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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 D

Explanation

Choice A rationale
Fresh citrus fruits are a good source of vitamin C, but they do not contain vitamin B125. Vitamin B12 is not naturally present in plant foods, so vegans need to get it from fortified foods or supplements.
Choice B rationale

Raw carrots are a good source of vitamins A and K, and dietary fiber, but they do not contain vitamin B125. Vegans need to get vitamin B12 from other sources.
Choice C rationale
Brown rice is a good source of B vitamins like B1 (thiamin) and B3 (niacin), but it does not contain vitamin B125. Vegans need to get vitamin B12 from other sources.
Choice D rationale
Fortified soy milk is a good source of vitamin B12 for vegans. Many brands of soy milk are fortified with vitamins, including B12, making them a good choice for vegans looking to increase their vitamin B12 intake.

A. Incompetent cervix B. Hyperemesis gravidarum C. Postpartum hemorrhage D. Ectopic pregnancy

Correct Answer is C

Explanation

Choice A rationale
An incompetent cervix is a condition that occurs when weak cervical tissue causes or contributes to premature birth or the loss of an otherwise healthy pregnancy. This condition is not directly related to the client’s current state of being 80% effaced and 8 cm dilated.
Choice B rationale
Hyperemesis gravidarum is a condition characterized by severe nausea, vomiting, weight loss, and electrolyte disturbance. Mild cases are treated with dietary changes, rest, and antacids.
More severe cases often require a stay in the hospital so that the mother can receive fluid and nutrition through an intravenous line. This condition is not directly related to the client’s current state of being 80% effaced and 8 cm dilated.
Choice C rationale
Postpartum hemorrhage is a condition that can occur due to a variety of factors, one of which is a rapid or prolonged labor, which can result in uterine atony. Given that the client is 80% effaced and 8 cm dilated, she is in active labor and could potentially be at risk for postpartum hemorrhage.
Choice D rationale

An ectopic pregnancy is a pregnancy in which the fertilized egg implants outside the uterus. The client is already in active labor, which means the pregnancy is not ectopic.

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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)

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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)