A first-time parent is pending discharge from the hospital with a well-newborn. What information should the nurse include in the discharge teaching to the parents?
"Expect to wake your baby for all feedings."
"Your baby will not need additional immunizations until the 1 or 2 month check-ups."
"Your baby should gain full head control by 1 month."
"Expect your baby to triple their birth weight by 4-6 months."
The Correct Answer is B
Rationale:
A. While newborns need to feed frequently, particularly breastfed infants, parents do not need to wake their baby for every feeding unless advised by their healthcare provider due to specific concerns like low birth weight.
B. After birth, the newborn receives initial vaccinations, such as the hepatitis B vaccine. The next set of vaccinations is typically administered at the 1 or 2-month check-up, so no additional immunizations are needed immediately after discharge.
C. Full head control is generally achieved by around 4 months of age, not 1 month.
D. Babies typically triple their birth weight by around 12 months of age, not by 4-6 months.
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Correct Answer is D
Explanation
Rationale:
A. Prone positioning is not recommended post-operatively for abdominal surgery and could exacerbate respiratory issues.
B. While monitoring white blood cell count is important, encouraging lung expansion and preventing complications such as atelectasis is a more immediate priority.
C. The client's pain rating is low and does not necessitate immediate administration of acetaminophen.
D. Encouraging the use of an incentive spirometer helps improve lung expansion, which is crucial to prevent atelectasis and promote proper oxygenation, particularly when breath sounds are diminished.
Correct Answer is B
Explanation
Rationale:
A. A PEFR of 45% of the personal best indicates a moderate asthma exacerbation, but immediate hospitalization is not necessarily required unless there are severe symptoms or other indicators of serious distress.
B. At 45% of the personal best PEFR, the child is experiencing a moderate asthma exacerbation. The recommended action is to use a quick-relief inhaler like albuterol, which is effective in providing immediate relief. Inhaled corticosteroids are part of the long-term management but should not replace the use of a quick-relief inhaler during an exacerbation.
C. Salmeterol is a long-acting beta-agonist used for maintenance therapy and is not typically used for acute exacerbations. Albuterol is preferred in this situation for immediate relief.
D. While monitoring PEFR is important, action should be taken when PEFR falls below 50% of the personal best, and more immediate intervention is needed at 45% of the personal best.