Which of the following information should a nurse include in the teaching to the parent of a 1-day-old newborn with a prescription for gavage feeding?

Administer 20 mL per feeding.

Feedings should be accompanied by nonnutritive sucking.

Place the newborn in a supine position after feedings.

Feedings may occur in clusters.

Answer and Explanation

The Correct Answer is B

Choice A reason: Administering 20 mL per feeding is not universally appropriate, as gavage feeding volumes depend on the newborn’s weight, gestational age, and medical condition. Standardized volumes risk over- or underfeeding, potentially causing gastric distress or inadequate nutrition. Neonatal physiology requires individualized feeding plans to support digestion and growth, guided by medical prescriptions and clinical assessment.

Choice B reason: Nonnutritive sucking, such as on a pacifier, supports neurological development and soothes newborns during gavage feeding. It stimulates the suck-swallow reflex, enhancing gastrointestinal motility and reducing feeding intolerance. Scientifically, this practice promotes oral motor skills, aiding transition to oral feeding, and provides comfort, which is critical for neonatal stress reduction and developmental progress.

Choice C reason: Placing a newborn in a supine position after gavage feeding increases the risk of aspiration, as milk may reflux into the airway. Neonatal physiology favors a side-lying or prone position to facilitate gastric emptying and reduce regurgitation. This position supports safer digestion and minimizes respiratory complications, aligning with evidence-based neonatal care practices for gavage-fed infants.

Choice D reason: Cluster feedings mimic natural breastfeeding patterns, supporting neonatal nutritional needs and growth. Newborns often feed in clusters to meet caloric demands, stabilize blood glucose, and promote weight gain. This practice aligns with neonatal physiology, as the stomach’s small capacity benefits from frequent, smaller feedings, enhancing digestion and nutrient absorption in gavage-fed infants.

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Correct Answer is D

Explanation

Choice A reason: Monitoring blood pressure every 30 minutes is inadequate for hypotension, which requires immediate intervention to restore placental perfusion. Epidural anesthesia can cause sympathetic blockade, reducing vascular tone and blood pressure. Frequent monitoring (every 5-10 minutes) is needed, but this action does not address the acute hypotension affecting fetal oxygenation.

Choice B reason: The knee-chest position is used for specific obstetric emergencies like cord prolapse, not hypotension from epidural anesthesia. It does not improve blood pressure or placental perfusion. Hypotension requires fluid or vasopressor support to restore circulation, as positional changes like knee-chest do not address the underlying sympathetic blockade causing reduced perfusion.

Choice C reason: Administering oxygen at 2 L/min via nasal cannula does not directly correct hypotension, the primary cause of decreased placental perfusion. While oxygen may support fetal oxygenation, it does not restore maternal blood pressure. Fluid boluses or vasopressors are needed to address the epidural-induced vasodilation and ensure adequate placental blood flow.

Choice D reason: A 500 mL lactated Ringer’s bolus corrects epidural-induced hypotension by expanding intravascular volume, restoring blood pressure, and improving placental perfusion. Epidurals cause sympathetic blockade, reducing vascular tone. Fluid administration counteracts this, enhancing cardiac output and uteroplacental blood flow, critical for fetal oxygenation and preventing hypoxia during labor.

A. It can be helpful to talk about your loss with others who have experienced a pregnancy loss. B. I have found that it is best to avoid seeing the fetal remains after the procedure. C. It is okay to feel some grief now, even though it is so early in the pregnancy for a loss. D. Once the fetus is passed, the provider will likely be able to determine what caused the pregnancy loss.

Correct Answer is A

Explanation

Choice A reason: Discussing pregnancy loss with others who have experienced it provides emotional support, reducing feelings of isolation. Grief triggers stress hormones like cortisol, which can affect mental health. Peer support normalizes emotional responses, aiding psychological recovery by fostering shared understanding and coping strategies, validated by psychosocial research in miscarriage care.

Choice B reason: Advising against seeing fetal remains is inappropriate, as it may dismiss the client’s emotional needs. Grief processing varies, and viewing remains can aid closure for some. This statement imposes a personal bias, ignoring individual psychological responses to loss, which are influenced by complex neuroendocrine and emotional pathways.

Choice C reason: While acknowledging grief is valid, stating it is okay “even though” it is early minimizes the loss’s impact. Early pregnancy loss can trigger significant grief due to hormonal shifts and attachment. This statement risks invalidating the client’s emotional experience, which is shaped by psychological and neuroendocrine responses to miscarriage.

Choice D reason: Determining the cause of a missed abortion at 10 weeks is often not feasible, as fetal tissue may not yield specific findings. Chromosomal abnormalities, a common cause, require genetic testing, not routine post-procedure analysis. This statement risks false reassurance, as miscarriage etiology is frequently multifactorial and not always identifiable.

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Which of the following information should a nurse include in the teaching to the parent of a 1-day-old newborn with a prescription for gavage feeding?

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