Which nursing action is appropriate when providing care to a ...

[sammy]

Which nursing action is appropriate when providing care to a newborn with a respiratory rate of 102 breaths per minute with lungs that are clear to auscultation?
 
  1. Administering the bath to the neonate in the nursery
  2. Transferring to the neonatal intensive care unit for further observation
  3. Allowing the neonate to room-in to promote bonding
  4. Providing the first feeding in the nursery

Question 2

Which positions are appropriate for the nurse to include in a plan of care for the infant who is diagnosed with acute respiratory distress? Select all that apply.
 
  1. Upright
  2. Semi-Fowler position
  3. Prone position
  4. With the infant's head hyperextended
  5. With the infant's head in a sniffing position

[katieost]

Answer to Question 1

2
Explanation:
1. The newborn is tachypneic. Bathing will only add to the respiratory distress and should be avoided.
2. This newborn needs to remain under constant observation due to the respiratory rate.
3. The newborn needs to be monitored.
4. With a respiratory rate this high, aspiration is likely so feeding should be avoided.

Answer to Question 2

2, 5
Explanation:
1. An infant cannot be placed in an upright position.
2. The semi-Fowler position elevates the head of bed. This allows better movement of the diaphragm.
3. Prone positioning will not promote respirations.
4. The head should not be hyperextended as that position does not open the airway in an infant.
5. A sniffing position straightens and shortens the airway and is the position that is best.

[sammy]

Thanks for the timely response, appreciate it

[diana chang]

Excellent