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A nurse is providing discharge instructions for newborn care.
The parents have chosen to formula feed their infant.
What should the nurse include in the discharge teaching about bottle feeding? (Select all that apply)

Bottles can be put in the dishwasher, boiled, or cleaned with hot soapy water.

Hold the baby in a supine position during feedings.

Only burp the baby after they have finished the entire feeding.

Do not prop the bottle.

Keep the nipple full of formula throughout the feeding.

Prepared formula can be kept in the refrigerator for 48 hours.

Answer and Explanation

Correct Answer : A,D,E,F

Choice A rationale

Bottles can be put in the dishwasher, boiled, or cleaned with hot soapy water to ensure they are thoroughly sanitized and safe for the infant.

Choice B rationale

Holding the baby in a supine position during feedings is incorrect because it increases the risk of aspiration. The baby should be held in a semi-upright position.

Choice C rationale

Only burping the baby after they have finished the entire feeding is incorrect because it can lead to discomfort and gas buildup. The baby should be burped during and after feedings.

Choice D rationale

Always holding the bottle while feeding and not propping the bottle is correct as it prevents choking and ensures the baby is feeding safely.

Choice E rationale

Keeping the nipple full of formula throughout the feeding is correct as it prevents the baby from swallowing air, which can cause gas and discomfort.

Choice F rationale

Prepared formula can be kept in the refrigerator for 48 hours, ensuring it remains safe and free from bacterial growth.

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Correct Answer is A

Explanation

Choice A rationale

Given the neonate’s symptoms and critically low blood glucose level (30 mg/dL), the most urgent action is to address the hypoglycemia. Therefore, the nurse shouldadminister a bolus of intravenous glucose (Option A). This immediate intervention is crucial to stabilize the neonate and prevent further complications associated with hypoglycemia.

Choice B rationale

While monitoring blood glucose levels is important, waiting 30 minutes to reassess without immediate intervention could allow the hypoglycemia to worsen, potentially leading to severe complications such as seizures or brain damage. Immediate treatment is necessary to stabilize the neonate..

Choice C rationale

Although feeding can help increase blood glucose levels, the neonate’s current symptoms (jitteriness, poor feeding, weak cry, and irritability) suggest that they may not be able to effectively feed. Additionally, the blood glucose level is critically low and requires more rapid correction than feeding alone can provide..

Choice D rationale

While maintaining an appropriate body temperature is important, the neonate’s temperature (36.1°C) is not critically low. The primary concern here is the hypoglycemia, which needs to be addressed immediately. Placing the neonate under a radiant warmer does not directly address the low blood glucose level..

A. The infant stretches their arms out and then back in toward their body. B. The infant turns their head toward their parent’s voice. C. The infant grasps the parent’s finger when placed in the infant’s palm. D. The infant brings their hand to their mouth.

Correct Answer is D

Explanation

Choice A rationale

Stretching arms out and then back in is a common reflex in newborns known as the Moro reflex. It is not a sign of feeding readiness but rather a response to a sudden loss of support or a loud noise.

Choice B rationale

Turning the head toward a parent’s voice is a sign of auditory recognition and bonding, not necessarily feeding readiness. It indicates the infant’s ability to recognize familiar sounds.

Choice C rationale

Grasping a parent’s finger when placed in the infant’s palm is a primitive reflex known as the palmar grasp reflex. It is not related to feeding readiness but is a normal reflexive action in newborns.

Choice D rationale

Bringing their hand to their mouth is a sign of feeding readiness. This action indicates that the infant is hungry and ready to feed. It is an early cue that the baby is ready to eat.

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A nurse is providing discharge instructions for newborn care.The parents have chosen to formula feed their infant.What should the nurse include in the discharge teaching about bottle feeding? (Select all that apply)

Nursing Test Bank

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Correct Answer is A

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Correct Answer is D

Explanation

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A nurse is providing discharge instructions for newborn care.
The parents have chosen to formula feed their infant.
What should the nurse include in the discharge teaching about bottle feeding? (Select all that apply)