A nurse in the delivery room is planning to promote maternal-infant bonding for a client who just delivered. What is the priority action by the nurse?
Limit noise and interruption in the delivery room.
Encourage the parents to touch and explore the neonate’s features.
Place the neonate skin-to-skin on the client’s chest.
Place the neonate at the client’s breast.
The Correct Answer is C
Choice A rationale
Limiting noise and interruption in the delivery room can help create a calm environment, which can be beneficial for both the mother and the newborn. However, this is not the priority action for promoting maternal-infant bonding.
Choice B rationale
Encouraging parents to touch and explore the neonate’s features can help foster a connection between the parents and the newborn. This tactile stimulation can also be comforting for the newborn. However, this is not the most immediate action to promote maternal-infant bonding.
Choice C rationale
Placing the neonate skin-to-skin on the client’s chest is the priority action. Skin-to-skin contact immediately after birth helps regulate the newborn’s temperature, heart rate, and breathing. It also promotes breastfeeding and bonding.
Choice D rationale
Placing the neonate at the client’s breast can promote breastfeeding, which can enhance maternal-infant bonding. However, this is not the first action to take. The priority is to establish skin-to-skin contact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Step 1 is: Calculate the Apgar score based on the given vital signs. The Apgar score is calculated based on five criteria: heart rate, respiratory effort, muscle tone, reflex irritability, and color.
Step 2 is: Assign points for each criterion. For heart rate of 160 bpm, assign 2 points. For good, vigorous respiratory effort, assign 2 points. For active movement and well-flexed muscle tone, assign 2 points. For crying with stimulation of soles of feet (reflex irritability), assign 2 points. For body pink but feet and hands cyanotic (color), assign 1 point.
Step 3 is: Add up the points. 2 (heart rate) + 2 (respiratory effort) + 2 (muscle tone) + 2 (reflex irritability) + 1 (color) = 9 points. So, the correct Apgar score for this newborn is 9.
Correct Answer is A
Explanation
Choice A rationale
Offering the parent the opportunity to hold their stillborn baby can be a crucial part of the grieving process. It allows the parent to acknowledge the reality of the loss and begin to say goodbye.
Choice B rationale
Telling a grieving parent that “this is for the best” can be perceived as dismissive and insensitive. It’s important to validate the parent’s feelings of loss and grief.
Choice C rationale
Sharing personal experiences of loss can shift the focus away from the grieving parent. It’s more helpful to provide empathetic support and allow the parent to share their feelings.
Choice D rationale
While spiritual support can be helpful for some, it’s not appropriate to assume that every parent will want this. It’s better to ask the parent if they would like to speak with a chaplain or other spiritual advisor.
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