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A nurse is caring for a neonate in the neonatal intensive care unit.

Exhibits

The nurse is reviewing the neonate's electronic medical record.

Drag words from the choices below to fill in each blank in the following sentence.

Following discontinuation of feedings, the nurse should monitor for

and

Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Sepsis: Preterm neonates are at increased risk for infections, including sepsis. Discontinuation of feedings, along with the other signs observed (such as abdominal distention, blood in stool, lethargy, and hypotonia), may suggest the onset of infection, which requires close monitoring.

Hypotension: Preterm neonates are also at risk for hypotension due to immature circulatory systems. The stress of gastrointestinal disturbances, such as abdominal distention and the potential for necrotizing enterocolitis (NEC), can result in decreased perfusion, contributing to hypotension.


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Related Questions

Correct Answer is D

Explanation

A. Ensure that the transfusion is completed within 6 hr: Incorrect. Blood transfusions should be completed within 4 hours to reduce the risk of bacterial contamination.

B. Obtain venous access using a 22-gauge needle: Incorrect. A larger gauge (18-20) is preferred to prevent hemolysis and allow for faster administration.

C. Store the unit of blood at room temperature for 1 hr prior to the infusion: Incorrect. Blood should remain refrigerated until it is ready to be transfused, and it should be started within 30 minutes of removal from refrigeration.

D. Use a solution of 0.9% sodium chloride to flush the transfusion tubing: 0.9% sodium chloride is the only compatible solution with blood products to prevent hemolysis.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"A"}

Explanation

Bowel perforation is a serious complication that can occur as a result of necrotizing enterocolitis (NEC), which is a condition often seen in preterm infants. In NEC, the intestines become inflamed and can eventually rupture, leading to bowel perforation. The neonate's symptoms, including abdominal distention, firm abdomen, decreased bowel sounds, and a small amount of blood in the stool, are consistent with NEC. The abdominal x-ray showing marked distention of the intestine further supports this diagnosis.

Necrotizing enterocolitis (NEC) is a common and life-threatening condition in preterm infants (like this neonate born at 34 weeks gestation), particularly those receiving enteral feedings. It can lead to bowel perforation, sepsis, and other serious complications.

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