A nurse is caring for a newborn with hyperbilirubinemia. Which of the following interventions should be taken during phototherapy?
Keep the newborn dressed while receiving phototherapy.
Apply lotion to the skin twice daily.
Maintain an eye mask over the newborn's eyes.
Maintain the phototherapy during blood draws.
The Correct Answer is C
Choice A rationale:
Keeping the newborn dressed while receiving phototherapy is not recommended because the baby's skin needs to be exposed to the light to effectively treat hyperbilirubinemia. Direct exposure to light helps break down the excess bilirubin in the baby's blood, leading to its excretion.
Choice B rationale:
Applying lotion to the skin twice daily is contraindicated during phototherapy. Lotions and creams can block the light from reaching the skin and hinder the therapeutic effects of the phototherapy. The baby's skin should remain exposed to the light for optimal treatment.
Choice C rationale:
Maintaining an eye mask over the newborn's eyes is essential during phototherapy. The eyes are sensitive to light, and prolonged exposure to the phototherapy light can lead to eye damage. Using an eye mask protects the baby's eyes while allowing the rest of the body to receive the necessary light treatment.
Choice D rationale:
Maintaining the phototherapy during blood draws is crucial to ensure continuous treatment of hyperbilirubinemia. Interrupting the phototherapy during blood draws might result in the rebound of bilirubin levels, which can be harmful to the baby.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
The client's statement about needing to have the IUD replaced each year is incorrect. The lifespan of most IUDs is longer than a year. Copper IUDs can last up to 10 years, and hormonal IUDs can last between 3 to 7 years, depending on the brand.
Choice B rationale:
The client's statement about needing to apply a spermicide prior to intercourse is unrelated to the correct use of an intrauterine device (IUD) for contraception. Spermicides are not required when using an IUD.
Choice C rationale:
The client's statement about expecting periods to stop while having the IUD is incorrect. Hormonal IUDs can often lead to lighter periods, and in some cases, periods may stop altogether. However, with a copper IUD, periods usually remain the same.
Choice D rationale:
This is the correct choice. The client's statement indicates an understanding of the teaching. Checking for the string each month after menstruation is crucial because it confirms that the IUD is still in place, reducing the risk of unintended pregnancy.
Correct Answer is B
Explanation
Choice A rationale:
Hypertonia (increased muscle tone) is not a manifestation of hypoglycemia in a newborn. Instead, hypotonia (decreased muscle tone) is more characteristic.
Choice B rationale:
This is the correct choice. Jitteriness is a common sign of hypoglycemia in a newborn. It may be accompanied by other symptoms like poor feeding, tremors, and irritability.
Choice C rationale:
Acrocyanosis (bluish discoloration of the hands and feet) is a normal finding in newborns and is not specifically associated with hypoglycemia.
Choice D rationale:
Generalized petechiae (small red or purple spots on the skin caused by bleeding under the skin) are not indicative of hypoglycemia but may be associated with other medical conditions.
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