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
Facial petechiae are small, pinpoint, red or purple spots on the skin that can occur when a newborn has a nuchal cord, or the umbilical cord wrapped around the neck. This is due to the pressure exerted on the baby’s face and neck during delivery.
Choice B rationale
Erythema toxicum is a common rash seen in newborns, characterized by tiny bumps surrounded by red skin. However, it is not specifically associated with a nuchal cord.
Choice C rationale
Periauricular papillomas are small skin tags or pits seen near the ear. They are a common minor anomaly seen in newborns, but they are not associated with a nuchal cord.
Choice D rationale
Telangiectatic nevi, also known as “stork bites,” are common birthmarks seen in newborns, characterized by small, light pink patches, usually on the back of the neck. However, they are not associated with a nuchal cord.
Correct Answer is D
Explanation
Choice A rationale
While a sleep sack can keep a baby warm, it should not be used in a car seat because it can interfere with the harness and affect its effectiveness.
Choice B rationale
A car seat challenge test is usually performed on premature babies or those with medical conditions. It is not routinely required for a newborn delivered at 38 weeks of gestation.
Choice C rationale
The American Academy of Pediatrics recommends that children remain in a rear-facing car seat until they reach the highest weight or height allowed by their car safety seat’s manufacturer, which is typically around 2 years of age.
Choice D rationale
The car seat should indeed be positioned at a 45-degree angle. This position helps to keep the baby’s airway open and protects them in the event of a crash.
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