The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication?

Lancet should penetrate the ball of the foot.

Lancet should penetrate at the outer aspect of the heel.

Lancet should penetrate the area just below the fifth toe.

Lancet should penetrate the walking surface of the heel.

Answer and Explanation

The Correct Answer is B

A.   The ball of the foot is not recommended for heelstick procedures.
B.   The outer aspect of the heel is the preferred site. This area has fewer nerve endings and less risk of damaging the bone or cartilage.
C. The area below the fifth toe is not a standard site for a heelstick.
D.   The walking surface of the heel should be avoided since it is prone to infection, more sensitive, and may interfere with walking.

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Correct Answer is C

Explanation

A. Turning the newborn on his side may be done after suctioning but is not the initial priority.
B. Using a suction catheter with low negative pressure may be appropriate, but a bulb syringe is commonly used for newborns.
C.Suctioning the mouth is a necessary step to ensure effective breathing.
D. Suctioningthe nose first may cause the infant to gasp and potentially draw the secretions present in the mouth into the airway, which could lead to aspiration.

A. A newborn who is 18 hr post-delivery and has acrocyanosis B. A newborn who is 24-hr post-delivery and has not passed meconium C. A newborn who is 24 hr post-delivery and has persistent tachycardia with a heart rate of 180 bpm D. A newborn who is 24 hr post-delivery and has not voided

Correct Answer is C

Explanation

A. Acrocyanosis is a normal finding in newborns and does not require immediate intervention.
B. Not passing meconium within the first 24 hours is not uncommon and may be normal.
C. Persistent tachycardia in a newborn, especially with a heart rate of 180 bpm, requires immediate intervention as it may indicate a cardiac or other medical issue.
D. Not voiding within the first 24 hours may be normal, but it should be monitored.

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The most serious complication of an infant heelstick is necrotizing osteochondritis resulting from lancet penetration of the bone. What approach should the nurse take when performing the test to prevent this complication?

Nursing Test Bank

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