The parents of a newborn who is being treated for bacterial septicemia ask the nurse why their baby didn't seem very ill. The best response of the nurse is:
Select one:
"You would have seen more symptoms if you had been looking more closely at your baby."
"A newborn's immune system isn't mature, so symptoms are subtle and can be hard to recognize."
"A high fever will always be present in sick newborns, including your baby."
"A mother's immunity usually protects the infant from illness, but not in this case."
The Correct Answer is B
Choice A Reason: "You would have seen more symptoms if you had been looking more closely at your baby." This is an inappropriate response that blames the parents for missing the signs of sepsis and does not explain the Reason for the subtle symptoms.
Choice B Reason: "A newborn's immune system isn't mature, so symptoms are subtle and can be hard to recognize." This is an appropriate response that educates the parents about the immunological basis of sepsis in newborns and reassures them that they are not at fault for not noticing the symptoms.
Choice C Reason: "A high fever will always be present in sick newborns, including your baby." This is an incorrect response that contradicts the fact that newborns may not develop fever in response to infection due to their immature immune systems.
Choice D Reason: "A mother's immunity usually protects the infant from illness, but not in this case." This is an inaccurate response that implies that the mother failed to provide adequate immunity to her baby and does not address the question of why the baby did not seem very ill.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason: Shoulder dystocia. This is an incorrect answer that describes a different obstetric complication. Shoulder dystocia is a condition where the baby's shoulder gets stuck behind the mother's pubic bone during delivery, which can cause nerve injury, fracture, or asphyxia to the baby. Shoulder dystocia does not cause fetal bradycardia, abdominal pain, or vaginal bleeding.
Choice B Reason: Placental abruption. This is a correct answer that explains the symptoms of fetal bradycardia, abdominal pain, and vaginal bleeding in a woman with a history of crack cocaine use. Placental abruption. This is because placental abruption is a condition where the placenta separates from the uterine wall before delivery, which can cause fetal distress, maternal hemorrhage, and shock. Placental abruption can be triggered by maternal hypertension, trauma, or substance abuse, such as crack cocaine.
Choice C Reason: Anaphylactoid syndrome of pregnancy. This is an incorrect answer that refers to a rare and fatal condition also known as amniotic fluid embolism. Anaphylactoid syndrome of pregnancy is a condition where amniotic fluid enters into the maternal bloodstream and causes an allergic reaction, which can lead to respiratory failure, cardiac arrest, coagulopathy, and coma. Anaphylactoid syndrome of pregnancy does not cause fetal bradycardia or vaginal bleeding.
Choice D Reason: Placenta previa. This is an incorrect answer that indicates another placental disorder. Placenta previa is a condition where the placenta covers or is near the cervix, which can cause painless bright red bleeding during pregnancy or labor. Placenta previa does not cause fetal bradycardia or abdominal pain.
Correct Answer is A
Explanation
Choice A Reason: Inspecting the placenta after delivery for intactness. This is because inspecting the placenta after delivery for intactness is a nursing intervention that can prevent late postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders. Inspecting the placenta after delivery for intactness can help identify and remove any retained placental fragments that may interfere with uterine contraction and involution, which are essential for hemostasis.
Choice B Reason: Manually removing the placenta at delivery. This is an incorrect answer that indicates an inappropriate and risky intervention that can cause late postpartum hemorrhage. Manually removing the placenta at delivery is a procedure that involves inserting a hand into the uterus and detaching the placenta from the uterine wall. Manually removing the placenta at delivery is indicated only for a retained or adherent placenta that does not separate spontaneously or with gentle traction within 30 minutes after delivery. Manually removing the placenta at delivery can cause trauma, infection, or incomplete removal of the placenta, which can increase the risk of late postpartum hemorrhage.
Choice C Reason: Administering broad-spectrum antibiotics prophylactically. This is an incorrect answer that suggests an unnecessary and ineffective intervention that can prevent late postpartum hemorrhage. Administering broad- spectrum antibiotics prophylactically is a pharmacological intervention that involves giving antibiotics to prevent or treat infection. Administering broad-spectrum antibiotics prophylactically is indicated for women with risk factors or signs of infection during or after delivery, such as prolonged rupture of membranes, chorioamnionitis, fever, or foul- smelling lochia. Administering broad-spectrum antibiotics prophylactically may reduce the risk of infection-related late postpartum hemorrhage, but it does not address other causes of late postpartum hemorrhage such as retained placental fragments or subinvolution of the uterus.
Choice D Reason: Applying traction on the umbilical cord to speed up separation of the placenta. This is an incorrect answer that refers to a different intervention that can prevent early postpartum hemorrhage, not late postpartum hemorrhage. Applying traction on the umbilical cord to speed up separation of the placenta is a technique that involves pulling on the umbilical cord while applying counter pressure on the uterus to facilitate placental expulsion. Applying traction on the umbilical cord to speed up separation of the placenta is indicated for active management of the third stage of labor, which can prevent early postpartum hemorrhage, which is excessive bleeding from the uterus or genital tract that occurs within 24 hours after delivery. Early postpartum hemorrhage can be caused by uterine atony, retained placenta, lacerations, or coagulation disorders.
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