A nurse is caring for a newborn immediately following birth and notes a large amount of mucus in the newborn's mouth and nose. Identify the sequence the nurse should follow when performing suction with a bulb syringe.
Assess the newborn for reflex bradycardia.
Compress the bulb syringe.
Use the bulb syringe to suction the newborn's nose.
Place the bulb syringe in the newborn's mouth.
The Correct Answer is B,D,C,A
The correct answer is choice B, D, C, A. B. Compress the bulb syringe: The nurse should first compress the bulb syringe to expel air from it. This ensures that when it is placed in the newborn’s mouth or nose, it can create suction to effectively remove mucus. D. Place the bulb syringe in the newborn's mouth: The nurse should then place the compressed bulb syringe into the newborn’s mouth first, as clearing the mouth is essential before the nose to prevent aspiration. C. Use the bulb syringe to suction the newborn's nose: After suctioning the mouth, the nurse should use the bulb syringe to suction the nose. Suctioning the nose after the mouth helps to clear the airway more effectively and reduce the risk of mucus being aspirated into the lungs. A. Assess the newborn for reflex bradycardia: After suctioning, the nurse should assess the newborn for any signs of reflex bradycardia, which can occur due to vagal stimulation during suctioning. This ensures the newborn's heart rate and overall well-being are monitored.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Discomfort in the lower back (sacral area) is common during labor, particularly during contractions. This is not an unusual finding that would require immediate reassessment.
B. Contractions lasting between 45 to 60 seconds are typical during the active phase of labor. This duration of contractions is expected as labor progresses, and does not require immediate reassessment.
C. This sensation can indicate that the fetus has descended into the birth canal and may be a sign that the client is entering the second stage of labor, or is close to delivery. This requires immediate reassessment by the nurse to check for full cervical dilation and fetal descent.
D. Emotional excitement and changes in skin temperature are typical responses during labor due to the physiological and emotional aspects of childbirth. This does not indicate the need for immediate reassessment.
Correct Answer is B
Explanation
administer a bolus infusion of lactated Ringer's. Maternal hypotension is a common complication of epidural anesthesia. A bolus infusion of lactated Ringer's is an appropriate intervention for maternal hypotension due to the increased volume and pressure it provides, which can help to raise the client's blood pressure. The knee-chest position is not an appropriate intervention for maternal hypotension as it can cause a decrease in venous return to the heart. Terbutaline is a tocolytic medication used to stop premature labor, and it is not indicated for maternal hypotension. Oxygen via a nonrebreather face mask at 2 L/min is not an appropriate intervention for maternal hypotension as it does not address the underlying cause of the hypotension.
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