The nurse is preparing for the discharge of a neonate diagnosed with a congenital breathing disorder. Which health team members does the nurse include in discharge planning? Select all that apply.

Correct Answer: D

Rationale: The correct answer is D: Home health agency nurse. The nurse includes the home health agency nurse in discharge planning as they will provide ongoing care and support for the neonate with a congenital breathing disorder at home. The home health agency nurse can assess the home environment, educate the family on care techniques, monitor the neonate's condition, and provide necessary interventions. A: Respiratory therapist may be involved in managing acute respiratory issues but may not provide ongoing care at home. B: Community agency manager may help with connecting to community resources but may not provide direct care. C: Social worker may assist with psychosocial support but may not have the expertise in managing the neonate's medical needs at home.

Correct Answer: C

Rationale: The correct answer is C: Report the blood glucose level to the practitioner. A blood glucose level of 42 mg/dL in a newborn is considered low and may indicate hypoglycemia. It is important to involve the practitioner immediately for further evaluation and management. Reporting to the practitioner ensures timely intervention and appropriate treatment. Summary: A: Recording the number in the chart without taking any action may lead to delayed intervention. B: Immediately asking the mother to feed the newborn may not address the underlying cause of the low blood glucose level. D: Observing for hypoglycemia is important but reporting to the practitioner should be prioritized for proper management.

Correct Answer: B

Rationale: The correct answer is B: Covering the newborn’s eyes during phototherapy. This is important because exposure to the bright lights used in phototherapy can harm the newborn’s eyes. Covering the eyes with a protective mask or eye patches helps prevent damage. Incorrect choices: A: Anticipatory guidance regarding immunization schedules is important but not the most immediate concern in this scenario. C: Proper clothing for the newborn during seasonal changes is important for general care but not as critical as protecting the eyes during phototherapy. D: How to accurately measure the newborn’s temperature is essential but not as urgent as ensuring eye protection during phototherapy. In summary, educating the family on covering the newborn’s eyes during phototherapy is crucial to prevent eye damage, making it the most important consideration in this situation.

Correct Answer: B

Rationale: The correct answer is B: Periodic episodes of grunting during expiration. This warrants further investigation as grunting during expiration is a sign of respiratory distress in newborns, indicating potential respiratory compromise. It can be a sign of underlying lung pathology or inadequate oxygenation. It is important to assess and address this promptly to prevent further deterioration. Incorrect choices: A: Irregular patterns of breathing with periods of apnea lasting 5 seconds - While apnea can be concerning, it is common in newborns. This alone may not warrant immediate further investigation. C: Breathing at a rate of 45 breaths per minute - A respiratory rate of 45 breaths per minute can be within normal range for a newborn. It may not be abnormal unless accompanied by other signs of distress. D: Mild sternal retractions - Sternal retractions can be a sign of increased work of breathing, but mild retractions alone may not be as concerning as grunting during expiration.

Correct Answer: D

Rationale: The correct answer is D: Breastfeeding. Newborns exclusively breastfed are at risk of hypoglycemia due to delayed milk production, inadequate feeding, and poor latching. Prematurity (A) and being large for gestational age (B) can increase the risk, but they are not primary causes. Cold stress (C) can contribute, but it's not a direct risk factor for hypoglycemia in newborns. By process of elimination and understanding the physiological effects of breastfeeding on newborn glucose levels, choice D is the most relevant risk factor.