A nurse in an obstetric clinic is caring for four clients. The nurse should identify that an intrauterine device is contraindicated for which of the following clients?

A client who smokes one pack of cigarettes per day

A client who has a history of gallbladder disease

A client who has a positive pregnancy test

A client who is nulliparous

Answer and Explanation

The Correct Answer is C

(A) A client who smokes one pack of cigarettes per day:
While smoking is a significant risk factor for many health issues, including cardiovascular disease, it is not a direct contraindication for the use of an intrauterine device (IUD). However, smokers should be counseled about the risks of smoking and offered support to quit.

(B) A client who has a history of gallbladder disease:
A history of gallbladder disease does not contraindicate the use of an IUD. IUDs are primarily contraindicated in cases of active pelvic infection, certain uterine abnormalities, and confirmed pregnancy, but not gallbladder disease.

(C) A client who has a positive pregnancy test:
An IUD should not be inserted in a client who has a positive pregnancy test. Inserting an IUD during pregnancy can lead to complications such as infection, miscarriage, and preterm birth. It is crucial to confirm the absence of pregnancy before IUD insertion.

(D) A client who is nulliparous:
Being nulliparous (having never given birth) is not a contraindication for IUD use. IUDs can be safely used by nulliparous women, though some might have a slightly higher risk of expulsion or insertion-related discomfort compared to women who have given birth.

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Correct Answer is C

Explanation

(a) Avoid swaddling the newborn:
Swaddling is actually beneficial for newborns experiencing neonatal abstinence syndrome. It helps provide comfort and security, reducing irritability and promoting better sleep.

(b) Minimize holding the newborn:
Minimizing holding is not recommended. Holding and gentle handling are important as they provide comfort and can help soothe the newborn. Skin-to-skin contact and gentle rocking are beneficial practices for these infants.

(c) Decrease environmental noise:
Decreasing environmental noise is a key intervention for newborns with neonatal abstinence syndrome. These newborns are often hypersensitive to stimuli, and reducing noise helps create a calming environment that can reduce stress and overstimulation.

(d) Avoid using a pacifier:
Using a pacifier can be helpful for soothing a newborn experiencing neonatal abstinence syndrome. Sucking on a pacifier can provide comfort and help with self-regulation, reducing irritability and distress.

A. Reposition the newborn every 2 to 3 hr. B. Monitor the newborn's blood glucose level every 2 hr. C. Give the newborn 30 ml of distilled water after each feeding. D. Apply a water-based ointment to the newborn's skin every 4 to 6 hr.

Correct Answer is A

Explanation

(A) Reposition the newborn every 2 to 3 hr:
Repositioning the newborn every 2 to 3 hours helps ensure uniform exposure to the phototherapy lights, maximizing the effectiveness of the treatment. This prevents uneven distribution of light and reduces the risk of pressure ulcers or skin breakdown from prolonged immobility.

(B) Monitor the newborn's blood glucose level every 2 hr:
Monitoring the newborn's blood glucose level every 2 hours is not directly related to phototherapy for hyperbilirubinemia. While monitoring blood glucose levels may be necessary for certain newborns, especially those at risk for hypoglycemia, it is not a routine intervention during phototherapy.

(C) Give the newborn 30 ml of distilled water after each feeding:
Giving the newborn distilled water after each feeding is not indicated during phototherapy for hyperbilirubinemia. Breast milk or formula is sufficient for hydration, and providing additional water can interfere with adequate feeding and potentially lead to electrolyte imbalances.

(D) Apply a water-based ointment to the newborn's skin every 4 to 6 hr:
Applying a water-based ointment to the newborn's skin is not typically recommended during phototherapy. Ointments can create a barrier on the skin, reducing the effectiveness of the phototherapy treatment by blocking light absorption.

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A nurse in an obstetric clinic is caring for four clients. The nurse should identify that an intrauterine device is contraindicated for which of the following clients?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is A

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