A nurse is planning care for a newborn who has spinal bifida.
Which of the following actions should be included in the plan of care?
Obtain rectal temperatures
Cover the lesion with a dry dressing
Apply snug clean diapers
Place the newborn in the prone position .
The Correct Answer is D
Choice A rationale
Obtaining rectal temperatures is not recommended for newborns with spinal bifida. This is because the rectal route can introduce bacteria into the body, which can lead to infection.
Additionally, the rectal route may not provide an accurate temperature reading for these newborns.
Choice B rationale
Covering the lesion with a dry dressing is not recommended for newborns with spinal bifida. The lesion should be kept moist to prevent drying and cracking, which can lead to infection.
Choice C rationale
Applying snug clean diapers is not recommended for newborns with spinal bifida. This is because the pressure from the diaper can damage the exposed nerves and tissues in the lesion area.
Choice D rationale
Placing the newborn in the prone position is recommended for newborns with spinal bifida. This position helps to minimize pressure on the lesion and reduces the risk of trauma and infection.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
While it is true that preterm newborns have a smaller body surface area than full-term newborns, this is not the primary reason for using an incubator. A smaller body surface area can contribute to heat loss, but the main issue is the lack of adequate temperature control mechanisms.
Choice B rationale
Preterm newborns lack the adequate temperature control mechanisms that full-term newborns have. They have less subcutaneous fat to insulate them and a higher surface area to volume ratio, which increases heat loss. They also lack the ability to shiver to generate heat.
Therefore, an incubator is used to maintain a neutral thermal environment.
Choice C rationale
The heat in the incubator does not rapidly dry the sweat of preterm newborns. In fact, preterm newborns do not sweat as efficiently as full-term newborns or adults, so they are less likely to lose heat through sweating.
Choice D rationale
The statement that the added brown fat layer in preterm newborn reduces his ability to generate heat is incorrect. In fact, preterm newborns have less brown fat than full-term newborns. Brown fat is a type of fat that generates heat when metabolized, and it is an important source of heat for newborns.
Correct Answer is C
Explanation
Choice A rationale
Repaglinide is an oral diabetes medication that helps control blood sugar levels by causing the pancreas to produce insulin. However, it is not typically the first choice for treating gestational diabetes. It is usually used for type 2 diabetes and is not commonly recommended during pregnancy.
Choice B rationale
Glipizide is another oral diabetes medication that works by stimulating the pancreas to produce insulin. Like repaglinide, it is not typically used as a first-line treatment for gestational diabetes and is not commonly recommended during pregnancy.
Choice C rationale
Insulin is the most common treatment for gestational diabetes. It does not cross the placenta and thus does not cause hypoglycemia in the baby. It can be used safely during pregnancy and is effective in controlling blood glucose levels.
Choice D rationale
Acarbose is an alpha-glucosidase inhibitor, which works by slowing the absorption of carbohydrates from the intestine. It is not typically used in pregnancy due to lack of safety data.
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