A nurse is planning care for a newborn who has neonatal abstinence syndrome. Which of the following interventions should the nurse include in the plan of care?

Correct Answer: D

Rationale: Neonatal abstinence syndrome (NAS) occurs in newborns who were exposed to addictive drugs in utero, commonly seen in infants born to mothers with substance use disorders. These babies often experience withdrawal symptoms such as tremors, irritability, and difficulty sleeping. Swaddling the newborn in a flexed position can help provide comfort and security to the infant, which may help alleviate some of the withdrawal symptoms they are experiencing. This intervention can also mimic the snug environment of the womb, promoting a sense of calmness for the newborn. It is important to create a soothing environment to aid in the management of NAS symptoms.

Correct Answer: A

Rationale: The important counseling that should be included when discussing coitus interruptus (withdrawal method) is that the partners must communicate well to use this method effectively. Coitus interruptus involves the male partner withdrawing his penis from the vagina before ejaculation to prevent sperm from entering the woman's reproductive tract. Effective communication between partners is crucial to ensure that the method is used correctly and consistently. This method does not protect against sexually transmitted infections (STIs), so it's also important to discuss alternative methods of contraception for STI prevention. The statement that this method is 100 percent effective is incorrect, as pre-ejaculate can contain sperm and there is a risk of pregnancy if withdrawal is not done correctly.

Correct Answer: C

Rationale: Assessing fundal firmness helps detect uterine atony and prevent postpartum hemorrhage after delivery.

Correct Answer: D

Rationale: Ensuring signed informed consent is a priority before any surgical procedure, including cesarean delivery.

Correct Answer: B

Rationale: Ensuring the newborn's mouth is wide open before latching to the breast is the correct action to take when caring for a client experiencing sore nipples from breastfeeding. When the newborn latches onto the breast correctly with a wide open mouth, it helps to prevent nipple soreness and discomfort by allowing proper positioning and attachment, which reduces pressure on the nipple. This action can promote effective and comfortable breastfeeding for both the client and the newborn. Placing a snug dressing on the nipple when not breastfeeding (Choice A) could hinder air circulation, leading to moisture, which may increase the risk of nipple soreness. Limiting the newborn's feeding to 10 minutes on each breast (Choice C) can be insufficient for adequate milk intake and can lead to feeding issues. Instructing the client to begin the feeding with the nipple that is most tender (Choice D) may exacerbate the issue and cause further discomfort.