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Umbilical cord care

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Total Questions : 4

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Question 1:

A nurse is teaching a new mother how to care for her baby’s umbilical cord stump at home.

Which of the following instructions should the nurse include? (Select all that apply.)

A. Apply antiseptic solution to the cord stump once a day until it falls off. B. Keep the cord stump above the diaper level to prevent irritation and infection. C. Change the diapers frequently and check for signs of wetness or soiling around the cord stump D. Give the baby tub baths with mild soap and water until the cord stump falls off. E. Report any signs of infection such as redness, swelling, foul odor, or purulent drainage to the health care provider.

Answer and Explanation

Choice A:

Applying antiseptic solution to the cord stump is not necessary and may delay healing. The stump should be kept dry and clean with gauze and water only.

Choice B:

The nurse should instruct the new mother to keep the cord stump above the diaper level to prevent irritation and infection and to change the diapers frequently and check for signs of wetness or soiling around the cord stump.

Choice C:

Choice D:

Giving the baby tub baths with mild soap and water may cause the cord stump to get wet and increase the risk of infection. The baby should be given sponge baths until the cord stump falls off.

Choice E:

Is correct but not part of the question. The nurse should tell the mother to report any signs of infection such as redness, swelling, foul odor, or purulent drainage to the health care provider, but this is not an instruction on how to care for the cord stump at home.

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Question 2:

A nurse is assessing a newborn’s umbilical cord after delivery.

What is the normal number of vessels in the cord?

A. One B. Two C. Three D. Four

Answer and Explanation

Choice A:

One vessel in the umbilical cord is not enough to support the fetal circulation

Choice B:

Two vessels in the umbilical cord is a condition called two-vessel cord or single umbilical artery, which can be associated with some birth defects or growth problems

Choice C:

The normal number of vessels in the umbilical cord is three: one umbilical vein and two umbilical arteries.The umbilical vein carries oxygenated blood and nutrients from the placenta to the fetus, while the umbilical arteries carry deoxygenated blood and waste products from the fetus to the placenta.

Choice D:

Four vessels in the umbilical cord is not a normal variation and can cause complications such as cord prolapse or knotting.The normal range of the umbilical cord length is 50-60 cm and the diameter is 1-2 cm.

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Question 3:

A nurse is monitoring a newborn’s temperature and notes that it is 97.2°F (36.2°C).

What is the most appropriate action for the nurse to take?

A. Recheck the temperature in 15 minutes B. Notify the health care provider immediately C. Place the newborn under a radiant warmer D. Cover the newborn with a blanket

Answer and Explanation

Choice A:

The normal temperature range for newborn babies is between 96.8°F and 100.3°F, with the average being 98.6°F.A rectal reading is the most accurate way to take a baby’s temperature.A fever is considered to be a temperature of 100.4°F or higher.If a baby is under 3 months old and has a fever of 100.4°F or higher, it requires urgent care and a pediatrician should be called immediately.

However, if the baby’s temperature is slightly below the normal range, it may not be a cause for concern.It could be due to being wrapped up tightly in a blanket, in a very warm room, very active, cuddling a hot water bottle, wearing a lot of clothes or having a bath.Therefore, the nurse should recheck the temperature in 15 minutes after allowing the baby to cool down for a few minutes.

Choice B:

Notifying the health care provider immediately is not necessary unless the baby has a fever of 100.4°F or higher or other signs of illness.

Choice C:

Placing the newborn under a radiant warmer is not appropriate unless the baby has hypothermia

Choice D:

N/A

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Question 4:

A nurse is preparing to clamp and cut a newborn’s umbilical cord with sterile instruments.

When should the nurse perform this procedure?

A. Within 1 to 3 minutes after birth B. Within 5 to 10 minutes after birth C. Within 15 to 20 minutes after birth D. Within 30 to 45 minutes after birth

Answer and Explanation

Choice A:

The nurse should clamp and cut the newborn’s umbilical cord within 1 to 3 minutes after birth.This is because delaying the cord clamping for longer than 3 minutes may increase the risk of jaundice in the baby.

Jaundice is a condition where the skin and eyes turn yellow due to high levels of bilirubin in the blood.

Bilirubin is a waste product that is normally removed by the liver, but in newborns, the liver may not be fully developed yet.

Choice B:

Waiting for 5 to 10 minutes after birth to clamp and cut the cord may not have any significant benefits for the baby compared to clamping within 1 to 3 minutes

Choice C:

Waiting for 15 to 20 seconds after birth to clamp and cut the cord is too early and may deprive the baby of some blood, oxygen, and nutrients that are still flowing from the placenta

Choice D:

Waiting for 30 to 45 minutes after birth to clamp and cut the cord is too late and may expose the baby to infection or bleeding from the cord.

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Umbilical cord care

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