A nurse is assisting with the care of a newborn who has neonatal abstinence syndrome.Which of the following actions should the nurse take first?
Auscultate the newborn’s bowel sounds.
Swaddle the newborn in blankets.
Weigh the newborn’s wet diaper.
Determine the newborn’s respiratory rate.
The Correct Answer is D
Choice A rationale
Auscultating the newborn’s bowel sounds is important for assessing gastrointestinal function, but it is not the first priority in managing a newborn with neonatal abstinence syndrome (NAS). Initial care should focus on stabilizing the newborn and addressing withdrawal symptoms.
Choice B rationale
Swaddling the newborn in blankets can help provide comfort and reduce excessive stimulation, which is beneficial for newborns with NAS. However, it is not the first priority. The primary focus should be on assessing and stabilizing the newborn’s vital signs.
Choice C rationale
Weighing the newborn’s wet diaper is important for monitoring fluid balance and hydration status, but it is not the first priority in managing NAS. Initial care should focus on stabilizing the newborn and addressing withdrawal symptoms.
Choice D rationale
Determining the newborn’s respiratory rate is the first priority in managing a newborn with NAS. Assessing and stabilizing the newborn’s vital signs, including respiratory rate, is crucial to ensure the newborn’s immediate health and safety.
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Correct Answer is D
Explanation
Choice A rationale
Using a breast pump can help maintain milk supply if the client plans to return to work, but it does not directly prevent mastitis.
Choice B rationale
Covering the breasts immediately after feedings is not necessary and does not prevent mastitis. Proper hygiene and feeding techniques are more important.
Choice C rationale
Wearing an underwire bra can restrict milk flow and increase the risk of mastitis. A well-fitting, non-restrictive bra is recommended.
Choice D rationale
Washing nipples with soap and water daily can cause dryness and irritation, increasing the risk of mastitis. It is better to clean the nipples with water only and ensure proper latch and feeding techniques. .
Correct Answer is A
Explanation
Choice A rationale
Placing the retainer clip at the level of the baby’s armpits is the correct position for the clip. This ensures that the harness straps are positioned correctly over the baby’s shoulders, providing optimal protection in the event of a crash.
Choice B rationale
Placing the baby in the car seat at a 90-degree angle is incorrect. Newborns should be placed in a rear-facing car seat at an angle of approximately 45 degrees to ensure their airway remains open and to provide proper support for their head and neck.
Choice C rationale
Turning the car seat to face forward when the baby weighs 15 pounds is not recommended. Babies should remain in a rear-facing car seat until they reach the maximum weight or height limit specified by the car seat manufacturer, typically around 2 years of age.
Choice D rationale
Placing a thick, soft pad behind the baby’s back is not recommended. Additional padding can interfere with the proper fit of the harness and reduce the effectiveness of the car seat in protecting the baby during a crash.