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?
The newborn weighs less than 2.5 kg (5.5 lb).
The newborn was delivered via cesarean birth.
To allow manifestations of infection to be identified.
To facilitate bonding between the newborn and parent.
The Correct Answer is D
Choice A rationale
The weight of the newborn is not a factor in the decision to delay the instillation of antibiotic ophthalmic ointment. The ointment is used to prevent eye infections caused by bacteria present in the mother’s birth canal, and this risk is not related to the newborn’s weight.
Choice B rationale
Whether the newborn was delivered via cesarean birth or vaginal birth does not affect the decision to delay the instillation of antibiotic ophthalmic ointment. The ointment is used to prevent eye infections that can occur regardless of the method of delivery.
Choice C rationale
While it is important to monitor newborns for signs of infection, delaying the instillation of antibiotic ophthalmic ointment would not aid in identifying manifestations of infection. The ointment is a preventative measure and does not interfere with the observation of symptoms.
Choice D rationale
Correct answer. The instillation of antibiotic ophthalmic ointment can cause blurred vision in the newborn. Delaying the instillation of the ointment facilitates immediate bonding between the newborn and parent, as the newborn will be able to see more clearly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Ensuring the newborn’s diaper is snug is not specific to the Plastibell circumcision technique. It is a general care tip for all newborns.
Choice B rationale
While it’s important to monitor the circumcision site for signs of infection, a dark red tip of the penis is not a specific concern related to the Plastibell circumcision technique.
Choice C rationale
Yellow exudate, which is a normal part of the healing process, will form at the surgical site within 24 hours. This is a normal part of the healing process and should not be mistaken for pus, which would indicate an infection.
Choice D rationale
The Plastibell device is not removed 4 hours after the procedure. Instead, it falls off naturally after about a week.
Correct Answer is B
Explanation
Choice A rationale
A hematocrit level of 37% is within the normal range for a pregnant woman, which is 33% to 46%. Therefore, this result does not need to be reported to the provider.
Choice B rationale
A fasting blood glucose level of 180 mg/dL is significantly higher than the normal range of 74 to 106 mg/dL. This could indicate gestational diabetes, which can lead to various complications for both the mother and the baby. Therefore, this finding should be reported to the provider.
Choice C rationale
A creatinine level of 0.9 mg/dL is within the normal range of 0.5 to 1 mg/dL for a female client aged 18 to 40 years.
Choice D rationale
A WBC count of 11,000/mm is slightly above the normal range of 5,000 to 10,000/mm. However, it’s common for the WBC count to increase during pregnancy due to physiological changes. Therefore, this result does not need to be reported to the provider.
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