A nurse is assisting in planning care for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse recommend?

Avoid swaddling the newborn

Minimize holding the newborn

Decrease environmental noise.

Avoid using a pacifier.

Answer and Explanation

The Correct Answer is C

(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.

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Correct Answer is A

Explanation

(A) Perform fundal massage:
Performing fundal massage is the highest priority action in this scenario. Complete saturation of the perineal pad within 30 minutes postpartum suggests excessive bleeding, which could indicate postpartum hemorrhage (PPH). Fundal massage helps to stimulate uterine contractions, which can aid in controlling bleeding by compressing blood vessels at the placental site. It is essential to assess the fundus for firmness and position and massage it if necessary, to prevent or manage PPH.

(B) Weigh the perineal pad:
Weighing the perineal pad can provide information about the amount of blood loss, but it is not the highest priority action at this moment. Fundal massage takes precedence to address the potential underlying cause of excessive bleeding.

(C) Apply oxygen by face mask:
While oxygen therapy may be indicated in certain situations, such as respiratory distress, it is not the highest priority in this scenario. The priority is to address the potential cause of excessive bleeding and prevent further complications associated with postpartum hemorrhage.

(D) Monitor urine output:
Monitoring urine output is an important aspect of postpartum care, but it is not the highest priority when the client is experiencing excessive bleeding. Addressing the potential cause of bleeding and preventing complications associated with postpartum hemorrhage take precedence.

A. Diuresis B. Fever C. Diarrhea D. Sedation

Correct Answer is D

Explanation

(A) Diuresis:
Diuresis, or increased urine production, is not a typical adverse effect of nalbuphine hydrochloride. Opioids generally do not affect urine output in the same way as diuretic medications.

(B) Fever:
Fever is not a common adverse effect of nalbuphine hydrochloride. If a client develops a fever during labor, it could indicate other underlying causes such as infection or inflammation, but it is not directly related to the administration of this medication.

(C) Diarrhea:
Diarrhea is not a typical adverse effect of nalbuphine hydrochloride. Opioid medications are more commonly associated with constipation due to their effects on gastrointestinal motility and function.

(D) Sedation:
Nalbuphine hydrochloride is an opioid analgesic used for pain relief during labor. Sedation is a common adverse effect of opioid medications, including nalbuphine. Opioids can depress the central nervous system, leading to drowsiness, sedation, and decreased level of consciousness. It's essential for the nurse to monitor the client closely for signs of sedation, especially during labor, to ensure the safety of both the mother and the baby.

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A nurse is assisting in planning care for a newborn who is experiencing neonatal abstinence syndrome. Which of the following actions should the nurse recommend?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of a client who is 3 hours postpartum and reports complete saturation of their perineal pad in the past 30 minutes. Which of the following actions is the highest priority?

Correct Answer is A

Explanation

A nurse is assisting with the care of a client who is in labor and has received nalbuphine hydrochloride. Which of the following manifestations should the nurse identify as an adverse effect of this medication?

Correct Answer is D

Explanation

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