A nurse is contributing to the plan of care for a newborn who has a temperature of 36.4° C (97.5° F) at 1 hr after birth. Which of the following interventions should the nurse include?

Dress the newborn in a warm gown when placing them next to the parent's skin.

Delay the newborn's feedings until their temperature is stabilized.

Postpone the newborn's initial bath

Place the swaddled newborn under a radiant warmer.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Dress the newborn in a warm gown when placing them next to the parent's skin: Skin-to-skin contact, not clothing layers, is the priority for thermoregulation in the first hours after birth. A warm gown may interfere with skin contact and reduce the effectiveness of heat transfer from parent to newborn.

B. Delay the newborn's feedings until their temperature is stabilized: Early feeding is encouraged for newborns to promote bonding, glucose stabilization, and warmth. Feeding should not be delayed, as it can help the baby generate heat through metabolism.

C. Postpone the newborn's initial bath: A newborn’s bath should be delayed until their temperature is stable to prevent further heat loss. Bathing can cause evaporation-related cooling, which may worsen mild hypothermia in a newborn during the early hours of life.

D. Place the swaddled newborn under a radiant warmer: Swaddling under a radiant warmer interferes with direct heat transfer. The newborn should be unclothed (except for a diaper) under the warmer to ensure effective warming through radiation.

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Correct Answer is A

Explanation

Rationale:

A. Swelling of the lips: Swelling of the lips can be an early sign of anaphylaxis, a severe allergic reaction. Epinephrine is the first-line treatment for anaphylaxis because it rapidly reduces airway swelling, improves breathing, and supports blood pressure by constricting blood vessels.

B. Nausea: While nausea may occur during an allergic reaction, it is not a primary life-threatening symptom addressed by epinephrine. Epinephrine targets cardiovascular and respiratory symptoms more directly, not gastrointestinal discomfort.

C. Hand tremors: Tremors are actually a potential side effect of epinephrine due to its stimulation of the sympathetic nervous system. The medication is not intended to treat tremors and may even cause or worsen them temporarily.

D. Hyperglycemia: Epinephrine can increase blood glucose levels as a side effect, but it is not prescribed to treat or manage hyperglycemia. Managing blood glucose is not part of the therapeutic purpose of this emergency medication.

A. Put a simple lock on the client's bedroom door. B. Give the client a barbiturate medication at bedtime. C. Encourage the client to take frequent walks during the day. D. Allow the client to nap for at least 1 hr during the day.

Correct Answer is C

Explanation

Rationale:

A. Put a simple lock on the client's bedroom door: Locking the client's door could pose a safety risk, especially in the event of an emergency such as a fire. It also restricts the client's autonomy and may increase confusion or agitation in clients with Alzheimer's disease.

B. Give the client a barbiturate medication at bedtime: Barbiturates are not recommended for older adults due to their sedating effects and risk of dependence, falls, and worsening cognitive function. Non-pharmacologic strategies are preferred first in managing sleep disturbances.

C. Encourage the client to take frequent walks during the day: Physical activity during the day helps reduce nighttime restlessness and improve sleep patterns. Walking can also help regulate circadian rhythms, promote relaxation, and reduce wandering behavior at night.

D. Allow the client to nap for at least 1 hr during the day: Long daytime naps may disrupt the sleep-wake cycle, worsening insomnia and nighttime wandering. Limiting daytime napping and encouraging activity is more effective in promoting restful nighttime sleep.

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A nurse is contributing to the plan of care for a newborn who has a temperature of 36.4° C (97.5° F) at 1 hr after birth. Which of the following interventions should the nurse include?

Nursing Test Bank

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