A nurse is developing a plan of care for a newborn who has hyperbilirubinemia and a prescription for phototherapy. Which of the following interventions should the nurse include?

Correct Answer: D

Rationale: In this scenario, the correct intervention is to reposition the newborn every 2 to 3 hours (Option D). Repositioning the newborn helps to ensure optimal exposure to the phototherapy lights, which is crucial for the treatment of hyperbilirubinemia. Option A, checking the newborn's temperature every 8 hours, is not the priority intervention in this case. While monitoring temperature is important, it is secondary to ensuring effective phototherapy. Option B, applying moisturizing lotion to the newborn's skin every 4 hours, is not indicated for the treatment of hyperbilirubinemia. This intervention does not address the underlying cause or contribute to the effectiveness of phototherapy. Option C, giving the newborn glucose water every 4 hours, is not an appropriate intervention for hyperbilirubinemia. Providing glucose water is unrelated to the treatment of this condition and does not address the need for phototherapy. In an educational context, it is important for nurses to understand the rationale behind interventions for newborns with hyperbilirubinemia. By repositioning the newborn regularly, nurses can optimize the effectiveness of phototherapy and ensure the best possible outcome for the newborn. This knowledge is essential for providing safe and effective care to neonates with this condition.

Correct Answer: B

Rationale: The correct answer is B) Family-centered care, as it best exemplifies contemporary maternity nursing practice. Family-centered care focuses on involving the family in all aspects of care, promoting a partnership between healthcare providers and families to support the well-being of both the mother and the newborn. This approach recognizes the importance of the family unit in the care process and aims to provide holistic and personalized care that takes into account the physical, emotional, and social needs of the family. Option A) Use of midwives for all vaginal deliveries is not a comprehensive approach to contemporary maternity nursing. While midwives play a crucial role in supporting women during childbirth, the use of midwives for all vaginal deliveries may not always be feasible or appropriate, as the healthcare team should consider individualized care plans based on the needs of the mother and baby. Option C) Free-standing birth clinics may offer alternative birthing options, but they do not necessarily represent the mainstream practice in maternity nursing. The choice of birthing setting should be based on the preferences and needs of the mother, with safety and quality of care being paramount considerations. Option D) Physician-driven care, while historically common, does not align with the current trend in maternity nursing towards a more collaborative and patient-centered approach. In contemporary practice, healthcare providers work together as a team, including midwives, nurses, obstetricians, and other specialists, to provide comprehensive care that meets the diverse needs of pregnant women and their families. Educationally, understanding the shift towards family-centered care in maternity nursing is essential for nursing students and healthcare professionals. It emphasizes the importance of communication, collaboration, and respect for the preferences and values of families, ultimately leading to improved maternal and newborn outcomes. Emphasizing this approach in education can help prepare future nurses to provide compassionate and holistic care in the dynamic field of maternal newborn nursing.

Correct Answer: A

Rationale: The correct answer is A) Births to unmarried women are more likely to have less favorable outcomes. This trend is crucial for nurses caring for pregnant clients to understand because it highlights the importance of providing comprehensive care and support to all pregnant individuals, regardless of their marital status. Unmarried women may face unique challenges during pregnancy, such as lack of social support, financial constraints, and limited access to healthcare, which can contribute to less favorable outcomes for both the mother and the newborn. Option B) Birth rates for women 40 to 44 years of age are declining is incorrect because in recent years, there has actually been an increase in birth rates among women in this age group due to various factors such as advancements in fertility treatments and changing societal norms. Option C) Cigarette smoking among pregnant women continues to increase is incorrect as there have been significant efforts and campaigns to reduce smoking among pregnant women due to the known harmful effects on maternal and fetal health. Option D) Rates of pregnancy and abortion among teenagers are lower in the United States than in any other industrialized country is incorrect because the United States actually has higher rates of teenage pregnancy and abortion compared to many other industrialized nations, highlighting the ongoing need for comprehensive sex education and access to reproductive healthcare for teenagers. Understanding these trends in maternal newborn health is essential for nurses to provide evidence-based care and support to pregnant individuals across diverse backgrounds and situations.

Correct Answer: A

Rationale: The most concerning pitfall for nurses using social media technology is option A, violation of client privacy and confidentiality. This is because nurses have a legal and ethical duty to protect patient information, and sharing any identifiable patient details on social media platforms can breach confidentiality and violate HIPAA regulations. Nurses must always prioritize patient privacy and maintain professional boundaries, even in online interactions. Option B, institutions and colleagues being portrayed negatively, is a potential concern, but it is not as critical as compromising client confidentiality. Nurses should be mindful of how their actions online reflect on their workplace and colleagues, but this does not pose as significant a risk as breaching patient privacy. Option C, unintended negative consequences of social media use, is a broad concern that may encompass various issues but does not directly address the core ethical dilemma of violating patient confidentiality. Option D, lack of institutional policy governing online contact, is important for providing guidance and boundaries, but it is not as critical as nurses' individual responsibility to uphold patient confidentiality. Nurses should be proactive in understanding and following professional standards even in the absence of specific institutional policies. In an educational context, it is crucial for nursing students and professionals to be aware of the ethical and legal implications of using social media in healthcare. Emphasizing the importance of confidentiality, professionalism, and adherence to regulations can help prevent potential pitfalls and maintain trust in the nurse-patient relationship. Regular education and training on social media best practices can empower nurses to navigate these platforms responsibly while leveraging the benefits of networking and advocacy.

Correct Answer: A

Rationale: The correct answer is A) Situation, background, assessment, recommendation. The SBAR technique is a structured method of communication widely used in healthcare settings to improve the effectiveness of information exchange between healthcare providers. Explanation of why other options are incorrect: - B) Situation, baseline, assessment, recommendation: This option is incorrect because "baseline" is not typically a component of the SBAR communication technique. - C) Subjective, background, analysis, recommendation: This option is incorrect as "subjective" and "analysis" are not part of the SBAR acronym. - D) Subjective, background, analysis, review: This option is incorrect because "review" is not a component of the SBAR communication model. Educational context: Understanding and utilizing the SBAR technique is crucial for maternity nurses to effectively communicate important information about their patients to other healthcare providers. By using SBAR, nurses can ensure that critical details are clearly and concisely conveyed, leading to better coordination of care, improved patient safety, and enhanced overall outcomes in maternal newborn nursing practice.