What is the quickest and most common method to obtain neonatal blood for glucose screening 1 hour after birth?
Puncture the lateral pad of the heel.
Obtain a sample from the umbilical cord.
Puncture a fingertip.
Obtain a laboratory chemical determination.
The Correct Answer is A
Choice A rationale
Puncturing the lateral or medial plantar surface of the heel is the standard and safest technique for neonatal heel sticks to obtain capillary blood, typically used for glucose screening or newborn screens. This area avoids the central calcaneus bone, reducing the risk of osteomyelitis, and provides sufficient blood flow due to high capillary density, making it the quickest and most common method used one hour after birth. The puncture depth should be less than 2.0 mm.
Choice B rationale
Obtaining a sample from the umbilical cord, while a source of fetal blood, is generally performed immediately at birth for blood typing or gas analysis, not as a quick or common method for routine glucose screening one hour postpartum. Capillary heel stick is preferred as it is less invasive and more suitable for ongoing monitoring in the postnatal period, reflecting the infant's current physiological status.
Choice C rationale
Puncturing a fingertip is not the preferred or common site for capillary blood collection in neonates or infants under one year of age because the fingertip pad lacks sufficient tissue volume and the bone is too close to the surface. Using the heel ensures better blood flow for adequate sampling while minimizing the risk of bone injury and infection, which are greater risks in an infant's small digits.
Choice D rationale
Obtaining a laboratory chemical determination is a broad action describing the analysis of blood components like glucose, but it is not a method of specimen collection itself. The physical action of obtaining the blood sample, which is the focus of the question, must precede the laboratory analysis, making this choice an incomplete answer regarding the collection technique.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The normal range for meconium passage is generally within the first 24 to 48 hours of life. A 16-hour-old newborn who has not yet passed any meconium is still within the expected time frame and is not an immediate cause for alarm, although documentation is important. However, the nurse should continue to monitor for bowel sounds and abdominal distention.
Choice B rationale
The normal blood glucose level for a newborn is typically 45 mg/dL or higher. A glucose level of 55 mg/dL for a 16-hour-old newborn is within the acceptable and safe range, indicating adequate metabolic function and requiring only routine monitoring rather than immediate reporting to the healthcare provider.
Choice C rationale
A respiratory rate of 70 breaths/minute in a 2-day-old newborn (48 hours old) is tachypnea, as the normal range is 30 to 60 breaths/minute. Persistent tachypnea beyond the immediate transitional period, especially when associated with an irregular pattern, is a sign of potential respiratory distress or other underlying pulmonary or cardiac pathology and must be reported immediately.
Choice D rationale
Excreting a milky discharge (sometimes called "witch's milk") from the nipples in both female and male newborns is a common and benign temporary condition caused by the withdrawal of maternal hormones (estrogen and prolactin) after birth. This is a normal, transient finding and does not require reporting to the healthcare provider.
Correct Answer is A
Explanation
Choice A rationale
Skeletal traction involves inserting a pin directly into the bone to apply a continuous pulling force, typically used for complex fractures or severe orthopedic deformities. This is generally not a primary or common treatment for cerebral palsy, where management focuses on function, muscle tone, movement, and joint stability using non-invasive or less invasive techniques.
Choice B rationale
Physical therapy is a fundamental and expected treatment for cerebral palsy (CP). It focuses on improving muscle strength, mobility, balance, gait, and coordination. Specific exercises and techniques are employed to maximize functional independence and minimize the progression of secondary musculoskeletal complications.
Choice C rationale
Orthotics, such as ankle-foot orthoses (AFOs) or braces, are commonly prescribed treatments in the plan of care for children with CP. They provide support, maintain proper body alignment, prevent or correct deformities, and enhance walking ability by assisting with muscle control and joint stability during movement.
Choice D rationale
Occupational therapy is an essential component of the CP treatment plan. It addresses fine motor skills, activities of daily living (ADLs) like dressing and feeding, and visual-motor integration. The goal is to maximize the child's independence in self-care, school, and play activities tailored to their specific deficits.
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