The nurse receives a newborn within the first minutes after a vaginal delivery and intervenes to establish adequate respirations.
Which priority issue should the nurse address to ensure the newborn's survival?
Bleeding tendencies.
Fluid balance.
Heat loss.
Hypoglycemia.
The Correct Answer is C
Choice A rationale
While bleeding tendencies can be a concern in newborns, especially if there are clotting disorders, it is not the immediate priority in the first minutes after birth. Immediate interventions focus on establishing effective respirations and ensuring adequate oxygenation.
Choice B rationale
Fluid balance is important for newborns, particularly in the context of hydration and potential complications like hypovolemia. However, the most immediate concern after birth is ensuring the newborn can breathe adequately to deliver oxygen to the body's tissues.
Choice C rationale
Heat loss is a critical issue for newborns, as they are at high risk for hypothermia due to their large surface area relative to body weight and limited ability to generate heat. Preventing heat loss helps to stabilize the newborn's temperature and supports overall physiological stability, including respiratory function.
Choice D rationale
Hypoglycemia can be a concern in newborns, particularly those who are small for gestational age or have other risk factors. However, the most immediate concern in the first minutes after birth is ensuring adequate breathing to support oxygenation and prevent complications related to hypoxia. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Reduction of fever is not the primary goal of albumin therapy. Albumin's role in nephrotic syndrome is to manage severe edema, not to reduce fever, which might be managed by antipyretics if present.
Choice B rationale
Weight gain is typically undesirable in nephrotic syndrome patients due to fluid retention and edema. Albumin therapy aims to reduce edema, potentially decreasing weight as fluid balance improves.
Choice C rationale
Albumin infusion helps reduce edema by increasing plasma oncotic pressure, drawing fluid back into the vascular system. A reduction in edema indicates the therapy’s effectiveness in managing nephrotic syndrome symptoms.
Choice D rationale
Improved caloric intake is not directly affected by albumin infusion. While managing edema might improve overall well-being, albumin’s primary function in this context is fluid balance and reducing swelling.
Correct Answer is A
Explanation
Choice A rationale
Benzocaine otic drops are used for pain relief and do not address the root cause of infections. Regular use without medical advice can lead to masking of symptoms and possibly delay appropriate treatment. The focus should be on preventing infections through other methods like vaccinations and avoiding irritants.
Choice B rationale
Scheduling a visit for the pneumococcal vaccine is appropriate as it can help protect against Streptococcus pneumoniae, a common cause of otitis media. Vaccinations are a preventive measure to reduce the frequency and severity of infections in infants and children.
Choice C rationale
Giving the infant the full course of antibiotics is crucial in treating and preventing recurrent infections. Incomplete antibiotic courses can lead to bacterial resistance and recurrence of infections. Caregivers must be educated on the importance of adhering to the prescribed treatment plan.
Choice D rationale
Avoiding smoking inside the house is essential as secondhand smoke is a significant risk factor for otitis media. Smoke can irritate the respiratory system and Eustachian tubes, making infants more susceptible to infections. Caregivers should be advised to maintain a smoke-free environment to protect the child's health.
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