A nurse is teaching a newborn’s parent to care for the umbilical cord stump. Which of the following instructions should the nurse include?
Wipe the cord daily with alcohol prep pads.
Keep the cord moist.
Fold the top of the diaper underneath the cord.
Apply petroleum jelly to the cord stump.
The Correct Answer is C
Choice A rationale
Wiping the cord daily with alcohol prep pads is not recommended. Current guidelines suggest keeping the cord clean and dry without the use of alcohol, as it can delay the natural drying and falling off process.
Choice B rationale
Keeping the cord moist is not recommended. The cord should be kept dry to promote natural drying and separation. Moisture can increase the risk of infection.
Choice C rationale
Folding the top of the diaper underneath the cord is recommended to keep the cord exposed to air and prevent irritation from urine or stool. This helps the cord dry out and fall off naturally.
Choice D rationale
Applying petroleum jelly to the cord stump is not recommended. The cord should be kept dry, and the use of ointments or creams can interfere with the natural drying process. .
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Correct Answer is D
Explanation
Choice A rationale
Hyperbilirubinemia, or high levels of bilirubin in the blood, can occur in newborns of diabetic mothers due to increased red blood cell breakdown. However, it is not the primary concern immediately after birth. The priority is to address conditions that can cause immediate harm, such as hypoglycemia.
Choice B rationale
Hypomagnesemia, or low magnesium levels, can occur in newborns of diabetic mothers, but it is not the most critical issue. Magnesium levels can be monitored and corrected if necessary, but hypoglycemia poses a more immediate threat to the newborn’s health.
Choice C rationale
Hypocalcemia, or low calcium levels, can also occur in newborns of diabetic mothers. While it is important to monitor and manage calcium levels, hypoglycemia is a more urgent concern because it can lead to severe complications if not addressed promptly.
Choice D rationale
Hypoglycemia, or low blood sugar levels, is the most critical concern for newborns of diabetic mothers. These newborns are at high risk for hypoglycemia due to the high levels of insulin they produce in response to their mother’s elevated blood glucose levels during pregnancy. Hypoglycemia can cause serious complications, including seizures and brain damage, if not treated immediately.
Correct Answer is A
Explanation
Choice A rationale
Drying the newborn’s skin thoroughly immediately after birth helps reduce heat loss by evaporation, which is a significant concern as wet skin can cause rapid heat loss.
Choice B rationale
Maintaining ambient room temperature at 24°C (75°F) helps prevent heat loss by convection but does not directly address evaporation.
Choice C rationale
Placing the newborn on a warm surface helps prevent heat loss by conduction but does not address evaporation.
Choice D rationale
Preventing air drafts helps reduce heat loss by convection but does not address evaporation.