A nurse is caring for a 1-week-old newborn who has hyperbilirubinemia and is being treated with phototherapy. Which of the following actions should the nurse take?
Check the newborn's eyes every 8 hr.
Place mittens on the newborn's hands.
Monitor the newborn's temperature every 2 hr.
Apply lotion to the newborn's skin.
The Correct Answer is C
Rationale:
A. Checking the newborn's eyes every 8 hours is not necessary for the management of hyperbilirubinemia or phototherapy.
B. Placing mittens on the newborn's hands is unrelated to the management of hyperbilirubinemia or phototherapy.
C. Monitoring the newborn's temperature every 2 hours is essential during phototherapy because infants are at risk of hypothermia due to increased heat loss from the lights.
D. Applying lotion to the newborn's skin is not recommended during phototherapy as it can interfere with the effectiveness of the lights.
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Related Questions
Correct Answer is C
Explanation
A. Allowing the infant to cry before feeding increases energy expenditure and may worsen fatigue in infants with heart failure.
B. A recumbent position can increase the risk of aspiration; a semi-upright position is preferred.
C. Implementing a 3-hour feeding schedule ensures the infant receives adequate nutrition without excessive fatigue.
D. Feedings should be limited to 30 minutes to prevent excessive energy expenditure.
Correct Answer is B
Explanation
A. Unopened bottles of formula are not typically sources of healthcare-associated infections.
B. Bedside computer keyboards can harbor pathogens and serve as fomites for transmitting infections.
C. Disposable diapers are not typically sources of healthcare-associated infections if used appropriately.
D. Protective plastic gowns are not typically sources of healthcare-associated infections if used appropriately.
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