A nurse is planning care for a client who is 1 hour postpartum and has peripartum cardiomyopathy.

Which of the following actions should the nurse plan to take?

Choice A rationale
Erythromycin ophthalmic ointment is administered to newborns to prevent neonatal conjunctivitis, also known as ophthalmia neonatorum, specifically for Neisseria gonorrhoeae infection prevention. If the guardian refuses the administration of erythromycin, the healthcare provider should respect the guardian’s decision and document the refusal. It’s important to note that the refusal should be informed, meaning the guardian should understand the potential risks associated with not administering the medication.
Choice B rationale
Informing the guardian that the medication can be given after discharge may not be the best course of action. The purpose of the ointment is to prevent infection immediately after birth when the risk is highest. Delaying the administration could potentially increase the risk of the newborn developing an infection.
Choice C rationale
Reporting the guardian’s refusal of the medication to social services is not the first step unless there are other concerns about the safety or well-being of the child. The healthcare provider should respect the guardian’s autonomy and their right to make informed decisions about the newborn’s care.
Choice D rationale
Notifying the facility’s ethics committee about the guardian’s medication refusal is not typically necessary unless the refusal puts the newborn at significant risk and other attempts to resolve the situation have failed. In this case, the refusal of erythromycin ophthalmic ointment, while not ideal, is not likely to warrant an ethics consultation.

Choice A rationale
Washing a baby’s face with plain water is a safe and effective way to keep it clean without causing irritation or dryness. This is especially important for newborns, whose skin is more sensitive than that of older children and adults.
Choice B rationale
Bumper pads are not recommended for use in a baby’s crib. They pose a risk of suffocation, strangulation, and entrapment. Instead, the crib should be kept bare, with only a firm mattress and a fitted sheet.
Choice C rationale
A soft mattress is not safe for a baby’s crib. It increases the risk of sudden infant death syndrome (SIDS) because it can conform to the shape of the baby’s head or face, leading to suffocation. A firm mattress is recommended.
Choice D rationale
Bathing a baby immediately after feeding is not recommended. It can cause discomfort and may lead to vomiting. It’s better to wait at least a little while after a feeding before bathing the baby.