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

Answer and Explanation

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.

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Correct Answer is A

Explanation

A. Ask the patient to empty her bladder:
A boggy uterus that is displaced above and to the right of the umbilicus is often a sign of bladder distention. A full bladder can push the uterus out of its normal position, preventing it from contracting properly and leading to uterine atony. Asking the patient to empty her bladder is the most appropriate initial action, as it can help reposition the uterus and promote uterine contraction, reducing the risk of postpartum hemorrhage.

B. Notify the MD about an impending hemorrhage:
While a boggy, displaced uterus can be a sign of uterine atony and the risk of hemorrhage, the first action should be to address the likely cause—bladder distention. Emptying the bladder may resolve the issue and help the uterus contract. Notifying the healthcare provider may be necessary later if other complications arise, but it’s not the most immediate intervention in this situation.

C. Assess blood pressure and pulse:
Assessing vital signs, including blood pressure and pulse, is important for monitoring the patient’s overall condition, especially if there is suspicion of hemorrhage. However, this is a secondary action after addressing the immediate problem (bladder distention). The priority is to help the uterus contract and reposition it before worrying about potential hemorrhage.

D. Evaluate lochia:
Evaluating lochia is an important step in assessing the patient’s postpartum status, especially to monitor for excessive bleeding. However, the immediate concern in this case is the displaced uterus, which is most likely due to bladder distention. The most effective action would be to address the bladder fullness first. After addressing this, lochia should be assessed to monitor for bleeding.

A. Don't concern yourself with it and agree with the family that it is cute B. Begin Resuscitation on the infant C. Realize that the baby is grunting and continue to assess infant's respiratory status D. Put the baby on Nasal Cannula at 100%

Correct Answer is C

Explanation

A) Don’t concern yourself with it and agree with the family that it is cute:
While it may seem cute, it is important to recognize that abnormal sounds like grunting in a newborn can be a sign of respiratory distress. Grunting is a compensatory mechanism used by the infant to help keep the alveoli open during exhalation, indicating that the baby may be struggling to maintain adequate oxygenation. Ignoring these signs could delay necessary interventions.

B) Begin Resuscitation on the infant:
Resuscitation would be indicated if the baby were showing signs of severe respiratory distress, such as a significant drop in heart rate, poor oxygenation, or altered mental status. However, a cooing sound that is consistent with the baby’s respiratory effort does not immediately warrant resuscitation. The correct approach is to assess the baby further to determine if the issue is respiratory distress or something less severe.

C) Realize that the baby is grunting and continue to assess infant's respiratory status:
Grunting in a newborn can be a sign of respiratory distress. It is important to differentiate between normal sounds (like cooing) and abnormal sounds (like grunting) that might indicate the infant is working harder to breathe. In this scenario, the nurse should continue to assess the baby’s respiratory rate, effort, oxygen saturation, and overall condition. If the grunting persists or worsens, further intervention may be required.

D) Put the baby on Nasal Cannula at 100%:
While supplemental oxygen may be necessary if the infant is in respiratory distress, placing the baby on nasal cannula at 100% oxygen without further assessment is premature. First, the nurse should assess the baby's overall respiratory status, including oxygen saturation, effort, and any signs of distress before deciding if oxygen therapy is needed.

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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)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the right of the umbilicus?

Correct Answer is A

Explanation

You come in to your patient and hear a cooing sound coming from the baby. The family says ‘’Oh listen to the cute noise the baby is making" You assess some more and realize that the coos are consistent with the babies respirations. You:

Correct Answer is C

Explanation

As part of the postpartum assessment, the nurse examines the breasts of a primiparous (first baby) breastfeeding woman who is 1 day postpartum. Which of the following findings should the nurse anticipate?

You know that _________ promotes bonding, helps infant maintain their temperature and promotes involution.

Lochia progresses in the following order:

The nurse has received shift report on the postpartum unit. Which patient should the nurse see first?

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While assessing a patient who gave birth 5 hours ago, the nurse finds that the woman has completely saturated: pad within 15 minutes. What is the nurse's first action?

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