A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include in the plan?
Give the newborn 1 oz of glucose water every 4 hr.
Apply a thin layer of lotion to the newborn's skin every 8 hr.
Ensure the newborn's eyes are closed beneath the shield.
Dress the newborn in a thin layer of clothing during therapy.
The Correct Answer is C
The correct answer is choice C, Ensure the newborn's eyes are closed beneath the shield. Phototherapy is a treatment used to reduce high bilirubin levels in newborns. It involves exposing the newborn's skin to special lights, which helps to break down the excess bilirubin in the blood. It is important to ensure that the newborn's eyes are closed beneath the shield to prevent damage to the eyes from the bright lights. Giving the newborn 1 oz of glucose water every 4 hr, applying lotion to the newborn's skin every 8 hr, and dressing the newborn in a thin layer of clothing during therapy are not indicated interventions during phototherapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
The correct answer is choice C: Uterine tenderness. Endometritis is an infection of the endometrial lining of the uterus. Uterine tenderness is a common finding in clients with endometritis.
Choice A, scant lochia, and choice D, WBC count 9,000/mm², are not typical findings in clients with endometritis. Choice B, temperature 37.4° C (99.3° F), is within the normal range and may not be indicative of endometritis.
Correct Answer is B
Explanation
The correct answer is choice B. Facial petechiae are a clinical finding that can occur in newborns who had a nuchal cord during delivery. The nuchal cord occurs when the umbilical cord becomes wrapped around the fetal neck one or more times. Erythema toxicum is a common, benign rash that appears as small, firm, yellow, or white papules surrounded by a red halo. Periauricular papillomas and telangiectatic nevi are not associated with the nuchal cord.
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