The nurse is teaching the parents of a newborn who is going to receive phototherapy. What other measure does the nurse teach to help reduce the bilirubin?
Increase oral intake of water between feedings.
Wrap the infant in triple blankets to prevent cold stress during phototherapy.
How to prepare the newborn for an exchange transfusion.
Increase the frequency of feedings.
The Correct Answer is D
Choice A) Increase oral intake of water between feedings is incorrect because this is not a helpful or recommended measure to help reduce the bilirubin in a newborn who is receiving phototherapy. Bilirubin is a yellow pigment that is produced when red blood cells are broken down. It is normally excreted by the liver into bile and then eliminated by the intestines. However, some newborns have high levels of bilirubin in their blood, which can cause jaundice, a condition that makes the skin and eyes look yellow. Phototherapy is a treatment that uses blue light to help break down the bilirubin and make it easier for the liver to process. Increasing oral intake of water between feedings does not have any effect on the bilirubin level, as water does not contain any nutrients or calories that can stimulate the liver or bowel function. Moreover, giving water to a newborn can cause hyponatremia, which is a low level of sodium in the blood that can lead to seizures, brain damage, or death. Therefore, this measure should be avoided or used with caution for newborns who are receiving phototherapy.
Choice B) Wrap the infant in triple blankets to prevent cold stress during phototherapy is incorrect because this is not a safe or appropriate measure to help reduce the bilirubin in a newborn who is receiving phototherapy. Cold stress is a condition that occurs when a newborn loses too much heat and has difficulty maintaining a normal body temperature. It can cause complications such as hypoglycemia, hypoxia, acidosis, or bleeding. Wrapping the infant in triple blankets may seem like a good way to prevent cold stress, but it can actually cause overheating, dehydration, or hyperthermia, which are equally dangerous for the newborn. Moreover, wrapping the infant in blankets can reduce the effectiveness of phototherapy, as it blocks the exposure of the skin to the blue light. Therefore, this measure should be avoided or used with caution for newborns who are receiving phototherapy.
Choice C) How to prepare the newborn for an exchange transfusion is incorrect because this is not a relevant or necessary measure to help reduce the bilirubin in a newborn who is receiving phototherapy. An exchange transfusion is a procedure that involves replacing some of the newborn's blood with donor blood to lower the bilirubin level and prevent brain damage. It is usually reserved for severe cases of jaundice that do not respond to phototherapy or other treatments. Preparing the newborn for an exchange transfusion involves obtaining informed consent from the parents, placing an umbilical venous catheter, monitoring vital signs and blood tests, and administering medications and fluids. However, these steps are not part of routine care for newborns who are receiving phototherapy, and they do not help to reduce the bilirubin level by themselves. Therefore, this measure should be done only when indicated by the physician and explained by the nurse.
Choice D) Increase the frequency of feedings is correct because this is an effective and recommended measure to help reduce the bilirubin in a newborn who is receiving phototherapy. Feeding provides nutrients and calories that can stimulate the liver and bowel function, which are essential for processing and eliminating bilirubin from the body. Feeding also helps to prevent dehydration, which can worsen jaundice and increase the risk of complications.
Feeding can be done by breast milk or formula, depending on the mother's preference and availability. The frequency of feedings should be increased to at least every 2 to 3 hours or on demand, as long as the newborn shows signs of hunger and satisfaction. Therefore, this measure should be encouraged and supported by the nurse for newborns who are receiving phototherapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice a) D5W intravenously is incorrect because this is not the preferred method of feeding for a hypoglycemic infant. D5W stands for dextrose 5% in water, which is a solution that contains glucose and water. It can be used to treat hypoglycemia by providing a source of energy and fluid to the infant. However, it has several disadvantages, such as requiring an invasive procedure, increasing the risk of infection, causing fluid overload or electrolyte imbalance, and stimulating insulin secretion, which can lead to rebound hypoglycemia. Therefore, D5W intravenously should be reserved for severe cases of hypoglycemia that do not respond to oral or enteral feeding.
Choice b) Formula via nasogastric tube is incorrect because this is not the first-line option of feeding for a hypoglycemic infant. Formula is an artificial substitute for breast milk that contains nutrients and calories to support the infant's growth and development. It can be given via nasogastric tube, which is a tube that passes through the nose and into the stomach, when the infant cannot suck or swallow effectively. However, formula has several disadvantages, such as being less digestible, less immunogenic, and less adaptable than breast milk, as well as increasing the risk of necrotizing enterocolitis, allergy, or infection. Therefore, formula via nasogastric tube should be used only when breast milk is unavailable or contraindicated.
Choice c) Breast milk is correct because this is the best and most recommended type of feeding for a hypoglycemic infant. Breast milk is the natural and optimal food for infants that contains all the nutrients and antibodies they need to grow and thrive. It can be given directly from the breast or expressed and fed by bottle or cup. Breast milk has several advantages, such as being easily digestible, enhancing immune function, promoting bonding, and adjusting to the infant's needs. Breast milk also contains lactose, which is a natural sugar that can raise the blood glucose level of the infant without causing a spike in insulin secretion. Therefore, breast milk should be offered to the hypoglycemic infant as soon as possible after birth and at regular intervals thereafter.
Choice d) Glucose water in a bottle is incorrect because this is not an appropriate type of feeding for a hypoglycemic infant. Glucose water is a solution that contains glucose and water. It can be given by bottle or cup to provide a quick source of energy to the infant. However, it has several disadvantages, such as providing no other nutrients or calories, interfering with breastfeeding, causing diarrhea or dehydration, and stimulating insulin secretion, which can lead to rebound hypoglycemia. Therefore, glucose water in a bottle should be avoided or used sparingly for mild cases of hypoglycemia that do not respond to breast milk.
Correct Answer is D
Explanation
Choice a) A phase of the female menstrual cycle that involves the release of an egg (ovum) from one of the ovaries is incorrect because this is not the definition of Mittelschmerz, but rather the definition of ovulation. Ovulation is the process by which one or more eggs are released from the ovaries and travel to the fallopian tubes, where they can be fertilized by sperm. Ovulation usually occurs around the middle of the menstrual cycle, which is typically 28 days long, but can vary from person to person. Ovulation can be detected by changes in basal body temperature, cervical mucus, or hormone levels. Therefore, this response is inaccurate and misleading.
Choice B) A female reproductive organ in which ova or eggs are produced is incorrect because this is not the definition of Mittelschmerz, but rather the definition of ovary. The ovary is a paired organ that is located on either side of the uterus in the lower abdomen. The ovary contains thousands of follicles, which are sacs that contain immature eggs. Each month, one or more follicles mature and release an egg during ovulation. The ovary also produces hormones such as estrogen and progesterone, which regulate the menstrual cycle and pregnancy. Therefore, this response is irrelevant and inaccurate.
Choice C) The regular discharge of blood and mucosal tissue from the inner lining of the uterus through the vagina is incorrect because this is not the definition of Mittelschmerz, but rather the definition of menstruation. Menstruation is the process by which the endometrium, which is the tissue that lines the uterus and prepares for implantation of a fertilized egg, is shed and expelled through the vagina if pregnancy does not occur. Menstruation usually occurs once a month and lasts for about 3 to 7 days, but can vary from person to person. Menstruation can be accompanied by symptoms such as cramps, bloating, mood swings, or headaches. Therefore, this response is irrelevant and inaccurate.
Choice D) One-sided, lower belly pain associated with normal ovulation. Usually occurs about 14 days before the next menstrual period is correct because this is the definition of Mittelschmerz. Mittelschmerz is a German word that means "middle pain". It refers to a mild to moderate pain or discomfort that some women experience in their lower abdomen around the time of ovulation. The pain may last for a few minutes to a few hours and may switch sides from month to month depending on which ovary releases an egg. The pain may be caused by irritation or stretching of the ovarian or abdominal wall by the maturing follicle or by fluid or blood released during ovulation.
Mittelschmerz is not a sign of any disease or problem and does not require any treatment. However, it can be confused with other conditions that cause pelvic pain, such as appendicitis, ectopic pregnancy, or ovarian cysts. Therefore, women who have severe or persistent pain should consult their doctor for diagnosis and treatment. Therefore, this response is clear and accurate.
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