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
Administering only the Hepatitis B vaccine within 1 hour of birth is not sufficient for a newborn born to a Hepatitis B positive mother. The newborn also needs Hepatitis B immunoglobulin (HBIG) to provide immediate passive immunity.
Choice B rationale
Administering both the Hepatitis B vaccine and Hepatitis B immunoglobulin (HBIG) within 12 hours of delivery is the recommended practice for newborns born to Hepatitis B positive mothers. This provides both active and passive immunity.
Choice C rationale
Administering only Hepatitis B immunoglobulin (HBIG) within 12 hours of birth is not sufficient. The newborn also needs the Hepatitis B vaccine to develop long-term immunity.
Choice D rationale
Administering Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by monthly Hepatitis B vaccines for 12 months, is not the standard practice. The newborn should receive the Hepatitis B vaccine series according to the recommended schedule. .
Correct Answer is A
Explanation
Choice A rationale
Given the neonate’s symptoms and critically low blood glucose level (30 mg/dL), the most urgent action is to address the hypoglycemia. Therefore, the nurse shouldadminister a bolus of intravenous glucose (Option A). This immediate intervention is crucial to stabilize the neonate and prevent further complications associated with hypoglycemia.
Choice B rationale
While monitoring blood glucose levels is important, waiting 30 minutes to reassess without immediate intervention could allow the hypoglycemia to worsen, potentially leading to severe complications such as seizures or brain damage. Immediate treatment is necessary to stabilize the neonate.
Choice C rationale
Although feeding can help increase blood glucose levels, the neonate’s current symptoms (jitteriness, poor feeding, weak cry, and irritability) suggest that they may not be able to effectively feed. Additionally, the blood glucose level is critically low and requires more rapid correction than feeding alone can provide.
Choice D rationale
While maintaining an appropriate body temperature is important, the neonate’s temperature (36.1°C) is not critically low. The primary concern here is the hypoglycemia, which needs to be addressed immediately. Placing the neonate under a radiant warmer does not directly address the low blood glucose level.