A newborn develops hyperbilirubinemia when 24 hours old and is prescribed phototherapy.
Which measure is an important part of this newborn’s care plan?
Elevate the head of the infant’s crib.
Apply a water-soluble ointment to the infant’s eyes.
Dress the infant in a long-sleeved shirt.
Keep the infant well hydrated.
The Correct Answer is D
he correct answer is choice D. Keep the infant well hydrated.This is because phototherapy can cause dehydration due to increased insensible water loss from the skin. Hydration helps the infant excrete bilirubin in urine and stool.
Choice A is wrong because elevating the head of the infant’s crib does not affect bilirubin levels or phototherapy effectiveness.
Choice B is wrong because applying a water-soluble ointment to the infant’s eyes can interfere with eye protection and cause eye irritation. The infant’s eyes should be covered with opaque patches or goggles during phototherapy to prevent eye damage.
Choice C is wrong because dressing the infant in a long-sleeved shirt reduces the amount of skin exposed to light and decreases the efficacy of phototherapy. The infant should be undressed except for a diaper and eye protection during phototherapy.
Normal ranges for bilirubin levels vary depending on the age of the infant, the type of jaundice, and the method of measurement. Generally, bilirubin levels above 25 mg/dL are considered dangerous and require urgent treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice A. A breastfed baby is likely to gain weight more rapidly in the first month of life.This statement is wrong because breastfed babies generally gain weight faster than formula-fed babies for the first 3 months of life.They also double their birth weight by 3-4 months and triple it by one year.
Therefore, a breastfed baby’s weight gain in the first month of life is not unusual or concerning.
Choice B is correct because breastfeeding is not a reliable method of birth control.A woman can still ovulate and become pregnant while breastfeeding, especially if she feeds her baby less frequently or supplements with formula or solids.
Choice C is correct because breastfeeding has been shown to reduce the risk of allergies in babies.Breast milk contains antibodies and other immune factors that protect the baby from infections and allergic reactions.
Choice D is correct because breastfeeding mothers need to drink enough fluids to stay hydrated and produce enough milk.The recommended fluid intake for breastfeeding mothers is about 13 cups (3 liters) per day.
Correct Answer is C
Explanation
This is because pregnancy-induced hypertension (PIH) can cause eclampsia, a condition characterized by seizures and coma.Eclampsia can occur during pregnancy, labor, or postpartum.
A nurse should monitor the client for signs of increased blood pressure, headache, blurred vision, epigastric pain, and hyperreflexia, which may indicate an impending convulsion.
Choice A is wrong because hemorrhage is not a common complication of PIH.
Hemorrhage may occur due to other causes such as uterine atony, lacerations, or retained placenta.
Choice B is wrong because urinary retention is not a common complication of PIH.
Urinary retention may occur due to other causes such as anesthesia, trauma, or infection.
Choice D is wrong because thrombophlebitis is not a common complication of PIH.
Thrombophlebitis is a condition where a blood clot forms in a vein and causes inflammation.
It may occur due to other risk factors such as immobility, dehydration, or injury.
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