A nurse is providing discharge teaching to a client who delivered a pre-term newborn at 34 weeks of gestation.
Which of the following instructions should the nurse include in the teaching?
Avoid breastfeeding until the newborn reaches term gestation
Use an apnea monitor at home as prescribed
Keep the newborn in a warm environment at all times
Delay immunizations until the newborn reaches term gestation.
The Correct Answer is B
Pre-term newborns are at risk of apnea of prematurity, which is a pause in breathing for more than 20 seconds or less than 20 seconds with bradycardia or cyanosis. An apnea monitor can detect and alert the parents of any episodes of apnea and help them intervene promptly.
Choice A is wrong because breastfeeding is beneficial for pre-term newborns and can provide them with antibodies, nutrients, and bonding with the mother. Breastfeeding should be encouraged as soon as the newborn is medically stable and able to suck and swallow.
Choice C is wrong because keeping the newborn in a warm environment at all times can lead to overheating, dehydration, and increased metabolic rate. Pre-term newborns have difficulty regulating their body temperature and need to be dressed appropriately for the ambient temperature. They should also be monitored for signs of cold stress or heat stress.
Choice D is wrong because delaying immunizations until the newborn reaches term gestation can expose the newborn to preventable infections that ...
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Correct Answer is D
Explanation
All of the above.The nurse should include all of these signs and symptoms in the teaching as they may indicate pre-term labor.Pre-term labor occurs when regular contractions begin to open the cervix before 37 weeks of pregnancy.
Choice A is wrong because decreased fetal movement is not a normal sign of pre-term labor, but it may indicate fetal distress or other complications.
Choice B is wrong because increased vaginal discharge is not a normal sign of pre-term labor, but it may indicate infection or rupture of membranes.
Choice C is wrong because pelvic pressure is not a normal sign of pre-term labor, but it may indicate cervical dilation or descent of the fetus.
Correct Answer is D
Explanation
“I will call my doctor if I have more than four contractions in an hour.” This statement indicates that the client understands the signs of preterm labor and when to seek medical attention.Preterm labor is defined as having regular contractions and cervical changes before 37 weeks of gestation.More than four contractions in an hour may indicate that preterm labor is occurring and requires prompt evaluation.
Choice A is wrong because drinking at least eight glasses of water every day is not a specific instruction for preventing preterm labor.However, dehydration can trigger contractions and should be avoided.
Choice B is wrong because lying on the back with a pillow under the knees can reduce blood flow to the uterus and the baby.This position can also increase the risk of blood clots in the legs.A better position is lying on the left side, which improves circulation and reduces pressure on the cervix.
Choice C is wrong because avoiding sexual intercourse until reaching term is not necessary for most women with a history of preterm labor.Sexual activity does not cause preterm labor or premature rupture of membranes (PROM).However, some women may be advised to abstain from sex if they have certain conditions, such as placenta previa or a short cervix.
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