A nurse is teaching about car seat safety to the parents of a newborn who was delivered at 38 weeks of gestation. Which of the following statements by a parent indicates an understanding of the teaching?
I can use a sleep sack to keep my baby warm in the car seat.
My baby will need a car seat challenge test before discharge.
When my baby is 1 year old, I can turn their car seat facing forward.
The car seat should be positioned in the car at a 45-degree angle.
The Correct Answer is D
Choice A rationale
While a sleep sack can keep a baby warm, it should not be used in a car seat because it can interfere with the harness and affect its effectiveness.
Choice B rationale
A car seat challenge test is usually performed on premature babies or those with medical conditions. It is not routinely required for a newborn delivered at 38 weeks of gestation.
Choice C rationale
The American Academy of Pediatrics recommends that children remain in a rear-facing car seat until they reach the highest weight or height allowed by their car safety seat’s manufacturer, which is typically around 2 years of age.
Choice D rationale
The car seat should indeed be positioned at a 45-degree angle. This position helps to keep the baby’s airway open and protects them in the event of a crash.
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Correct Answer is C
Explanation
Choice A rationale
Massaging the client’s fundus is not indicated in this situation. Fundal massage is typically done after childbirth to help the uterus contract and prevent excessive bleeding.
Choice B rationale
Applying oxygen can help increase the client’s oxygen saturation levels, but it does not directly address the cause of the hypotension.
Choice C rationale
Turning the client to a side-lying position, specifically the left lateral position, can help improve blood flow to the heart, increasing cardiac output and blood pressure.
Choice D rationale
Assisting the client to empty their bladder is important in postpartum care, but it is not the immediate action to take when a client is hypotensive following the administration of epidural anesthesia.
Correct Answer is D
Explanation
Choice A rationale
Initiating an amnioinfusion is not the first action to take after discontinuing oxytocin infusion due to persistent late decelerations in the FHR. Amnioinfusion is a procedure where a saline solution is infused into the uterus to increase the volume of amniotic fluid. It is typically used to treat variable decelerations in the FHR, not late decelerations.
Choice B rationale
Placing the patient in a supine position is not recommended as it can decrease blood flow to the uterus and fetus, potentially worsening the late decelerations.
Choice C rationale
Instructing the patient to bear down and push with contractions is not appropriate in this situation. Persistent late decelerations in the FHR are a sign of fetal distress, and further contractions could exacerbate this.
Choice D rationale
Administering oxygen at 10 L/min via a non-rebreather face mask is the correct action. This increases the amount of oxygen available to the mother and fetus, potentially improving the FHR pattern.
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