A nurse is reinforcing teaching with the parents of a newborn about caring for the umbilical cord stump. Which of the following instructions should the nurse include?

Give the newborn a sponge bath until the cord stump falls off.

Cover the cord with the diaper.

Wash the cord daily with mild soap and water.

Wrap the cord in petroleum jelly gauze.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

The correct guidance includes giving the newborn sponge baths until the cord stump falls off, which helps to keep the area dry. It is essential to keep the umbilical cord stump clean and dry to prevent infection. Submerging the cord stump in water could increase the risk of infection.

Choice B rationale:

Covering the cord with the diaper is not advisable. The diaper could trap moisture around the cord stump, leading to a higher risk of infection. The cord stump should be exposed to air as much as possible to aid in drying and healing.

Choice C rationale:

Washing the cord with mild soap and water is not necessary and could introduce moisture, which should be avoided. Instead, the stump should be cleaned gently with a soft, dry cloth if it gets dirty.

Choice D rationale:

Wrapping the cord in petroleum jelly gauze is not a recommended practice. Applying petroleum jelly or other substances to the cord stump can interfere with the drying process and increase the risk of bacterial growth, leading to infection.

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Correct Answer is A

Explanation

Choice A rationale:

Cephalhematoma is the correct answer because it presents as a swelling on the newborn's head confined to one cranial bone and does not cross suture lines. It usually resolves on its own within a few weeks to months but can increase the risk of jaundice due to the breakdown of red blood cells in the hematoma.

Choice B rationale:

Nevus flammeus, also known as a port-wine stain, is a type of vascular birthmark. It presents as a flat, pink, or red mark on the skin and does not involve swelling of the head. This choice is unrelated to the findings described in the question and is therefore incorrect.

Choice C rationale:

Caput succedaneum refers to a diffuse, soft tissue swelling of the scalp that does cross suture lines. It is caused by pressure on the head during delivery, leading to edema and bruising. It typically resolves within a few days after birth.

Choice D rationale:

Molding refers to the shaping of the fetal head during childbirth as it passes through the birth canal. It may cause temporary elongation or molding of the head, but it does not present as a localized swollen area. This choice is not applicable to the findings mentioned in the question and is thus incorrect.

A. Bilirubin 18 mg/dL. B. Hemoglobin 22 g/dL. C. Blood glucose 50 mg/dL. D. Platelets 200,000/mm³.

Correct Answer is A

Explanation

Choice A rationale:

This is the priority finding because a bilirubin level of 18 mg/dL in a 4-hour-old newborn is significantly elevated. High bilirubin levels in newborns can lead to jaundice, which can be harmful if not promptly addressed. Hyperbilirubinemia in newborns requires close monitoring and, in some cases, treatment with phototherapy.

Choice B rationale:

A hemoglobin level of 22 g/dL is within the normal range for a newborn and is not a priority concern at this time.

Choice C rationale:

A blood glucose level of 50 mg/dL is within the normal range for a newborn. While monitoring blood glucose levels is essential, it is not the priority in this situation.

Choice D rationale:

A platelet count of 200,000/mm³ is within the normal range for a newborn and does not require immediate action.

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A nurse is reinforcing teaching with the parents of a newborn about caring for the umbilical cord stump. Which of the following instructions should the nurse include?

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