Share This Link

The supine position with knees flexed, or the Sims' position (lateral with upper leg flexed), is preferred for vaginal insertion as it promotes relaxation of the perineal muscles, facilitating easier and less painful insertion. The prone position is contraindicated because it increases intra-abdominal pressure and makes accessing the vaginal opening difficult, hindering proper placement of the suppository.

Water-soluble lubricant, not petroleum jelly, should be applied to the suppository or the gloved finger to reduce friction and minimize irritation during insertion. Petroleum jelly is an oil-based product that can break down the latex in some gloves or condoms and is not easily absorbed, potentially interfering with the medication's dissolution and absorption rate.

The suppository should be inserted approximately 7.5 to 10 cm (3 to 4 inches) into the vaginal canal, aiming for the posterior fornix, to ensure it rests deep within the vagina. Inserting only 5 cm (2 inches) is insufficient, as the suppository may be expelled or not reach the areas of the vaginal mucosa necessary for effective systemic or local antifungal treatment.

Relating the newborn to oneself is a normal process during the "taking-hold" phase of maternal role attainment, typically occurring 2-10 days postpartum, where the mother focuses on the infant and parental role. This involves identifying the newborn as a separate individual while making comparisons, which is an expected psychosocial milestone and not indicative of a concern.

Postpartum fatigue and a desire to sleep are common physiological and psychological responses due to the physical exertion of labor, blood loss (normal postpartum blood loss is ≤ 500 mL for vaginal delivery), and interrupted sleep patterns. This is an expected finding and reflects the body's need for rest and recovery, not a pathological psychosocial concern within 48 hours.

Discussing the desire for future children indicates a healthy anticipation of a continued family life and is a sign of good adjustment and optimism regarding the maternal role and relationship. This finding is reassuring and signifies positive psychological adaptation rather than a postpartum psychosocial concern within this early timeframe.

While the date of birth is essential information, asking a parent to state it only provides a detail from the medical record, which does not serve as a primary security confirmation of the newborn's identity for safe transport. The primary identification security relies on matching identifiers between the infant and the parent/guardian at the bedside.

The newborn's name is recorded in the medical record after birth, but verbal verification of the name alone is not a fail-safe security measure. Identification protocols require objective data comparison, such as unique numbers on corresponding identification bands, to prevent accidental mismatches and potential abduction.

The newborn's footprint sheet is typically used as a permanent record for identification purposes but is not the standard, immediate bedside method for confirming identity before transport. The process requires a direct comparison of unique numerical identifiers on the physical bands worn by the client and the newborn.

A typical NST usually takes about 20 to 40 minutes to complete. A prolonged duration of 2 to 4 hours is usually not necessary unless the fetus is initially inactive, requiring stimulation or extended monitoring to obtain a conclusive tracing. This duration suggests a misunderstanding of the expected procedure length.

An NST is generally performed for pregnancies deemed high-risk (e.g., post-dates, diabetes, hypertension, decreased fetal movement), not simply because it is the client's first pregnancy (primigravida). This statement indicates a misconception about the clinical indication for undergoing this specific fetal surveillance test.

The primary purpose of an NST is to assess fetal heart rate reactivity; it does not measure the strength or intensity of uterine contractions. Uterine contractions are measured by the tocodynamometer but their strength would be assessed using an internal uterine pressure catheter, which is not part of the standard NST procedure.

A late preterm newborn (born between 34 0/7 and 36 6/7 weeks of gestation) often exhibits periods of alertness, but they are also commonly noted to have a sleepy, less sustained alert state compared to a full-term neonate. Their neurological immaturity contributes to poor state regulation and a less vigorous overall response.

Late preterm newborns are at an increased risk of hypoglycemia (serum glucose ≤ 40 mg/dL) due to inadequate glycogen stores, increased metabolic demands, and immature gluconeogenesis pathways. Hyperglycemia (serum glucose ≥ 125 mg/dL) is not typically expected unless the infant is under high stress or receiving high glucose infusions.

Leathery or cracked, dry skin is characteristic of a post-term newborn (born after 42 weeks) due to prolonged exposure to amniotic fluid and desiccation. Late preterm newborns have relatively thin, smooth skin with visible blood vessels because the subcutaneous fat layer is not yet fully developed.

Soft bumper pads in the crib increase the risk of suffocation or entrapment for the newborn. The current recommendation for safe sleep is a firm mattress in a crib that meets current safety standards, with only a fitted sheet. Cribs should be bare, with no soft objects, pillows, or loose bedding, to minimize the risk of Sudden Infant Death Syndrome (SIDS).

Placing a pillow under the newborn's head significantly increases the risk of suffocation or rebreathing exhaled air, which is a major risk factor for SIDS. Newborns should always be placed on their backs on a firm sleep surface for every sleep time. The head should remain uncovered, and the pillow offers no benefit, only hazard.

Using a warm, soapy washcloth on a newborn's delicate facial skin is unnecessary and may cause irritation or dryness. Newborns typically only require a plain water wash or a mild, non-soap cleanser for their face. Soap can remove the natural protective oils and disrupt the skin's barrier function.

The proper sequence for suctioning a newborn is the mouth first, then the nose, to prevent the newborn from aspirating secretions. Suctioning the nose first may cause the newborn to gasp, drawing pharyngeal secretions into the trachea and lungs, potentially leading to aspiration pneumonia or respiratory distress.

The bulb syringe does not require lubrication with sterile water before use; it is intended for immediate use as a mechanical suction device. Lubrication could potentially introduce excess fluid into the newborn's airway or dilute secretions, which does not enhance the device's primary function of removing mucus.

The bulb should be placed gently into the sides of the newborn's mouth, rather than the center, to avoid stimulating the gag reflex. Placing it at the sides directs suction toward the cheeks and gums, facilitating the removal of secretions from the oral cavity without causing discomfort or vomiting.

Loosely wrapping the cord is an important secondary intervention for prolapsed umbilical cord but is not the immediate first action. The priority is to relieve pressure on the cord to maintain fetal oxygenation by reducing compression and sustaining blood flow until delivery can be safely achieved.

Applying an external fetal monitor is a vital step for continuous fetal assessment, but it is not the first action in this emergency. Relieving the cord compression and ensuring adequate oxygenation by changing the maternal position takes precedence over monitoring the fetal heart rate, which will likely be non-reassuring due to the cord compression.

Administering high-flow oxygen to the mother is an important intervention to maximize maternal-fetal oxygen transfer and improve fetal oxygenation. However, restoring placental blood flow by relieving the cord compression via proper maternal positioning is the physiologically immediate and most critical action to prevent fetal injury.

For the first few weeks, the nurse should instruct the guardian to wake a sleepy newborn if more than 4 hours have passed since the last feeding to prevent excessive weight loss and hypoglycemia, as their small glycogen stores are rapidly depleted. However, after the initial period and once the infant is feeding well and gaining weight appropriately (usually about 2 weeks old), night waking is typically not necessary.

Diluting ready-to-feed formula by adding filtered water is contraindicated because it reduces the caloric and nutrient density below required levels for the newborn's growth. The proper ratio of formula powder or concentrate to water is crucial for providing essential electrolytes, protein, and carbohydrates. Dilution can lead to water intoxication or hyponatremia and cause serious neurological complications due to electrolyte imbalance.

Prepared infant formula should be used or discarded within 24 hours if stored in the refrigerator, not 72 hours. Bacteria can rapidly proliferate in prepared formula, even under refrigeration, increasing the risk of gastrointestinal infection for the newborn. Formula ready-to-feed containers, once opened, should also be used within 24 to 48 hours or discarded to maintain optimal safety.