A nurse is caring for a newborn who is 5 days old in the neonatal intensive care unit (NICU).
Exhibits
Which of the following actions should the nurse take? (Select all that apply)
Swaddle the newborn with flexed extremities.
Plan to administer naloxone.
Maintain a low stimulation environment.
Instruct the parent to avoid breastfeeding.
Perform Ballard newborn screening each shift.
Weigh the newborn daily.
Instruct the parent to avoid eye contact with the newborn during feeding.
Correct Answer : A,C,F
Choice A rationale: Swaddling the newborn with flexed extremities can provide a sense of security and help soothe the newborn. This is a common practice in managing neonates with Neonatal Abstinence Syndrome (NAS) as it can help reduce irritability and promote sleep.
Choice B rationale: Naloxone is not typically used in the treatment of NAS. Naloxone is an opioid antagonist and can precipitate withdrawal symptoms in opioid-dependent individuals. In a neonate with NAS due to maternal opioid use, naloxone can cause severe and immediate withdrawal.
Choice C rationale: Maintaining a low stimulation environment is crucial in managing neonates with NAS. These neonates are often hypersensitive to stimuli, and a quiet, dimly lit environment can help reduce irritability and promote sleep.
Choice D rationale: Breastfeeding is usually encouraged in mothers who are stable on their opioid replacement therapy, are not using illicit drugs, and have no other contraindications for breastfeeding. The benefits of breastfeeding include the passage of maternal antibodies and the promotion of mother-infant bonding.
Choice E rationale: The Ballard newborn screening is a tool used to estimate gestational age using physical and neuromuscular characteristics. It is typically performed shortly after birth and may not need to be performed each shift in a neonate with NAS.
Choice F rationale: Weighing the newborn daily is important in the management of NAS. Weight can provide information about feeding and hydration status, and any significant or sudden changes in weight can indicate a need for further evaluation.
Choice G rationale: Eye contact during feeding can promote bonding between the parent and the newborn. There is no need to avoid eye contact during feeding in a neonate with NAS.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Providing the patient with photos of the fetus can be a part of memory-making and is often a key component of care after a stillbirth. It allows parents to remember their baby and can aid in the grieving process.
Choice B rationale
While an autopsy can provide information about why a stillbirth occurred, it is not mandatory and should be discussed with the parents. The decision to perform an autopsy should be based on the parents’ wishes.
Choice C rationale
Limiting the amount of time the fetus is in the patient’s room is not necessarily beneficial. Some parents may want to spend time with their baby to say goodbye, which can be therapeutic.
Choice D rationale
Informing the patient that the law requires them to name the fetus is not accurate. The decision to name the fetus is a personal one and varies among individuals.
Correct Answer is C
Explanation
Choice A rationale
The use of an oil-based vaginal lubricant when inserting a diaphragm is not recommended. Oil- based lubricants can damage the material of the diaphragm, reducing its effectiveness as a contraceptive method.
Choice B rationale
Keeping the diaphragm in place for at least 4 hours after intercourse is a standard recommendation. However, it does not address the specific needs of a postpartum woman. After childbirth, the size and shape of a woman’s vagina can change, potentially affecting the fit of the diaphragm.
Choice C rationale
The provider should refit the client for a new diaphragm. After childbirth, the size and shape of a woman’s vagina can change, potentially affecting the fit of the diaphragm. A poorly fitting diaphragm may not provide effective contraception.
Choice D rationale
Storing the diaphragm in sterile water after each use is not a standard recommendation. The diaphragm should be cleaned with mild soap and water, dried, and stored in a cool, dry place.
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