A nurse is caring for a newborn immediately following birth.

For which of the following reasons should the nurse delay the instillation of antibiotic ophthalmic ointment?

Choice A rationale
Preterm newborns do not have a thick layer of brown fat. Brown fat is a type of fat that generates heat and is typically found in full-term newborns. It helps them maintain their body temperature. Preterm newborns have less brown fat, which makes them more susceptible to hypothermia.
Choice B rationale
Shivering is a mechanism used by the body to generate heat when it’s cold. However, preterm newborns cannot shiver. Their nervous systems are not fully developed, and they lack the muscle coordination necessary to shiver.
Choice C rationale
Sweating is another mechanism the body uses to regulate temperature. When the body is too warm, it produces sweat to cool down. However, preterm newborns do not sweat to cool off when they get too warm. Their sweat glands are not fully developed, and they may not be able to sweat effectively.
Choice D rationale
Preterm newborns have less muscle tone, which exposes more body surfaces to heat loss. Muscle tone provides insulation and generates heat. Because preterm newborns have less muscle mass, they have less insulation and generate less heat, making them more susceptible to hypothermia.

Choice A rationale
Turning a baby’s car seat forward when they are 1 year old is not recommended. According to the American Academy of Pediatrics, children should ride in a rear-facing car seat as long as possible, until they reach the highest weight or height allowed by their seat. This is because rear-facing car seats provide the best protection for the baby’s head, neck, and spine in a crash.
Choice B rationale
While it’s important to keep a baby warm in the car seat, using a sleep sack is not the safest option. Bulky outerwear and blankets can interfere with the tightness of the harness, which can compromise the safety of the baby. Instead, it’s recommended to dress the baby in lighter layers and place a warm blanket over them and the harness.
Choice C rationale
A car seat challenge test, also known as a car seat trial, is usually performed on babies who were born preterm, not at full term. This test checks whether the baby can sit in a car seat safely without any breathing problems or other complications. Since the newborn in question was delivered at 38 weeks of gestation, which is considered full term, a car seat challenge test is not typically required.
Choice D rationale
The car seat should indeed be positioned at a 45-degree angle. This angle is especially important for newborns and infants who are rear-facing, as it helps to support their head and prevent it from falling forward.