Your patient just had her first baby two days ago. The infant is healthy and breastfeeding well. What are important things to teach her about the safety of her baby: (select all that apply)
Keep the baby on his to back to sleep
Keep the cord as dry as possible until it falls off
Always keep the baby dressed and wrapped in 2 blankets when you go outside
After your milk comes in your baby should have 3-4 wet or dirty diapers a day
Have the bulb syringe near the baby at all times
Correct Answer : A,B,E
A) Keep the baby on his back to sleep:
Placing babies on their back to sleep is the most effective way to reduce the risk of sudden infant death syndrome (SIDS). The American Academy of Pediatrics (AAP) strongly recommends this practice. Babies should not sleep on their stomach or side because these positions increase the risk of suffocation. This position should be maintained until the baby is at least 1 year old, even though many parents may be encouraged to place babies on their tummies when they start rolling over on their own.
B) Keep the cord as dry as possible until it falls off:
It is important to keep the umbilical cord stump clean and dry until it falls off, which typically happens between 1-3 weeks of life. Moisture can cause infection, so avoiding unnecessary exposure to water and keeping the stump exposed to air is essential for healing. The area should not be submerged in water until the stump falls off, and the diaper should be folded down so it doesn’t rub against it, promoting proper drying and healing.
C) Always keep the baby dressed and wrapped in 2 blankets when you go outside:
This is not an ideal practice. Overheating can be dangerous for newborns, as they have a limited ability to regulate their body temperature. Instead of wrapping the baby in two blankets, the baby should be dressed appropriately for the weather—usually in one extra layer than an adult would wear in the same conditions. This ensures the baby stays warm without the risk of overheating, which is a risk factor for SIDS.
D) After your milk comes in your baby should have 3-4 wet or dirty diapers a day:
This information is inaccurate for a 2-day-old baby. After milk comes in (usually around day 3 or 4 postpartum), the baby should be producing at least 6-8 wet diapers a day and 3-4 dirty diapers by day 4 or 5. Fewer wet diapers or a decrease in bowel movements may indicate that the baby is not feeding effectively, and it is important to monitor this carefully. In the first few days, before the milk comes in, the baby might have fewer wet diapers, but by day 3-4, this is the standard for adequate hydration and nutrition.
E) Have the bulb syringe near the baby at all times:
Having a bulb syringe nearby is a good practice in case of respiratory distress. Newborns often have mucus in their airways, and a bulb syringe can help clear their nasal passages if they are having trouble breathing. While the baby should not be suctioned too frequently or aggressively, keeping a bulb syringe available can help manage mild congestion. Additionally, in the case of sudden breathing difficulties or choking, it’s important to be prepared.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Intracostal retractions:
Intracostal retractions indicate respiratory distress in the newborn and should be reported immediately to the neonatologist. Retractions occur when the muscles between the ribs (intercostal muscles) are drawn in with each breath, signifying increased effort to breathe. This could indicate a serious condition such as respiratory distress syndrome (RDS), pneumonia, or other respiratory compromise. This finding requires urgent assessment and potential intervention to ensure the neonate is receiving adequate oxygenation.
B) Caput succedaneum:
Caput succedaneum is a common and benign finding in newborns, especially after a vaginal delivery. It refers to a swelling of the soft tissue on the baby's head, often seen after prolonged labor or use of forceps during delivery. This condition is typically resolves on its own within a few days and does not require immediate intervention or reporting to the neonatologist.
C) Positive Babinski sign:
A positive Babinski sign (fanning of the toes when the sole is stroked) is a normal reflex in neonates and is expected up to about 2 years of age. It is part of the newborn's neurological development and indicates the functioning of the central nervous system. Therefore, this finding does not require reporting to the neonatologist.
D) Pink-tinged urine in the diaper:
Pink-tinged urine, also known as "brick dust" or uric acid crystals, is a common finding in the first few days of life. It is typically harmless and results from concentrated urine or from the breakdown of urates. It usually resolves as the newborn begins to consume more fluids and the urine becomes more diluted. This finding does not necessitate immediate reporting unless it persists or is associated with other symptoms.
Correct Answer is A
Explanation
A) "I'll walk you to the bathroom and stay with you."
After delivery, the patient is at risk for orthostatic hypotension and falling, especially within the first few hours postpartum. Even though the patient feels alert and active, her body is still adjusting after childbirth, and she may be unsteady. The nurse should assist her to the bathroom and provide supervision for her safety. Walking the patient to the bathroom ensures she can safely get there while allowing the nurse to assess her mobility and vital signs if necessary.
B) "I will get a bedpan for you."
While a bedpan may be appropriate if the patient is unable to get out of bed, this response does not prioritize the patient's expressed desire to go to the bathroom. Since she is alert, active, and able to communicate, walking her to the bathroom is a safer and more appropriate option than offering a bedpan. Using a bedpan would also restrict her mobility unnecessarily.
C) "Leave your peri-pad in place after you use the restroom so I can check your bleeding when you get back."
This does not address the immediate concern of the patient’s safety in getting to the bathroom. The nurse's priority should be her safety and mobility right after delivery, especially as the patient is still recovering and may be at risk for fainting or falling.
D) "Wait until I have had a chance to assess you first."
While it is important to assess the patient’s physical state postpartum, the response here should focus on immediate safety rather than delaying her need to use the restroom. A full assessment can be conducted later, but it is not appropriate to restrict the patient's autonomy when she has already indicated the need to go to the bathroom.
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