A nurse is caring for a newborn who is 72 hr old.
Vital signs
0900:
- Heart rate 160/min
- Respiratory rate 80/min
- Temperature 38.1° C (100.6° F)
- Oxygen saturation 97%
1000:
- Heart rate 167/min
- Respiratory rate 72/min
- Temperature 38°C (100.4°F)
- Oxygen saturation 97%
Medical History
0900:
A term newborn 37 weeks of gestation is admitted to the newborn nursery following a precipitous vaginal birth. Birthing parent has a history of heroin use during pregnancy and prenatal care beginning at 34 weeks of gestation. Birthing parent and newborn drug screens positive for heroin.
The nurse is planning to contact the provider regarding the newborn's status. Which of the following prescriptions should the nurse anticipate? Select the 3 interventions the nurse should anticipate.
Administer oral morphine.
Swaddle the newborn.
Administer naloxone for NAS scores greater than 24.
Encourage the birthing parent to breastfeed.
Continue NAS scoring as prescribed
Correct Answer : A,B,E
A. Administering oral morphine is anticipated because it is used to manage withdrawal symptoms in newborns with Neonatal Abstinence Syndrome (NAS..
B. Swaddling is a non-pharmacological intervention that can provide comfort and reduce overstimulation.
C. Administering naloxone is not typically the first line of treatment for NAS and is used in cases of acute opioid overdose, which is not indicated by the information provided.
D. Encouraging the birthing parent to breastfeed may not be appropriate due to the presence of heroin in the system, which can be transmitted to the newborn through breast milk.
E. Continuing NAS scoring is essential to monitor the newborn's condition and response to treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Frequent use of the call light does not necessarily indicate abuse. It could be due to various factors such as pain, discomfort, or needing assistance.
B. A child whose parents answer questions for the child may indicate potential parental control or intimidation, which can be a sign of emotional or psychological abuse.
C. Obesity alone does not necessarily indicate abuse. It could be due to various factors such as genetics, diet, or lack of physical activity.
D. Having frequent visitors does not necessarily indicate abuse. It could be due to a supportive social network or family involvement.
Correct Answer is ["B","C","D"]
Explanation
A. Having the client douche every morning and night is not recommended as it can disrupt the natural balance of vaginal flora and exacerbate the condition. It may worsen symptoms and increase the risk of complications.
B. Instructing the client to avoid alcohol for 72 hours after treatment is not necessary in this scenario. Metronidazole is an antibiotic used to treat bacterial vaginosis and does not typically interact with alcohol.
C. Metronidazole is the treatment of choice for bacterial vaginosis, which is suggested by the client's symptoms (frothy, yellow-green, malodorous discharge) and the provider's likely diagnosis based on the clinical presentation.
D. Recommending the client's partner receive treatment is important to prevent reinfection or transmission of the infection. Bacterial vaginosis can be sexually transmitted, and treating both partners helps reduce the risk of recurrence.
E. Performing an oatmeal sitz bath may provide symptomatic relief for certain conditions, but it is not typically indicated for the treatment of bacterial vaginosis.
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