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 A
Explanation
Rationale:
A. Profound cyanosis is a key sign of tricuspid atresia, a congenital heart defect where the tricuspid valve is absent, leading to poor oxygenation of the blood.
B. Periorbital edema is not typically associated with tricuspid atresia; it might be seen in other conditions like nephrotic syndrome.
C. Absent femoral pulses suggest coarctation of the aorta rather than tricuspid atresia.
D. Decreased blood pressure in the lower extremities is also more indicative of coarctation of the aorta, not tricuspid atresia.
Correct Answer is A
Explanation
Rationale:
A. The varicella vaccine, which is a live attenuated vaccine, may be withheld if the child is symptomatic of their illness or has a significantly compromised immune system. This is due to the increased risk of severe reactions or complications in immunocompromised individuals.
B. The vaccination schedule is still applicable to children with HIV, but there may be adjustments based on the child’s immunocompetence and specific health status.
C. The pneumococcal vaccine is recommended for children with HIV and is typically administered according to the standard schedule, not delayed until the first birthday.
D. The HPV vaccine is generally recommended for children with HIV, as they are at increased risk for HPV-related complications. It is not contraindicated.