A home health nurse visits a 2-week-old infant and observes the umbilical cord has dried and fallen off. The area appears healed with no drainage or erythema present. Given these assessment findings, what instruction should the nurse give the parent?

Correct Answer: D

Rationale: The correct answer is D) give the baby a bath in an infant tub now. This instruction is appropriate because the umbilical cord stump has already fallen off, indicating the area is healed and no longer needs to be kept dry. Bathing the baby helps in maintaining good hygiene and promoting skin health without increasing the risk of infection. Option A is incorrect as covering the umbilicus with a band-aid can trap moisture, leading to potential infection. Option B is incorrect as using alcohol to clean the stump is no longer necessary once it has fallen off and healed. Option C is incorrect as applying antibiotic ointment unnecessarily may disrupt the natural healing process and could lead to resistance issues in the future. In an educational context, it's essential for nurses to provide evidence-based care instructions to parents to promote optimal newborn care. Understanding the normal healing process of the umbilical cord stump and when it is appropriate to introduce bathing helps parents feel confident in caring for their newborn and prevents unnecessary interventions that could potentially harm the baby.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) cradle cap. Cradle cap, also known as infantile seborrheic dermatitis, is a common and harmless skin condition seen in infants. It presents as yellow scaly patches with a red rash on the scalp. This condition is caused by the overproduction of sebum, a natural oil in the skin, leading to the formation of crusty, oily patches on the scalp. Option A) erythema toxicum is a benign and common rash in newborns that appears as blotchy red spots with a white or yellow papule in the center. It is not associated with the scalp. Option B) eczema is a chronic inflammatory skin condition characterized by red, itchy rashes that can occur on various parts of the body, not specifically limited to the scalp. Option C) a skin allergy is a broad term referring to the body's immune response to a substance that it perceives as harmful. While infants can develop skin allergies, the presentation is typically different from cradle cap, involving hives, redness, itching, or swelling rather than the characteristic yellow scaly patches seen in cradle cap. Understanding common skin conditions in newborns is crucial for nurses caring for infants to provide appropriate education and support to parents. Recognizing cradle cap helps in guiding parents on proper management strategies such as gentle washing, moisturizing, and sometimes using mild baby shampoos to help alleviate the condition without causing harm to the infant's delicate skin.

Correct Answer: D

Rationale: In the context of pharmacology and nursing care of the newborn, the correct answer is D) The mother should continue to breast-feed the infant every 2 to 3 hours or more frequently as tolerated (every 2 hours if under phototherapy). This guidance is based on the fact that breast milk is crucial for the newborn's health and development. Breast milk helps to promote gut health, immunity, and overall well-being of the infant. Additionally, breast milk helps in the passage of meconium, which aids in the elimination of excess bilirubin, thus helping to reduce hyperbilirubinemia. Option A is incorrect as stopping breast-feeding is not recommended unless there are specific medical reasons to do so. Option B is also incorrect as it suggests switching to bottle-feeding until the bilirubin levels return to normal, which is unnecessary if breastfeeding can continue. Option C, alternating between breast and bottle-feeding, may lead to decreased breast milk supply and confusion for the newborn. Educationally, it is important for nurses to understand the benefits of breastfeeding and how breast milk can help manage conditions like hyperbilirubinemia in newborns. Providing evidence-based guidance to mothers can help optimize the health outcomes for both the baby and the mother.

Correct Answer: C

Rationale: In umbilical cord care for newborns, the correct answer is C) Keep the cord dry and open to the air. This is essential because allowing the cord to remain dry and exposed to air helps promote natural drying, prevents bacterial growth, and facilitates the natural process of cord separation without causing irritation or infection. Option A is incorrect because applying rubbing alcohol can actually delay cord separation and irritate the baby's delicate skin. Option B recommending covering the cord with bacitracin is unnecessary and may increase the risk of developing bacterial resistance. Option D suggesting washing the cord with soap and water daily during bath time can also be detrimental as it can introduce bacteria and disrupt the natural healing process. Educationally, it is crucial for nurses to provide evidence-based, safe practices in umbilical cord care to prevent complications and promote optimal newborn health. Teaching parents the correct method, as in option C, empowers them to care for their newborn effectively and fosters a trusting relationship with healthcare providers.

Correct Answer: C

Rationale: In the context of preventing SIDS (Sudden Infant Death Syndrome), placing the infant on their back to sleep is the correct action for the parent to take. This is in line with the safe sleep guidelines recommended by the American Academy of Pediatrics. Placing the baby on their back reduces the risk of SIDS as it maintains an open airway and prevents suffocation. The other options are incorrect and potentially dangerous. Wrapping the baby in layers of blankets increases the risk of overheating, which is a risk factor for SIDS. Putting stuffed animals in the crib can also pose a suffocation hazard. Additionally, sleeping or bed-sharing with the infant increases the risk of accidental suffocation or overlaying, both of which are associated with an increased risk of SIDS. Educationally, it is crucial for nurses to emphasize safe sleep practices to parents to reduce the risk of SIDS. By providing clear and accurate information on safe sleep guidelines, nurses empower parents to create a safe sleep environment for their newborns, ultimately promoting infant safety and well-being.