A nurse is updating the plan of care for a newborn who is undergoing phototherapy. Which of the following actions should the nurse include in the plan?

Monitor the newborn's blood glucose level hourly.

Apply lotion to the newborn's skin twice per day.

Maintain the newborn in a prone position

Encourage the newborn to breastfeed every 2 hr.

Answer and Explanation

The Correct Answer is D

Choice A reason:

Monitoring the newborn's blood glucose level hourly is not necessary for a newborn undergoing phototherapy. Phototherapy does not affect blood glucose levels, and hourly monitoring would be too invasive and stressful for the newborn. •

Choice B reason:

Applying lotion to the newborn's skin twice per day is not recommended for a newborn undergoing phototherapy. Lotion can interfere with the effectiveness of the phototherapy and increase the risk of skin irritation or infection. •

Choice C reason:

Maintaining the newborn in a prone position is not advisable for a newborn undergoing phototherapy. The newborn should be positioned on alternate sides to expose as much skin surface as possible to the light source. •

Choice D reason:

Encouraging the newborn to breastfeed every 2 hr is an appropriate action for a newborn undergoing phototherapy. Frequent feeding helps to promote hydration and the elimination of bilirubin from the body.

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Correct Answer is A

Explanation

Choice A reason:

Placental insufficiency is a condition in which the placenta does not deliver enough oxygen and nutrients to the developing baby, resulting in restricted growth and development. This is one of the most common causes of SGA babies.

Choice B reason:

Primipara means a woman who is pregnant for the first time or who has given birth to one child. Primipara is not a cause of SGA, although some studies have suggested that first-time mothers may have a slightly higher risk of having a low-birth-weight baby than multiparous women.

Choice C reason:

Maternal obesity is a condition in which the mother has a body mass index (BMI) of 30 or higher before or during pregnancy. Maternal obesity is not a cause of SGA, but rather a risk factor for having a large-for-gestational-age (LGA) baby, which can lead to complications such as macrosomia, shoulder dystocia, and birth trauma.

Choice D reason:

Perinatal asphyxia is a condition in which the baby does not receive enough oxygen before, during, or after birth, causing hypoxia and acidosis. Perinatal asphyxia is not a cause of SGA, but rather a possible complication of SGA, especially if the placental insufficiency is severe or prolonged. Perinatal asphyxia can damage the brain and other organs of the baby and lead to long-term neurological impairments.

A. Hypertonia. B. Long toenails. C. Lanugo. D. Dry skin.

Correct Answer is C

Explanation

Choice A reason:

Hypertonia is not a characteristic of a preterm infant, but rather of a post-term infant. Hypertonia means increased muscle tone or stiffness, which is more common in infants who are overdue. Preterm infants have poor muscle tone and less subcutaneous fat.

Choice B reason:

Long toenails are also not a characteristic of a preterm infant but of a post-term infant. Long toenails indicate that the infant has grown beyond the expected gestational age. Preterm infants have short and brittle nails.

Choice C reason:

Lanugo is a characteristic of a preterm infant. Lanugo is fine, downy hair that covers the body of the fetus. It usually disappears by the 36th week of gestation, but preterm infants may still have it at birth.

Choice D reason:

Dry skin is not a characteristic of a preterm infant but of a post-term infant. Dry skin indicates that the infant has lost moisture and subcutaneous fat due to prolonged exposure to the amniotic fluid. Preterm infants have thin and transparent skin that may be covered by vernix caseosa, a white, cheesy substance that protects the skin from the amniotic fluid.

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A nurse is updating the plan of care for a newborn who is undergoing phototherapy. Which of the following actions should the nurse include in the plan?

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