A 24-hour-old newborn male was circumcised 20 minutes ago. The nurse is doing 15-minute checks of the circumcision site. It appears that the newborn has had a bowel movement as meconium is leaking from the diaper leg. He is not crying and has just soothed from the last diaper check. What should the nurse do?

Correct Answer: D

Rationale: In this scenario, option D is the correct choice for the nurse to follow. Changing the newborn's diaper immediately, cleaning the meconium using water (and soap if needed), and refraining from changing the circumcision dressing until the next scheduled check is important. This approach ensures that the circumcision site is kept clean without excessive disturbance to the newborn, as frequent changes can increase the risk of infection and disrupt the healing process. Option A is incorrect because waiting an additional 10 minutes could lead to prolonged exposure of the circumcision site to meconium, potentially increasing the risk of infection. Option B is also incorrect as using packaged wipes may be too harsh for the delicate newborn skin, and immediate changes regardless of the scheduled checks may cause unnecessary disturbance. Option C is not the best choice as changing the dressing at the circumcision site immediately after cleaning the meconium may introduce unnecessary handling and increase the risk of infection. It is essential to follow a gentle and systematic approach to newborn care, considering their delicate skin and healing processes. The educational context here emphasizes the importance of proper wound care, infection prevention, and maintenance of newborn comfort and well-being in clinical practice.

Correct Answer: C

Rationale: The correct answer is C) Aspirin is linked to Reye syndrome, which is a potentially fatal condition for infants. Reye syndrome is a rare but serious disorder that can affect the brain and liver and is associated with the use of aspirin in children under the age of 18, particularly when they are recovering from a viral infection such as the flu or chickenpox. The liver damage and swelling of the brain that can occur with Reye syndrome can be life-threatening for infants and young children. Option A is incorrect because while aspirin can cause stomach upset and damage to the digestive system in individuals of any age, the main concern in newborns is the risk of Reye syndrome, not the strength of the medication. Option B is incorrect because while it is true that aspirin is not typically available in a liquid form suitable for infants, this is not the primary reason why it should not be given to newborns. Option D is incorrect because while aspirin is a blood thinner and can increase the risk of bleeding, the main concern with aspirin use in infants is the potential for Reye syndrome, not intracranial bleeding due to recent birth. Educationally, this question highlights the importance of understanding age-specific considerations in pharmacology. It emphasizes the critical need for healthcare providers to educate parents and caregivers on safe medication practices for newborns, including the avoidance of aspirin due to its association with Reye syndrome, a potentially fatal condition in infants.

Correct Answer: C

Rationale: In the context of pharmacology and nursing care of the newborn, understanding the risk factors associated with maternal diabetes is crucial for providing safe and effective care. In this scenario, the correct answer is C) hypoglycemia. Infants born to mothers with diabetes are at risk for hypoglycemia due to the abrupt cessation of the maternal glucose supply at birth. Hypoglycemia in newborns can lead to significant complications such as seizures, developmental delays, and long-term neurological issues if not promptly addressed. Therefore, nurses must closely monitor blood glucose levels in these newborns and be prepared to intervene quickly if hypoglycemia occurs. Regarding the incorrect options: A) Anemia is not a direct complication associated with maternal diabetes in newborns. B) Microcephaly is a condition characterized by a small head size and is not typically linked to maternal diabetes. D) Small for gestational age (SGA) refers to infants who are below the 10th percentile in weight for their gestational age, which can be influenced by various factors but is not directly caused by maternal diabetes. By understanding these specific risks and complications, nurses can provide targeted care and interventions to ensure the best outcomes for newborns of mothers with diabetes. This knowledge is essential for pharmacology students and practicing nurses to deliver safe and effective care in this specialized area of neonatal nursing.

Correct Answer: D

Rationale: In this scenario, option D is the statement that indicates the need for further teaching. This is because the statement suggests that a baby will fuss, get irritable, or cry inconsolably when starting to get sleepy, which is not a typical newborn behavior. Newborns usually exhibit subtle cues such as yawning, rubbing eyes, looking away, or ignoring stimuli when they are sleepy or overstimulated. Option A correctly identifies a common newborn behavior of yawning or rubbing eyes when sleepy. Option B also accurately describes how babies may react when they are overstimulated or tired by looking away or ignoring stimuli. Option C highlights how crying or fussing can occur when caregivers miss recognizing the baby's earlier sleep cues. To improve the educational content, it is essential to emphasize the importance of understanding and responding to the subtle cues that newborns display when they are tired or overstimulated. Teaching parents to recognize these cues can help them respond promptly to their baby's needs, fostering a stronger parent-child bond and promoting better sleep patterns for the newborn. Additionally, educating parents on responsive caregiving practices can lead to a more positive and supportive environment for the newborn's development.

Correct Answer: A

Rationale: In this scenario, the correct answer is option A) an infant between 1 and 4 months of age. This age group is at the greatest risk for Sudden Infant Death Syndrome (SIDS) due to various factors. Infants between 1 and 4 months have not yet developed the full ability to regulate their breathing and arousal from sleep, which are crucial in preventing SIDS. Additionally, this age range is when the risk of SIDS is highest according to research and statistics. Option B) a post-date neonate is not the correct answer because while being post-date can pose certain risks to the newborn, it is not specifically linked to an increased risk of SIDS. Option C) a baby 6 to 12 months of age is also incorrect as the risk of SIDS decreases after the age of 6 months when infants have better developed physiological mechanisms to protect themselves during sleep. Option D) a baby 4 to 6 months of age is not the greatest risk group, although infants in this age range are still susceptible to SIDS. In an educational context, it is crucial for nurses caring for newborns and their families to understand the risk factors associated with SIDS to provide appropriate education and support. By recognizing that infants between 1 and 4 months are at the highest risk, nurses can tailor their education efforts to focus on safe sleep practices, such as placing the baby on their back to sleep, using a firm sleep surface, and keeping soft bedding and toys out of the sleep area. This knowledge empowers nurses to effectively educate parents and caregivers on reducing the risk of SIDS and promoting infant safety.