The parents of a 28-week gestation neonate ask the nurse, “Why does he have to be fed through a tube in his mouth? What is the nurse’s best response?”
The baby’s sucking, swallowing, and breathing are not coordinated yet.
The baby’s stomach cannot digest formula at this time.
It allows us to accurately determine the baby’s intake since he is so small.
It helps to prevent thrush, an infection that could affect the baby’s mouth.
The Correct Answer is A
Choice A rationale
Preterm infants lack coordination for sucking, swallowing, and breathing until approximately 32-34 weeks' gestation. Gavage feeding prevents aspiration by bypassing the immature oral motor mechanisms required for safe oral feeding.
Choice B rationale
Preterm infants can digest milk due to functional gastrointestinal enzymes. Digestive immaturity relates more to delayed gastric emptying rather than the inability to process nutrients, which is managed with small frequent feeds.
Choice C rationale
Monitoring intake is crucial for growth and hydration, but gavage feeding primarily addresses feeding immaturity, not intake measurement. Accurate intake can be monitored through oral feeds with supplemental measurements.
Choice D rationale
Gavage feeding does not directly prevent thrush. Thrush prevention involves oral hygiene and immune support rather than feeding methods, as thrush may still occur regardless of tube feeding or oral intake.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Gastric problems later in life, such as gastrointestinal motility issues, may occur in infants with myelomeningocele but are not an immediate risk requiring urgent intervention.
Choice B rationale
Respiratory depression is not a direct consequence of myelomeningocele unless associated with other congenital anomalies or complications like Chiari malformation affecting brainstem function.
Choice C rationale
Decreased cardiac output is not a primary concern in myelomeningocele unless secondary to severe infection or other systemic complications, which are less immediate risks.
Choice D rationale
Infection is the greatest immediate risk due to the exposed neural tissue in myelomeningocele, which provides a direct pathway for pathogens, necessitating prompt surgical closure and sterile management.
Correct Answer is A
Explanation
Choice A rationale
Narcan (naloxone) is contraindicated as it can precipitate acute withdrawal symptoms in neonates exposed to opioids in utero, leading to seizures and severe distress due to sudden opioid receptor blockade.
Choice B rationale
Phenobarbital is used to manage neonatal abstinence syndrome by reducing central nervous system hyperexcitability and seizures. It is not contraindicated as it provides symptomatic relief for withdrawal symptoms.
Choice C rationale
Methadone is used to treat neonatal abstinence syndrome by stabilizing opioid levels and preventing withdrawal symptoms. It is not contraindicated and helps manage symptoms effectively in opioid-exposed neonates.
Choice D rationale
Morphine is a first-line treatment for neonatal abstinence syndrome, reducing withdrawal symptoms by mimicking the effects of opioids. It is not contraindicated and is commonly used in neonatal care.
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