A charge nurse in a newborn nursery is providing information to a group of nurses about risk factors for hypoglycemia. Which of the following risk factors should the charge nurse include? (Select all that apply.)

Maternal diabetes

Prematurity

Hypothermia

Thrombocytopenia

Anemia

Answer and Explanation

Correct Answer : A,B,C

Rationale:

A. Maternal diabetes: Infants born to diabetic mothers are at increased risk for hypoglycemia due to elevated insulin levels stimulated by maternal hyperglycemia. After birth, the abrupt loss of maternal glucose can lead to a rapid drop in the infant’s blood sugar.

B. Prematurity: Premature infants have limited glycogen stores and immature metabolic systems, making them more susceptible to hypoglycemia. Their inability to effectively regulate glucose levels increases their risk after birth.

C. Hypothermia: Cold stress increases metabolic demands and glucose consumption. As the infant uses more energy to maintain body temperature, blood glucose levels can drop rapidly if not closely monitored and managed.

D. Thrombocytopenia: Low platelet counts may indicate other underlying conditions but are not directly associated with hypoglycemia. It is more relevant to clotting and bleeding risks rather than glucose regulation.

E. Anemia: Anemia affects oxygen-carrying capacity but does not have a direct link to blood glucose control. While it may indicate other health issues, it is not a recognized independent risk factor for neonatal hypoglycemia.

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Correct Answer is ["B","C"]

Explanation

Rationale:

A. Clamp the chest tube every 2 hr to assess the amount of drainage: Clamping a chest tube is not routine and can lead to tension pneumothorax by preventing air or fluid from escaping the pleural space. It should only be done briefly and under specific provider direction.

B. Add water to the water seal chamber as it evaporates: Water in the water seal chamber may evaporate over time and should be maintained at the prescribed level to preserve the one-way seal. This ensures proper functioning of the chest drainage system.

C. Mark the drainage output on the collection chamber: Marking the drainage level at regular intervals allows for accurate monitoring of output trends, which can help detect complications like hemorrhage or increased fluid accumulation.

D. Maintain the collection chamber above the level of the client's waist: The collection chamber should be kept below the level of the chest to promote gravity drainage. Elevating it above the waist can allow fluid or air to flow back into the pleural space.

E. Strip the chest tube vigorously to dislodge blood clots: Stripping is not recommended as it creates high negative pressure that may damage lung tissue. If clots are suspected, milking the tube gently or other interventions should be discussed with the provider.

A. "Opioids should not be given to older adults." B. "Pain perception is decreased in older adult clients." C. "Older adults report pain less frequently than younger clients." D. "Older adults require higher doses of pain medication."

Correct Answer is C

Explanation

Rationale:

A. "Opioids should not be given to older adults.": Opioids can be given to older adults when necessary, but with caution. The dose may need adjustment due to age-related changes in metabolism and increased sensitivity, not outright avoidance.

B. "Pain perception is decreased in older adult clients.": Pain perception does not decrease with age. Older adults may have conditions that affect communication or cognition, but their ability to feel pain remains intact, and they can still experience significant discomfort.

C. "Older adults report pain less frequently than younger clients.": Older adults often underreport pain due to beliefs that pain is a normal part of aging or fear of treatment consequences. This makes active assessment and trust-building essential in managing their pain effectively.

D. "Older adults require higher doses of pain medication.": Older adults typically require lower or more carefully titrated doses due to slower metabolism, decreased renal clearance, and heightened drug sensitivity, especially to central nervous system effects.

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A charge nurse in a newborn nursery is providing information to a group of nurses about risk factors for hypoglycemia. Which of the following risk factors should the charge nurse include? (Select all that apply.)

Nursing Test Bank

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Explanation

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