A nurse is providing teaching to a postpartum client about strategies to reduce the risk of newborn abduction from the facility.
Which of the following instructions should the nurse include in the teaching?
"Give your newborn only to staff members you recognize.”.
"Remove your newborn's microchip identification band after you have arrived home.”.
"Personally carry your newborn to the nursery if you need assistance.”.
"Bring your newborn in the bassinet into the bathroom with you.”.
The Correct Answer is D
Choice A rationale
Relying solely on facial recognition of staff members is an insufficient and potentially dangerous security measure. Hospital staff members can change shifts, and imposters might attempt to abduct newborns. Robust security protocols, such as mandatory identification badges and alarm systems on infant security tags, are designed to prevent unauthorized individuals from leaving the unit with an infant, providing a more reliable defense against abduction.
Choice B rationale
The instruction to remove a newborn's microchip identification band after arriving home is inaccurate and potentially misleading. Hospitals typically use infant security tags or bands that are removed by staff upon discharge, not by the parents at home. These bands are crucial for preventing abductions within the facility by triggering alarms if an infant is taken beyond designated boundaries.
Choice C rationale
Personally carrying a newborn to the nursery, especially without supervision or adherence to facility protocols, increases the risk of abduction. Hospitals often require staff to transport infants in bassinets or cribs, typically with two staff members present, to minimize opportunities for unauthorized individuals to gain access to or abduct a newborn. This procedure enhances infant safety significantly.
Choice D rationale
Bringing the newborn in the bassinet into the bathroom with the mother maintains constant direct observation and reduces the risk of abduction. This strategy minimizes the time the infant is left unattended, preventing opportunities for an abductor to seize the child. Maintaining proximity and direct line of sight is a fundamental principle of infant security in a hospital environment.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
Choice C rationale
The client is tachycardic and has cool skin, indicating potential hypovolemia or shock due to excessive bleeding. Administering oxygen at 2 L/min via nasal cannula increases oxygen delivery to the tissues, improving cellular oxygenation and mitigating the effects of decreased circulating blood volume. This supports vital organ function and helps address tissue hypoxia, a common consequence of significant blood loss. Normal heart rate postpartum is 60-100 beats per minute.
Choice D rationale
Oxytocin is a uterotonic agent that stimulates uterine contractions. A boggy uterus and excessive bleeding are hallmark signs of uterine atony, the most common cause of postpartum hemorrhage. Initiating an infusion of oxytocin will promote uterine contraction, which compresses blood vessels and reduces blood loss, thereby addressing the underlying cause of the client's symptoms and preventing further hemorrhage. Normal lochia should be moderate in amount.
Correct Answer is C
Explanation
Choice A rationale
Giving glucose water after feedings is not recommended for newborns undergoing phototherapy for hyperbilirubinemia. Glucose water provides no nutritional benefit, can lead to decreased breast milk intake, and does not aid in the excretion of bilirubin, which is primarily excreted through conjugated bile in stool.
Choice B rationale
Instructing the client to avoid breastfeeding during treatment for hyperbilirubinemia is incorrect. Breastfeeding should be continued and encouraged, as adequate hydration and caloric intake are crucial for promoting bowel movements, which help in the excretion of bilirubin from the body. Interruption of breastfeeding can also negatively impact milk supply.
Choice C rationale
Monitoring intake and output is critical for a newborn undergoing phototherapy. Phototherapy can increase insensible fluid losses through the skin, potentially leading to dehydration. Close monitoring of fluid intake (e.g., breastfeeding, formula) and urine/stool output ensures adequate hydration and helps assess the effectiveness of bilirubin excretion.
Choice D rationale
Applying lotions and ointments throughout phototherapy treatment is contraindicated. These products can absorb the light emitted by the phototherapy unit, leading to potential burns or uneven light distribution on the newborn's skin, thereby reducing the effectiveness of the treatment for hyperbilirubinemia.
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