A neonate is being discharged home with a fiber-optic blanket for treatment of physiologic jaundice. What is important for the nurse to include in the discharge instructions?

Correct Answer: C

Rationale: The correct instruction for the nurse to include in the discharge plan is to encourage frequent feeding to increase intake. Fiber-optic blankets for treating physiologic jaundice work by promoting the breakdown of bilirubin in the skin through phototherapy. Encouraging frequent feeding helps increase the infant's intake, leading to more frequent bowel movements which aids in the elimination of excess bilirubin from the body. This, in turn, helps in resolving physiologic jaundice more quickly. Covering the infant's eyes during treatment may be necessary to protect them from the bright light, but it is not directly related to the effectiveness of the treatment. Reducing the number of formula feedings could decrease the baby's intake, potentially leading to more concentrated levels of bilirubin. Expecting constipation until jaundice clears is not a typical consequence of using a fiber-optic blanket for jaundice treatment.

Correct Answer: A

Rationale: Engorgement is a common issue for breastfeeding mothers and can lead to discomfort and difficulty with milk flow. The most appropriate nursing intervention for a breastfeeding mother experiencing engorgement is to apply cold compresses to the breasts after feeding (Option A). Cold compresses help reduce inflammation, swelling, and discomfort associated with engorgement. The cold temperature constricts blood vessels, reducing blood flow to the breasts and decreasing swelling. Option B, limiting breastfeeding to every 6 hours, is incorrect. Engorgement requires more frequent, rather than less frequent, breastfeeding sessions to relieve the fullness and facilitate milk flow. Infrequent breastfeeding can worsen engorgement and lead to complications like mastitis. Option C, using formula supplements to reduce milk supply, is not recommended as it can decrease milk production and interfere with establishing a good breastfeeding routine. Supplementing with formula can also impact the baby's latch and hinder the establishment of a sufficient milk supply. Option D, massaging the breasts before feeding, can be helpful in some cases to promote milk flow and relieve engorgement. However, in the context of this question, applying cold compresses after feeding is more effective in reducing engorgement-related discomfort. In an educational context, it is important for nursing students to understand the appropriate interventions for common breastfeeding issues like engorgement. Providing evidence-based care, such as using cold compresses, not only alleviates discomfort for the mother but also supports successful breastfeeding and milk supply regulation. Nursing students should be equipped with the knowledge and skills to address breastfeeding challenges effectively to promote maternal and infant well-being.

Correct Answer: B

Rationale: In the context of a newborn experiencing signs of hypoglycemia, the primary nursing action should be to feed the newborn breastmilk or formula (Option B). This is the correct answer because providing nutrition, specifically glucose, is essential to raise the blood sugar levels promptly in a hypoglycemic newborn. Breastmilk or formula contains the necessary nutrients, including glucose, to address the hypoglycemic state efficiently. Option A, administering glucose water via a bottle, is incorrect as it may not provide adequate nutrition and could lead to improper dosing of glucose, potentially causing further complications. Option C, monitoring glucose levels and reassessing in 30 minutes, is not the primary action because immediate intervention is necessary to prevent complications associated with hypoglycemia in newborns. Option D, starting an IV glucose drip, is a more invasive intervention that should be considered if the newborn's condition does not improve with oral feeding. However, initiating IV therapy is not the primary action when managing hypoglycemia in newborns unless absolutely necessary. In an educational context, it is crucial for nurses to understand the immediate management of hypoglycemia in newborns to prevent long-term consequences. Providing timely and appropriate nutrition is a fundamental nursing intervention in addressing hypoglycemia in newborns and promoting their well-being.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Administer oxygen at 2 L/min via nasal cannula. Grunting and nasal flaring in a newborn indicate respiratory distress, which is a serious concern requiring immediate attention. Providing oxygen via nasal cannula helps improve oxygenation, relieve respiratory distress, and prevent further complications such as hypoxia. Option B) Start IV fluids to maintain hydration is incorrect because while hydration is important, it is not the priority when a newborn is showing signs of respiratory distress. Addressing the respiratory issue takes precedence over hydration. Option C) Position the newborn in a semi-Fowler's position is incorrect as well. While positioning can help optimize lung expansion, in this case, the newborn needs immediate oxygen therapy to address the respiratory distress. Option D) Administer antibiotics to prevent infection is also incorrect because the primary issue at hand is respiratory distress, not an infection that requires antibiotics. In an educational context, understanding the priority interventions for newborns in distress is crucial for nurses and healthcare providers working in maternal newborn care. Recognizing and promptly addressing respiratory distress in newborns can be life-saving and prevent further complications. Oxygen therapy should be initiated quickly to ensure adequate oxygenation and support respiratory function in these vulnerable patients.

Correct Answer: C

Rationale: This statement indicates a correct understanding of perineal care after a midline episiotomy. After vaginal birth, it is important to avoid wiping the perineal area to prevent irritation and infection. Instead, gently patting the area dry is recommended to promote healing and prevent discomfort. This approach helps to minimize trauma to the sensitive tissues of the perineum and reduces the risk of introducing bacteria from wiping.