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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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

Choice A rationale
Obtaining a specimen for a Kleihauer-Betke test is not the immediate action to take when a patient is experiencing a large amount of vaginal bleeding due to uterine atony.
Choice B rationale
Misoprostol is a medication that can be used to treat uterine atony. It helps to contract the uterus and reduce bleeding.
Choice C rationale
Administering betamethasone IM is not the appropriate action. Betamethasone is a steroid medication often used to mature the lungs of a fetus at risk of premature birth, not to treat uterine atony.
Choice D rationale

Avoiding sterile vaginal examinations is not the immediate action to take when a patient is experiencing a large amount of vaginal bleeding due to uterine atony.

A. A client who has gestational diabetes mellitus B. A client who had a previous stillbirth C. A client who had a nonreactive nonstress test D. A client who has a previous classical incision .

Correct Answer is D

Explanation

Choice A rationale
A client who has gestational diabetes mellitus does not have a contraindication for a contraction stress test.
Choice B rationale
A client who had a previous stillbirth does not have a contraindication for a contraction stress test.
Choice C rationale

A client who had a nonreactive nonstress test does not have a contraindication for a contraction stress test. In fact, a nonreactive nonstress test is often an indication for further testing, such as a contraction stress test.
Choice D rationale
A client who has a previous classical incision is at risk for uterine rupture, which is a contraindication for a contraction stress test.

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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)

Nursing Test Bank

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Correct Answer is B

Explanation

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Correct Answer is D

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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)