A newborn was just admitted to the neonatal intensive care unit with a meningomyelocele. What is the priority preoperative nursing care of this newborn?

Correct Answer: C

Rationale: The correct answer is C) Position prone in an incubator. Rationale: Positioning the newborn prone in an incubator is the priority preoperative nursing care for a newborn with a meningomyelocele. Placing the baby in a prone position helps prevent trauma to the sac, reduces the risk of infection, and minimizes tension on the neural tissue, which can help prevent further damage or complications. Additionally, positioning the baby in an incubator provides a controlled environment with regulated temperature and humidity, which is crucial for the delicate condition of the newborn. Explanation of Incorrect Options: A) Keeping the sac dry is important to prevent infection, but positioning the baby prone in an incubator takes precedence in this situation. B) Diapering snugly can put pressure on the sac, leading to complications. It is not appropriate for a newborn with a meningomyelocele. D) Moving the newborn from side to side every hour can increase the risk of trauma to the sac and neural tissue. It is not the recommended care for a newborn with this condition. Educational Context: Understanding the priority nursing care for newborns with specific conditions like meningomyelocele is crucial for providing safe and effective care. Nurses must prioritize interventions based on the immediate needs of the newborn to promote optimal outcomes and prevent complications. Positioning, infection prevention, and maintaining a controlled environment are key aspects of caring for a newborn with a meningomyelocele.

Correct Answer: A

Rationale: Rationale: The correct answer is A) A Pavlik harness. Developmental hip dysplasia in infants is a condition where the hip joint hasn't formed properly. The Pavlik harness is a non-invasive treatment that helps position the hip joint correctly, allowing normal development to occur. It keeps the infant's hips flexed and abducted, which helps maintain proper alignment for optimal growth and development of the hip joint. Option B) A body spica cast is not typically used for infants with developmental hip dysplasia as it is a more invasive treatment method that may not be necessary at this stage. Option C) Traction is not commonly used in infants with developmental hip dysplasia as it may not provide the specific positioning and support needed for proper hip joint development. Option D) Triple-diapering is not a treatment for developmental hip dysplasia. It is important for educators and healthcare providers to understand the appropriate interventions for developmental hip dysplasia to ensure optimal outcomes for infants. Early detection and proper management with interventions like the Pavlik harness are crucial in addressing this condition effectively.

Correct Answer: B

Rationale: The correct answer is B) Respiratory care. Infants with Down syndrome often have generalized hypotonicity, which can affect their respiratory muscles, leading to potential respiratory complications. Therefore, it is crucial for parents to pay special attention to the respiratory health of their child. Proper respiratory care, including monitoring for signs of respiratory distress, positioning the infant correctly during sleep, and seeking prompt medical attention if any breathing difficulties arise, is essential to ensure the well-being of the infant. Option A) Preventing hyperthermia is not directly related to the generalized hypotonicity seen in infants with Down syndrome. While it is important to prevent overheating, it is not the primary concern associated with hypotonicity. Option C) Prevention of diarrhea is also not specifically linked to hypotonicity in infants with Down syndrome. While gastrointestinal issues can be common in this population, the question is focused on the effects of hypotonicity on a different aspect of the infant's health. Option D) Incontinence care is not the most immediate concern related to hypotonicity in infants with Down syndrome. While muscle tone issues can impact bladder control, respiratory care is a more critical aspect to address first due to its direct impact on the infant's overall health and well-being. In an educational context, it is important for healthcare providers to educate parents of infants with Down syndrome about the specific health considerations and care needs associated with the condition. By understanding the potential challenges related to hypotonicity, parents can be better equipped to provide appropriate care and support to their child. Regular well visits and proactive communication with healthcare providers are essential for monitoring the infant's growth and development and addressing any concerns promptly.

Correct Answer: D

Rationale: The correct answer is D) The light breaks down bilirubin. Rationale: Phototherapy is the standard treatment for neonatal jaundice, a condition caused by elevated levels of bilirubin in the baby's blood. The light used in phototherapy, typically blue or white light, helps to break down bilirubin into a form that can be more easily excreted by the baby's body. This process, known as photoisomerization, converts the bilirubin into water-soluble forms that the infant can eliminate through urine and stool. Option A) The light increases the infant's metabolism: This is incorrect as the primary goal of phototherapy in jaundiced infants is to reduce bilirubin levels, not to increase metabolism. Option B) The light stimulates liver function: While phototherapy does support the liver in processing bilirubin, its main mechanism of action is through direct breakdown of bilirubin by the light itself. Option C) The light dilates blood vessels: This is not related to the mechanism of action of phototherapy in treating neonatal jaundice. Educational Context: Understanding the rationale behind the treatment of neonatal jaundice with phototherapy is crucial for healthcare professionals working with newborns. By knowing how phototherapy works to reduce bilirubin levels, nurses and other healthcare providers can effectively educate parents about the treatment and reassure them about its safety and efficacy in managing their infant's condition.

Correct Answer: A

Rationale: Rationale: The correct answer is A) Hypoglycemia. A macrosomic newborn of a mother with diabetes is at risk for hypoglycemia due to fetal hyperinsulinemia in response to maternal hyperglycemia. Insulin levels drop after birth, leading to hypoglycemia in the neonate. It is crucial for the nurse to monitor the newborn's blood glucose levels closely to prevent any potential complications. Option B) Erythroblastosis fetalis is incorrect as it is a condition where maternal antibodies attack fetal red blood cells, which is not directly related to maternal diabetes. Option C) Intracranial hemorrhage is not typically associated with a macrosomic newborn of a diabetic mother unless there are other complications during birth. Option D) Pancreatic failure is not a common concern in a macrosomic newborn of a diabetic mother; the primary focus would be on monitoring blood glucose levels and preventing hypoglycemia. Educational Context: Understanding the implications of maternal diabetes on a newborn is crucial for nurses caring for infants at risk. By recognizing the increased likelihood of hypoglycemia in macrosomic newborns of diabetic mothers, nurses can provide targeted monitoring and interventions to ensure the baby's well-being. This knowledge is essential for providing safe and effective care to this specific population of infants.