A home health nurse is caring for a newborn.
Click to highlight the findings that require further intervention. To deselect a finding, clock on the finding again.
The Correct Answer is ["<p>Follow-up newborn weight check. <strong>Parent is smoking a cigarette in the living room while the infant sleeps. Parent reports the newborn is breastfeeding well<\/strong>. The newborn is asleep in their bassinet in the living room.<strong> Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet in the parents’ bedroom overnight.<\/strong><\/p>"]
Nurses’ Notes:
3 weeks old:
Follow-up newborn weight check. Parent is smoking a cigarette in the living room while the infant sleeps. Parent reports the newborn is breastfeeding well. The newborn is asleep in their bassinet in the living room. Newborn currently asleep in prone position. Parent reports that the newborn sleeps in their bassinet in the parents’ bedroom overnight.
Vital Signs:
3 weeks old:
Temperature: 36.9°C (98.4°F) Heart rate: 138/min Respiratory rate: 42/min
The two findings from the nurse's notes that require further intervention:
Parent Smoking in Presence of Newborn and Newborn Asleep in Prone Position
Parent is smoking a cigarette in the living room while the infant sleeps.: Exposure to secondhand smoke is particularly harmful to infants, as their lungs are still developing. It can lead to severe health problems such as breathing difficulties, bad colds, respiratory issues, and delayed physical and mental development. More critically, it increases the risk of sudden infant death syndrome (SIDS). Therefore, it is imperative to educate the parent about the dangers of smoking around the newborn and to ensure that the infant is kept in a smoke-free environment.
Newborn currently asleep in prone position.: The safest sleeping position for a newborn is on their back, as recommended by the American Academy of Pediatrics (AAP). This position has been shown to reduce the incidence of SIDS. Sleeping in a prone position (on the stomach) can lead to less oxygen and more carbon dioxide re-breathing, which can be dangerous for the infant. The nurse should advise the parent to always place the newborn on their back to sleep, for naps and at night, to minimize the risk of SIDS.
The vital signs provided do not indicate any immediate concerns, as the temperature, heart rate, and respiratory rate are within normal ranges for a 3-week-old infant. However, the environmental factors noted in the nurse's observations are significant and require prompt attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This demonstrates cultural competence by acknowledging and incorporating the client's cultural practices into their care plan.
Choice B reason: This statement does not demonstrate cultural competence but rather a lack of understanding and respect for the client's cultural practices.
Choice C reason: While family members can be helpful, using a professional interpreter is recommended to ensure accurate communication and to maintain confidentiality.
Choice D reason: Advising against the use of herbal teas does not reflect cultural competence. A culturally competent approach would involve discussing the client's beliefs and providing evidence-based guidance.
Correct Answer is ["A","C","D"]
Explanation
Choice A reason: Financial instability can be a significant stressor in families and may contribute to an increased risk of child abuse.
Choice B reason: Having a pet, such as an indoor cat, is not a recognized risk factor for child abuse and does not place
the child at an increased risk.
Choice C reason: If one parent appears frightened of the other, it may suggest the presence of domestic violence, which is a known risk factor for child abuse.
Choice D reason: A history of alcohol use disorder in a parent is associated with an increased risk of child abuse, as substance abuse can impair judgment and lead to harmful behaviors.
Choice E reason: Spending time with grandparents, in itself, is not a risk factor for child abuse and does not place the child at an increased risk.
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