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?

To facilitate bonding between the newborn and parent

To allow manifestations of infection to be identified

The newborn weighs less than 2.5 kg (5.5 lb)

The newborn was delivered via cesarean birth

Answer and Explanation

The Correct Answer is A

A. To facilitate bonding between the newborn and parent. This is correct. Antibiotic ophthalmic ointment, typically used to prevent neonatal conjunctivitis, can temporarily blur the newborn's vision. Delaying its application for a short period allows the newborn to maintain eye contact with the parent during the critical bonding period immediately following birth.

B. To allow manifestations of infection to be identified. This is incorrect. The purpose of the antibiotic ointment is to prevent neonatal conjunctivitis caused by gonorrhea or chlamydia, which may not present with immediate symptoms. Delaying its application to observe for signs of infection would not be appropriate.

C. The newborn's weight is not a determining factor for delaying the instillation of antibiotic ophthalmic ointment.

D. The mode of delivery, whether vaginal or cesarean, does not affect the timing of antibiotic ophthalmic ointment instillation.

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Correct Answer is C

Explanation

Rationale:

A. Bathing the baby immediately after a feeding is not recommended, as it may cause discomfort or spit-up due to movement and manipulation of the baby's body. It's best to wait until the baby is settled and not hungry.

B. Putting a soft mattress in the baby's crib increases the risk of sudden infant death syndrome (SIDS). Firm mattresses are recommended to reduce the risk of suffocation.

C. Washing the baby's face with plain water is a safe and appropriate instruction. Using plain water helps prevent irritation or allergic reactions that may occur with soaps or other cleansing agents.

D. Placing a bumper pad in the baby's crib is not recommended due to the risk of suffocation and strangulation. Bumper pads can also increase the risk of SIDS.

A. "The car seat should be positioned in the car at a 45-degree angle." B. "My baby will need a car seat challenge test before discharge." C. "When my baby is 1 year old, I can turn their car seat facing forward." D. “I can use a sleep sack to keep my baby warm in the car seat."

Correct Answer is A

Explanation

A. "The car seat should be positioned in the car at a 45-degree angle." This statement is correct and indicates an understanding of car seat safety. Positioning the car seat at a 45-degree angle helps prevent the newborn's head from flopping forward, which could obstruct the airway. Proper positioning ensures both safety and comfort during travel.

B. "My baby will need a car seat challenge test before discharge." This statement is incorrect for a newborn delivered at 38 weeks of gestation. A car seat challenge test is typically required for premature infants (less than 37 weeks gestation) or those with specific health conditions to ensure they can tolerate sitting in a car seat without respiratory or cardiac issues.

C. "When my baby is 1 year old, I can turn their car seat facing forward." Incorrect. It is recommended to keep infants in a rear-facing car seat until they reach the maximum height or weight limit recommended by the car seat manufacturer, typically well beyond the first year of life.

D. “I can use a sleep sack to keep my baby warm in the car seat." While using a sleep sack can keep a baby warm, it's important not to use any additional padding or blankets in the car seat as they can interfere with the proper harness fit and increase the risk of injury in the event of a crash.

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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?

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