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.
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Related Questions
Correct Answer is D
Explanation
Rationale:
A. Asking a psychiatrist to talk with the parents may not be the most appropriate immediate
action when abuse is suspected. Reporting to the authorities should take precedence to ensure the child's safety.
B. Obtaining a detailed history is important but should be done after reporting the suspected abuse to the authorities.
C. Separating the child from the parents may not be feasible or appropriate in all situations.
Reporting to the authorities is the priority action to ensure proper investigation and protection of the child.
D. Report the suspected abuse to the authorities. Suspected child abuse must be reported
immediately to the appropriate authorities, such as child protective services or law enforcement, for further investigation and intervention to ensure the safety and well-being of the child.
Correct Answer is C
Explanation
Rationale:
A. Ibuprofen is not recommended for infants younger than six months without specific physician orders due to potential adverse effects.
B. Positioning the infant on her abdomen may not be suitable immediately postoperatively and should be guided by the surgical team's recommendations.
C. Offering a pacifier can provide non-nutritive sucking comfort, which can help soothe the infant and decrease pain perception.
D. While rocking the infant can be comforting, it may not address the immediate postoperative needs of the infant or provide sufficient pain relief.
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