A nursery nurse is caring for a newborn who was born 2 hours ago. Upon review of the prenatal records, the nurse notes the following prenatal panel results:
A positive, Hepatitis B positive, RPR negative, Rubella immune, HIV negative, GBS positive. In addition to Vitamin K and Erythromycin ophthalmic ointment, what injection(s) should the newborn receive?
Hepatitis B vaccine only, administered within 1 hour of birth.
Hepatitis B vaccine and Hepatitis B immunoglobulin administered within 12 hours of delivery.
Hepatitis B immunoglobulin (HBIG) only, administered within 12 hours of birth.
Hepatitis B immunoglobulin (HBIG) within 12 hours, followed by hepatitis B vaccine monthly for 12 months.
The Correct Answer is B
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. .
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Correct Answer is C
Explanation
Choice A rationale
Faint red marks on the plantar surface are more common in preterm infants and are not typically seen in post-term infants.
Choice B rationale
Copious vernix is usually seen in preterm infants. Post-term infants often have little to no vernix.
Choice C rationale
Dry, cracked skin is a common finding in post-term infants due to prolonged exposure to the amniotic fluid.
Choice D rationale
Scant scalp hair is more common in preterm infants. Post-term infants usually have more developed hair.
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.