount of time baby is skin to skin with parents."
Skin-to-skin contact is beneficial for newborns, especially in the early days after birth. It promotes bonding, stabilizes the baby’s body temperature, supports breastfeeding, and helps with the baby’s physiological stability. There is no need to limit skin-to-skin contact unless medically contraindicated.

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Correct Answer is A

Explanation

A) Protect the fetal skin from amniotic fluid:
Vernix caseosa is a whitish, cheese-like substance that covers the skin of the fetus during the second and third trimesters of pregnancy. It plays an essential role in protecting the fetal skin from prolonged exposure to amniotic fluid, which can be irritating. Vernix also serves as a barrier that helps prevent water loss and protects against potential infections.

B) Promote normal peripheral nervous system development:
While the development of the peripheral nervous system is vital to fetal development, the presence of vernix caseosa is not directly related to promoting nervous system development. The vernix's primary function is to protect the skin, not influence neural development. Neural development occurs due to other factors, such as adequate nutrition and hormonal regulation during pregnancy.

C) Allow transport of oxygen and nutrients across the amnion:
Vernix caseosa does not play a role in transporting oxygen or nutrients across the amnion. Oxygen and nutrients are transferred to the fetus through the placenta and the umbilical cord. The amniotic sac, which contains amniotic fluid, provides a cushioning effect for the fetus, but the vernix itself does not participate in nutrient or oxygen exchange.

D) Regulate fetal temperature:
Vernix caseosa does not directly regulate fetal temperature. Fetal temperature regulation is mainly managed by the mother's body through thermoregulation and the umbilical blood flow. The vernix may provide some protection against temperature fluctuations after birth, but its primary function is to protect the skin, not to regulate temperature.

A. Apply ice to the perineal area for the first 12-24 hours. B. Apply warm packs to the perineal area for the first 24-48 hours. C. Encourage sitz baths at least twice a day D. Use a topical antiseptic cream or spray on the perineal area. E. Obtain an order for an indwelling urinary catheter.

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

Explanation

A) Apply ice to the perineal area for the first 12-24 hours:
Applying ice to the perineal area in the first 12-24 hours after delivery is a common intervention for promoting comfort, especially for lacerations or episiotomies. The cold helps to reduce swelling and inflammation, and it numbs the area, providing pain relief. Ice also helps to constrict blood vessels, reducing blood flow to the affected area, which can prevent excessive bleeding and promote healing.

B) Apply warm packs to the perineal area for the first 24-48 hours:
Warm packs are generally not used in the first 24-48 hours after delivery for a laceration. Heat can increase blood flow, which is not ideal immediately after birth when the risk of swelling and bleeding is higher. Typically, warm packs are more beneficial after the first 48 hours to improve circulation and promote healing. Therefore, this is not the best intervention in the immediate postpartum period for a labial laceration.

C) Encourage sitz baths at least twice a day:
Sitz baths are highly effective for postpartum comfort, particularly for perineal trauma such as lacerations or episiotomies. A sitz bath helps to cleanse the area and promote relaxation, reducing discomfort. It also enhances circulation to the perineum, which can speed up healing. Encouraging sitz baths at least twice a day is a helpful intervention for postpartum care and is appropriate for a labial first-degree laceration.

D) Use a topical antiseptic cream or spray on the perineal area:
While topical antiseptics may help reduce infection risk, they are generally not necessary for most first-degree lacerations, especially if they are uncomplicated. In fact, overuse of antiseptics or antibiotic creams can irritate the sensitive tissue in the perineal area and delay healing. The focus should be on keeping the area clean and dry, using gentle care. Therefore, this intervention is not typically recommended for a labial laceration.

E) Obtain an order for an indwelling urinary catheter:
An indwelling urinary catheter is usually only needed in specific cases, such as when a woman is unable to void postpartum due to perineal trauma, epidural anesthesia, or bladder retention. In the case of a labial first-degree laceration, there is no indication for an indwelling catheter unless the woman is unable to void on her own. The best approach is to encourage frequent voiding and assist with comfortable positioning.

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The nurse is teaching a newborn care class to parents who are about to give birth to their first babies. Which statement indicates that teaching was effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A new mother asks the nurse about the white substance" covering her infant. The nurse explains that the purpose of vernix caseosa is to:

Correct Answer is A

Explanation

Which of the following nursing interventions will promote comfort for a client with a labial first degree laceration? Select all that apply.

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

Explanation

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Day 1 - 5 postpartum is significant in breastfeeding success due to what process?

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What hormone remains elevated in the immediate postpartum period in a breastfeeding patient?

A woman gave birth vaginally to a 9-lb, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of sitz bath TID, and a stool softener. What information is most closely correlated with these orders?

Which finding 12 hours after birth requires further assessment?