The nurse is planning care for a low-birth-weight newborn. Which ...

[ts19998]

The nurse is planning care for a low-birth-weight newborn. Which is an appropriate nursing intervention to promote adequate oxygenation?
 
  a. Place in Trendelenburg position periodically.
  b. Suction at least every 2 to 3 hours.
  c. Maintain neutral thermal environment.
  d. Hyperextend neck with nose pointing to ceiling.

Question 2

The nurse has been caring for a newborn who just died. The parents are present but say they are afraid to hold the dead newborn. Which is the most appropriate nursing intervention?
 
  a. Tell them there is nothing to fear.
  b. Insist that they hold newborn one last time.
  c. Respect their wishes and release body to morgue.
  d. Keep newborn's body available for a few hours in case they change their minds.

[komodo7]

Answer to Question 1

ANS: C
A neutral thermal environment is one that permits the newborn to maintain a normal core temperature with minimal oxygen consumption and caloric expenditure. The Trendelenburg position should be avoided. This position can contribute to increased intracranial pressure (ICP) and reduced lung capacity from gravity pushing organs against diaphragm. Suctioning should be done only as necessary. Routine suctioning may cause bronchospasm, bradycardia due to vagal nerve stimulation, hypoxia, and increased ICP. Neck hyperextension is avoided because it reduces diameter of trachea.

Answer to Question 2

ANS: D
When the parents are hesitant about holding and touching their newborn, the nurse should keep the newborn's body for a few hours. Many parents change their minds after the initial shock of the newborn's death. This will provide the parents time to see and hold their newborn if they desire. Stating that there is nothing to fear minimizes the parents' feelings. The nurse should allow the family to parent their child as they wish in death, as in life. Many parents change their minds; if possible, the nurse should wrap the newborn in blankets and keep the newborn's body on the unit for a few hours.

[ts19998]

Gracias!

[komodo7]

TYSM