A nurse is preparing to perform a heel stick on an infant. Which of the following actions should the nurse plan to take to reduce the infant's pain during the procedure?

Apply a cool cloth to the infant's heel 5 min prior to the procedure.

Promote skin-to-skin contact with the infant's guardian during the procedure.

Provide the infant with a bottle of water during the procedure.

Apply lidocaine/prilocaine cream 15 min prior to the procedure.

Answer and Explanation

The Correct Answer is B

A. Apply a cool cloth to the infant's heel 5 min prior to the procedure: Cooling the skin can cause vasoconstriction, making the heel stick more difficult and potentially increasing discomfort. This intervention does not support pain reduction and may prolong the procedure, which can further distress the infant.

B. Promote skin-to-skin contact with the infant's guardian during the procedure: Skin-to-skin contact is an evidence-based method that reduces procedural pain in infants by stabilizing heart rate, enhancing comfort, and lowering stress responses. It offers both analgesic and calming effects, making it an effective strategy during heel sticks.

C. Provide the infant with a bottle of water during the procedure: Water does not provide analgesic benefit to infants and does not activate soothing mechanisms such as the sucrose-induced endorphin release used for pain relief. Offering plain water may also be inappropriate for young infants due to risk of water intoxication.

D. Apply lidocaine/prilocaine cream 15 min prior to the procedure: This topical anesthetic requires significantly longer, typically 30 to 60 minutes, to achieve adequate analgesic effect. Applying it only 15 minutes before the heel stick would not provide sufficient pain control, limiting its effectiveness.

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Correct Answer is D

Explanation

A. “I will overarticulate words when speaking.": Overarticulating words can distort speech and make it more difficult for a client with hearing loss to understand. Clear, normal articulation combined with visual cues is more effective for communication.

B. “I will repeat words not heard by the client": Repeating words is useful, but it is a secondary strategy. Effective communication begins with proper positioning and visual cues, which enhance understanding before repetition is needed.

C. “I will speak in a loud voice when addressing the client.": Speaking louder does not necessarily improve comprehension and can distort speech. Many clients with hearing loss benefit more from clear, normal-volume speech and lip-reading rather than increased volume.

D. “I will face the client when speaking": Facing the client allows them to use visual cues, such as lip reading and facial expressions, which significantly improves understanding. This technique is the primary and most effective communication strategy for clients with hearing loss.

A. "Have you noticed a rash or reddening of your skin?" B. "Do you have a cough or any breathing problems?" C. "Have you noticed any loss of hearing or ringing in your ears?" D. "Do you have any numbness or tingling in your fingers?"

Correct Answer is B

Explanation

A. "Have you noticed a rash or reddening of your skin?": While skin irritation can occur with some occupational exposures, insulation installers are more commonly exposed to airborne fibers that affect the respiratory system rather than causing primary skin rashes.

B. "Do you have a cough or any breathing problems?": Insulation installers are at risk for inhaling fiberglass, asbestos, or other particles that can irritate the lungs and airways. Assessing for respiratory symptoms is essential to identify potential occupational lung disease or irritation.

C. "Have you noticed any loss of hearing or ringing in your ears?": Hearing loss and tinnitus are more relevant for workers exposed to loud noise, such as in manufacturing or construction environments with heavy machinery, rather than insulation installation specifically.

D. "Do you have any numbness or tingling in your fingers?": Numbness or tingling is usually associated with repetitive motion injuries, neuropathies, or exposure to vibrating tools. While possible, it is less directly related to the primary occupational hazards of insulation work.

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A nurse is preparing to perform a heel stick on an infant. Which of the following actions should the nurse plan to take to reduce the infant's pain during the procedure?

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