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A nurse is teaching the guardian of a newborn about formula feeding. Which of the following instructions should the nurse include?

A.

Boil bottle rings and nipples for 10 min to ensure sanitization.

B.

Keep the newborn on a strict 3 hr feeding schedule.

C.

Use bottles of refrigerated formula within 48 hr.

D.

Place the newborn on their abdomen for 30 min following each feeding.

Answer and Explanation

The Correct Answer is C

A. Boil bottle rings and nipples for 10 min to ensure sanitization. Boiling for 10 minutes is excessive and can damage bottle parts. A boil time of 5 minutes is typically sufficient for sanitizing feeding equipment before first use.
B. Keep the newborn on a strict 3 hr feeding schedule. Newborns should be fed on demand, which may be more or less frequently than every 3 hours. Hunger cues should guide feeding to promote healthy growth and bonding.
C. Use bottles of refrigerated formula within 48 hr. Prepared formula should be refrigerated and used within 48 hours to ensure safety and prevent bacterial growth. This is a safe practice when storing formula that has not been fed to the infant.
D. Place the newborn on their abdomen for 30 min following each feeding. Placing a newborn on the abdomen increases the risk of sudden infant death syndrome (SIDS). Infants should always be placed on their backs to sleep.


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Related Questions

Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"C"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A,B"},"F":{"answers":"A,B"}}

Explanation

  • Fever: Fever is a nonspecific but common symptom found in all three conditions—epiglottitis, RSV, and streptococcal pharyngitis. However, it is more severe and abrupt in epiglottitis and low to moderate in RSV and strep throat. In this case, the toddler has had a persistent fever over 38°C, consistent with both RSV and strep.
  • Exudate on pharynx: Pharyngeal exudate is a hallmark sign of acute streptococcal pharyngitis, resulting from the inflammatory response to GABHS. It is not typical in RSV or epiglottitis, where erythema and swelling may occur but without purulent exudate.
  • Wheezing upon auscultation: Wheezing is a classic sign of RSV, a lower respiratory viral infection leading to bronchiolitis and airway obstruction. It is not a feature of epiglottitis or strep throat, which involve the upper airway and oropharynx, respectively.
  • Drooling: Drooling is strongly associated with epiglottitis, due to inflammation and swelling of the epiglottis which makes it painful and difficult to swallow. It is not typical in RSV or strep pharyngitis unless there is severe oral involvement or dehydration.
  • Hypoxia: Hypoxia may occur in both epiglottitis and RSV due to airway obstruction or inflammation compromising oxygenation. In epiglottitis, it results from upper airway narrowing; in RSV, from lower airway inflammation and mucus plugging. It is not common in uncomplicated streptococcal pharyngitis.
  • Tachypnea: Tachypnea is a sign of respiratory distress and is often present in both epiglottitis and RSV, as the body attempts to compensate for impaired gas exchange. It is not a primary feature of strep pharyngitis unless accompanied by systemic infection or high fever.

Correct Answer is B

Explanation

A. "A cesarean birth is the only way to prevent transmission." Cesarean delivery is considered if active lesions or prodromal symptoms are present at the time of labor. However, it is not automatically required for all clients with a history of herpes.
B. "If you notice genital tingling be sure to notify your provider." Genital tingling or burning can be a prodromal sign of an impending herpes outbreak. Early reporting allows for appropriate evaluation and potential antiviral treatment to reduce the risk of transmission to the newborn.
C. "Hydrotherapy during labor can help reduce transmission." Hydrotherapy has no effect on herpes virus transmission and is not used for this purpose. Preventing neonatal herpes depends on careful monitoring and antiviral management.
D. "The provider will perform weekly visual inspections for lesions." Routine weekly inspections are not standard unless symptoms suggest an outbreak. Clients are generally monitored and evaluated for lesions closer to labor or if symptoms arise.

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