A nurse is assisting the parent of a preterm newborn to perform skin-to-skin care to enhance parental bonding. Which of the following actions should the nurse take?
Instruct the parent to remove his shirt.
Place the newborn and parent in a private room that is brightly lit.
Place the newborn in a horizontal position in the parent's arms.
Completely undress the newborn.
The Correct Answer is A
Choice A rationale:
Instructing the parent to remove their shirt allows for direct skin-to- skin contact between the parent's chest and the preterm newborn, which is commonly known as kangaroo care. This technique promotes bonding, warmth, and comfort for both the parent and the newborn.
Choice B rationale:
Placing the newborn and parent in a private room that is brightly lit might not be optimal for skin-to-skin care, as preterm newborns are sensitive to light and sound. A calm and dimly lit environment is preferred.
Choice C rationale:
Placing the newborn in a horizontal position in the parent's arms is appropriate, as it allows for skin-to-skin contact and facilitates bonding. The newborn's head is positioned near the parent's chest to listen to the heartbeat.
Choice D rationale:
Completely undressing the newborn is not necessary for skin-to-skin care and may cause discomfort to the newborn. Keeping the newborn dressed in a diaper is sufficient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Postoperative pain management is crucial for the client's comfort and recovery.
Choice B rationale:
Excoriated folds of the client's panniculus might be related to skin irritation and can be addressed without immediate provider notification.
Choice C rationale:
Hypoactive bowel sounds can be expected after surgery and might not require immediate reporting.
Choice D rationale:
Urine output of 80 mL in the past hour might be influenced by various factors and is not as high a priority as severe pain.
Correct Answer is C
Explanation
Choice A rationale:
Developing influenza after receiving the vaccine the previous year is not a contraindication for receiving the vaccine this year. In fact, the vaccine is recommended annually.
Choice B rationale:
Hypertension is not a contraindication for receiving the influenza vaccine.
Choice C rationale:
Clients with a history of Guillain-Barré syndrome should generally avoid receiving the influenza vaccine due to a potential increased risk of recurrence of the syndrome.
Choice D rationale:
Allergies to dairy products are not a contraindication for receiving the influenza vaccine.
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