A nurse is providing discharge instructions for newborn care. The parents have chosen to formula feed their infant. What should the nurse include in the discharge teaching about bottle feeding? (Select all that apply)
Bottles can be put in the dishwasher, boiled, or cleaned with hot soapy water.
Hold the baby in a supine position during feedings.
Only burp the baby after they have finished the entire feeding.
Always hold the bottle while feeding. Do not prop the bottle.
Keep the nipple full of formula throughout the feeding.
Prepared formula can be kept in the refrigerator for 48 hours.
Correct Answer : A,D,E,F
Choice A rationale
Bottles can be put in the dishwasher, boiled, or cleaned with hot soapy water to ensure they are thoroughly sanitized and safe for the infant.
Choice B rationale
Holding the baby in a supine position during feedings is incorrect because it increases the risk of aspiration. The baby should be held in a semi-upright position.
Choice C rationale
Only burping the baby after they have finished the entire feeding is incorrect because it can lead to discomfort and gas buildup. The baby should be burped during and after feedings.
Choice D rationale
Always holding the bottle while feeding and not propping the bottle is correct as it prevents choking and ensures the baby is feeding safely.
Choice E rationale
Keeping the nipple full of formula throughout the feeding is correct as it prevents the baby from swallowing air, which can cause gas and discomfort.
Choice F rationale
Prepared formula can be kept in the refrigerator for 48 hours, ensuring it remains safe and free from bacterial growth.
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Correct Answer is B
Explanation
Choice A rationale
A newborn with a temperature of 37.0°C (98.6°F) is within the normal range for newborns and does not require immediate intervention.
Choice B rationale
A newborn who has not voided within 27 hours post-delivery requires immediate intervention. Newborns should void within the first 24 hours of life. Failure to void may indicate dehydration, urinary tract obstruction, or renal issues.
Choice C rationale
A newborn who has not passed meconium within 18 hours post-delivery is concerning but not as urgent as not voiding. Newborns typically pass meconium within the first 24-48 hours.
Choice D rationale
Acrocyanosis, or bluish discoloration of the hands and feet, is common in newborns and usually resolves on its own. It does not require immediate intervention.
Correct Answer is D
Explanation
Choice A rationale
An apical pulse rate of 124 bpm is within the normal range for a neonate (110-160 bpm). There is no need to ask another nurse to verify the heart rate as it is not an abnormal finding.
Choice B rationale
Calling the provider for an apical pulse rate of 124 bpm is unnecessary as it is within the normal range for a neonate. This action would be appropriate if the heart rate were significantly outside the normal range.
Choice C rationale
Preparing the newborn for transport to the NICU for an apical pulse rate of 124 bpm is not warranted. The heart rate is within the normal range, and there is no indication for further cardiac observation.
Choice D rationale
Documenting the expected finding is the appropriate action. An apical pulse rate of 124 bpm is within the normal range for a neonate, and no further action is needed.