A new nurse is suctioning a neonate. What action by the new nurse would cause the preceptor to intervene?

Correct Answer: C

Rationale: In this scenario, the correct answer is option C) Positions the suction bulb at the back of the throat. This action would cause the preceptor to intervene because suctioning at the back of the throat can trigger the baby's gag reflex, leading to potential complications such as aspiration or airway obstruction. Option A) Assessing the infant for secretions in the airway is a correct step as it helps determine the need for suctioning. Option B) Placing the suction bulb into the baby's cheek is incorrect as it does not effectively clear secretions from the airway. Option D) Suctioning the baby's mouth first is also incorrect as the priority is to clear the airway before addressing the mouth. In an educational context, it is crucial for nurses to understand the correct technique for suctioning neonates to prevent potential harm and ensure effective airway clearance. Emphasizing proper positioning and technique during suctioning can help new nurses provide safe and competent care to newborns.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Temperature of 99.2F (37.3C). Achieving a stable body temperature within the normal range is a crucial goal for a neonate with imbalanced body temperature. Monitoring the infant's temperature is a direct and objective way to assess this parameter. Option A) Hands and feet turn pink may indicate improved peripheral circulation but do not directly confirm the achievement of a stable body temperature. Option B) Infant stops shivering is a sign of the body's attempt to generate heat, but it does not confirm whether the body temperature has reached a normal range. Option C) Pink and warm skin is a positive sign, but it does not provide a specific measurement of the body temperature. Educationally, it is vital for nurses to understand the significance of monitoring body temperature accurately in neonates as they are more vulnerable to temperature imbalances. By selecting the option D as the correct answer, nurses can ensure the infant's well-being and make informed decisions regarding further interventions if needed.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Prepares to administer the medication 4 hours after birth. The administration of erythromycin ointment to newborns is typically done within the first hour after birth to prevent neonatal conjunctivitis caused by chlamydia or gonorrhea. Delaying the administration by 4 hours increases the risk of infection transmission to the newborn. Option A is incorrect because applying the medication in a thin strip to each eye is the correct technique for administering erythromycin ointment. Option C is incorrect because starting to administer the medication at the inner canthus is the proper technique to ensure the ointment spreads over the eye. Option D is incorrect because it is important to inform parents that mild irritation can occur as a common side effect of the medication. In an educational context, understanding the correct timing and technique for medication administration in newborns is crucial for nursing care. This knowledge ensures the safety and well-being of the infant, highlighting the importance of adhering to evidence-based practices in pharmacology within the neonatal care setting.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Draws up 0.5 mg/kg. The reason this action prompts the faculty member to intervene is that vitamin K1 phytonadione should be administered as a single, intramuscular dose of 0.5 to 1 mg shortly after birth to prevent hemorrhagic disease in newborns. Dosage calculations are crucial in pediatric pharmacology to ensure the safety and efficacy of medications. Administering the incorrect dosage could lead to adverse effects or inadequate treatment. Option A) choosing a 25-gauge needle is incorrect as it is a suitable size for infant intramuscular injections. Option C) gently rubbing the injection site is also appropriate as it can help reduce discomfort. Option D) using a 1-mL syringe is acceptable for accurately measuring and administering the correct dosage. Educationally, this question highlights the importance of accurate dosage calculation and administration in pediatric pharmacology. It emphasizes the need for precision and attention to detail when administering medications to neonates to prevent medication errors and ensure optimal patient outcomes. Students need to be proficient in pediatric dosages and medication administration to provide safe and effective care to newborns and their families.

Correct Answer: D

Rationale: In this scenario, the correct answer is D) Tachypneic: suction if needed administer oxygen per protocol. The newborn's vital signs indicate tachypnea (rapid breathing) with a respiratory rate of 78 breaths/minute, which is above the normal range for a newborn. Tachypnea can be a sign of respiratory distress or other underlying issues. The nurse should first assess the baby's airway for any obstructions and suction if necessary. Administering oxygen per protocol is crucial to ensure the baby is receiving adequate oxygenation. Option A) Hypotensive: needs IV fluid administration is incorrect because the blood pressure of 64/44 mm Hg is within the normal range for a newborn. Option B) Hypothermic: needs to be put in an incubator is incorrect because the temperature of 97.9F (36.6C) is slightly lower but still within an acceptable range for a newborn. Option C) Tachycardic: take pulse again when the baby is not crying is incorrect because the pulse rate of 198 beats/minute is likely due to the baby crying and is not a true reflection of the baby's baseline heart rate. In an educational context, understanding newborn vital signs and their implications is crucial for nurses caring for newborns. Recognizing abnormal vital signs and knowing the appropriate interventions are essential skills for providing safe and effective care to newborns in various clinical settings.