A nurse is providing teaching to the parent of a newborn who has gastroesophageal reflux. Which of the following instructions should the nurse include?
Position the newborn at a 20-degree angle after feeding.
Dilute formula with 1 tablespoon of water.
Place the newborn in a side-lying position if vomiting.
Provide a small feeding just before bedtime.
The Correct Answer is A
Choice A reason: Positioning the newborn at a 20-degree angle after feeding can help prevent the reflux of gastric contents into the esophagus. This position allows gravity to keep the food in the stomach and reduces the pressure on the lower esophageal sphincter. The nurse should instruct the parent to keep the newborn in this position for at least 30 minutes after each feeding.
Choice B reason: Diluting formula with 1 tablespoon of water is not recommended, as it can cause water intoxication, electrolyte imbalance, and malnutrition in the newborn. Water intoxication can lead to seizures, coma, and death. The nurse should advise the parent to follow the manufacturer's instructions for preparing the formula and not to add extra water.
Choice C reason: Placing the newborn in a side-lying position if vomiting is not a safe practice, as it can increase the risk of aspiration and sudden infant death syndrome (SIDS). Aspiration is when food or liquid enters the lungs and causes pneumonia or respiratory distress. SIDS is when a healthy baby dies suddenly and unexpectedly during sleep. The nurse should instruct the parent to place the newborn on the back for sleeping and to avoid soft bedding, pillows, and stuffed animals.
Choice D reason: Providing a small feeding just before bedtime is not a good idea, as it can worsen the gastroesophageal reflux and disrupt the newborn's sleep. The nurse should suggest the parent to feed the newborn smaller and more frequent meals throughout the day and to avoid feeding the newborn within 2 to 3 hours of bedtime.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: TPN is a form of nutrition that is delivered directly into the bloodstream through a central venous catheter. It is used for clients who have impaired or nonfunctional gastrointestinal tracts, such as those with acute kidney injury, bowel obstruction, or short bowel syndrome.
Choice B reason: The TPN does not necessarily have higher levels of vitamins than the recommended daily intake. The TPN is individually tailored to meet the client's nutritional needs, which may vary depending on their condition, weight, and laboratory values.
Choice C reason: The TPN does not ensure that the client's glucose level stays within the expected range. In fact, TPN can cause hyperglycemia due to the high concentration of dextrose in the solution. The client's blood glucose level should be monitored frequently and insulin should be administered as prescribed to prevent complications.
Choice D reason: The TPN is not higher in fats and protein, but lower in carbohydrates. The TPN contains a balanced mixture of macronutrients, including carbohydrates, proteins, and lipids, as well as micronutrients, such as electrolytes, vitamins, and minerals. The ratio of these components may vary depending on the client's nutritional needs and goals.
Correct Answer is D
Explanation
Choice D reason: A calorie reduction of 500 fewer calories per day can result in a weight loss of about 0.45 kg (1 lb) per week, which is a safe and realistic goal for most clients. A pound of fat contains about 3,500 calories, so reducing the daily intake by 500 calories can create a deficit of 3,500 calories per week.
Choice A reason: A weight loss of 0.45 kg (1 lb) per day is too rapid and unhealthy, as it can cause dehydration, electrolyte imbalance, muscle loss, and metabolic slowdown. It can also be unsustainable and lead to weight regain. A calorie reduction of 500 fewer calories per day cannot achieve such a drastic weight loss.
Choice B reason: A weight loss of 0.23 kg (0.5 lb) per day is also too rapid and unhealthy, for the same reasons as choice A. A calorie reduction of 500 fewer calories per day cannot achieve such a drastic weight loss.
Choice C reason: A weight loss of 0.23 kg (0.5 lb) per week is too slow and unlikely, as it would require a calorie reduction of only 250 fewer calories per day. This is not enough to create a significant deficit and stimulate weight loss. A calorie reduction of 500 fewer calories per day can result in a faster weight loss.
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