A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?

"Provide a small feeding just before bedtime."

"Dilute formula with 1 tablespoon of water."

"Position the newborn at a 20-degree angle after feeding."

"Place the newborn in a side-lying position if vomiting."

Answer and Explanation

The Correct Answer is C

Gastroesophageal reflux (GER) is a common condition in infants where the contents of the stomach flow back into the esophagus. It often resolves on its own as the infant grows, but management strategies can help alleviate symptoms. Positioning the newborn upright or at a slight angle after feeding is a key recommendation to reduce reflux episodes.

Now, let's review the rationales for each option:

A) "Provide a small feeding just before bedtime." - Feeding a newborn just before bedtime can exacerbate reflux symptoms as lying down can increase the likelihood of stomach contents refluxing into the esophagus. Therefore, this instruction is not recommended as it may worsen GER symptoms.

B) "Dilute formula with 1 tablespoon of water." - Diluting formula with water can disrupt the balance of nutrients and calories in the formula, potentially affecting the infant's growth and nutritional status. Additionally, diluting formula does not address the underlying cause of GER and is not a recommended practice.

C) "Position the newborn at a 20-degree angle after feeding." - This instruction is correct. Placing the newborn at a 20-degree angle or slightly upright after feeding can help reduce the occurrence of reflux episodes by allowing gravity to assist in keeping stomach contents down. This position helps prevent the backflow of gastric contents into the esophagus and reduces discomfort for the infant.

D) "Place the newborn in a side-lying position if vomiting." - Placing the newborn in a side-lying position after vomiting may increase the risk of aspiration, especially in young infants. It is safer to position the infant upright or at a slight angle to minimize reflux and reduce the risk of aspiration.

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Correct Answer is D

Explanation

A. Place an identification bracelet:

While important for identification purposes, placing an identification bracelet is not the priority immediately following birth. Ensuring the newborn's physiological stability takes precedence.

B. Administer eye prophylaxis:

Administering eye prophylaxis is an essential newborn care procedure to prevent neonatal conjunctivitis caused by exposure to maternal gonorrhea or chlamydia. However, it is not the priority immediately after ensuring a patent airway.

C. Administer vitamin K:

Administering vitamin K is important for preventing vitamin K deficiency bleeding (VKDB) in newborns. However, it is typically done after drying the skin and other immediate newborn care tasks.

D. Dry the skin:

This is the correct answer. Drying the newborn's skin is the priority after ensuring a patent airway. Drying helps prevent heat loss and stimulates the newborn's breathing and circulation. It is an essential step in newborn care immediately after birth to promote thermal stability and adaptation to extrauterine life.

A. Provide the client with food cut into small bites. B. Instruct the client to take prescribed anticholinesterase with meals. C. Position the head of the client's bed to 40° while eating. D. Encourage the client to lie down a’ter eating.

Correct Answer is A

Explanation

A) Providing the client with food cut into small bites is a suitable action for a client with myasthenia gravis. This helps facilitate swallowing and reduces the risk of aspiration, which can be a concern for individuals with this condition due to muscle weakness, particularly in the throat and esophagus.

B) Instructing the client to take prescribed anticholinesterase medication with meals is indeed a crucial aspect of managing myasthenia gravis. Anticholinesterase medications help improve muscle strength by preventing the breakdown of acetylcholine, thus enhancing neuromuscular transmission. Taking these medications 30 minutes or so prior to meals optimizes absorption and minimizes gastrointestinal side effects.

C) Positioning the head of the client's bed to 40° while eating is beneficial for preventing aspiratio’ in clients with swallowing difficulties, including those with myasthenia gravis. This position helps reduce the risk of food or liquids entering the airway during swallowing.

D) Encouraging the client to lie down after eating is not recommended for individuals with myasthenia gravis, as it may increase the risk of aspiration. Instead, clients should remain upright for a period after eating to aid digestion and reduce the risk of reflux and aspiration pneumonia.

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A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a newborn immediately following birth. After assuring a patent airway, what is the priority nursing action?

Correct Answer is D

Explanation

A nurse is caring for a client who has myasthenia gravis. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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