A nurse places a newborn under a radiant heat warmer after birth. The purpose of this action is to prevent which of the following in the newborn?
Basal metabolic rate reduction.
Brown fat production.
Shivering.
Cold stress.
The Correct Answer is D
Choice A reason:
Basal metabolic rate reduction. This is incorrect because a newborn under a radiant heat warmer will have an increased basal metabolic rate, not a reduced one. The basal metabolic rate is the amount of energy the body uses at rest, and it is influenced by temperature. A warmer environment will stimulate the newborn's metabolism and increase the energy expenditure. • Choice B reason:
Brown fat production. This is incorrect because a newborn under a radiant heat warmer will have less need for brown fat production, not more. Brown fat is a type of fat tissue that generates heat by burning calories. It is found in newborns and helps them maintain their body temperature in cold environments. A warmer environment will reduce the need for brown fat activation. • Choice C reason:
Shivering. This is incorrect because a newborn under a radiant heat warmer will not shiver, but shivering is not the main mechanism of heat production in newborns. Shivering is an involuntary contraction of muscles that generates heat by increasing metabolism. Newborns have limited ability to shiver because of their immature nervous system and low muscle mass. They rely more on brown fat and increased metabolic rate to produce heat. • Choice D reason:
Cold stress. This is correct because a newborn under a radiant heat warmer will prevent cold stress, which is a condition where the newborn's body temperature drops below normal and causes adverse effects. Cold stress can impair oxygen delivery, increase acidosis, decrease blood glucose, and increase the risk of infection and bleeding. A radiant heat warmer provides a neutral thermal environment for the newborn and prevents heat loss by radiation.
: 1 : 2 : 3 : 4.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
While hypoglycemia (glucose <45 mg/dL) is concerning,58 mg/dLis within acceptable ranges for many institutions, especially in asymptomatic newborns. Monitoring is required, but it is less urgent than respiratory distress.
Choice B reason:
Respiratory rate of 78 breaths per minute is also within the normal range for a newborn, which typically ranges from 30 to 60 breaths per minute. Though respiratory rate is essential to assess, it does not take priority over other critical issues.
Choice C reason:
Newborns typically have a normal respiratory rate of30-60 breaths/minute. A rate of78indicatessignificant tachypnea, which could signal respiratory distress (e.g., transient tachypnea of the newborn, infection, or respiratory distress syndrome). Rapid breathing can lead to fatigue, hypoxia, or respiratory failure if not promptly addressed.
Choice D reason:
A glucose reading of 58 mg/dL is concerning in a newborn. Hypoglycemia (low blood glucose) can lead to serious complications if not promptly addressed. Newborns are particularly susceptible to hypoglycemia, and it requires immediate assessment and intervention.
Correct Answer is C
Explanation
The correct answer is: c. The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.
Choice A reason:
If this baby was born vaginally, it could indicate a pneumothorax.
A pneumothorax occurs when air leaks into the space between the lung and chest wall, causing the lung to collapse. This condition can happen in newborns, especially those with underlying lung issues or those who have undergone mechanical ventilation However, moist lung sounds in a newborn are not typically indicative of a pneumothorax. Pneumothorax is more likely to present with symptoms such as rapid breathing, grunting, and cyanosis.
Choice B reason:
The neonate must have aspirated surfactant.
Surfactant aspiration is not a common cause of moist lung sounds. Surfactant is a substance that helps keep the lungs’ air sacs open and is crucial for proper lung function. Aspiration of surfactant is not a typical diagnosis and would not usually result in moist lung sounds. Instead, surfactant deficiency or dysfunction can lead to respiratory distress syndrome, which presents differently.
Choice C reason:
The lungs of a baby delivered by cesarean section may sound moist for 24 hours after birth.
Babies born via cesarean section often have moist lung sounds because they do not experience the compression of the chest that occurs during vaginal delivery, which helps expel fluid from the lungs. This retained fluid can cause moist lung sounds, which typically resolve within the first 24 hours after birth. This is a normal finding and does not usually indicate a serious problem.
Choice D reason:
The nurse should notify the pediatrician stat for this emergency situation.
While it is always important to monitor newborns closely, moist lung sounds alone in a baby born via cesarean section are not typically an emergency. This finding is usually due to retained fluid in the lungs, which is expected to clear within the first day of life. Immediate notification of the pediatrician is not necessary unless the baby shows other signs of respiratory distress or other concerning symptoms.
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