Author Question: The nurse is ready to perform a discharge assessment for a 2-day-old male infant that has been ... (Read 42 times)

olgavictoria · **on:** Jun 28, 2018

The nurse is ready to perform a discharge assessment for a 2-day-old male infant that has been circumcised. Which of the following findings require immediate intervention?

1. The umbilical cord clamp has been removed.
2. The infant has had a dry diaper since the circumcision procedure.
3. The mother is ready to breastfeed on demand.
4. The infant maintains temperature when wrapped in a blanket.

Question 2

At birth, an infant weighed 8 pounds, 4 ounces. Three days later, the newborn is being discharged. The parents note that the baby now weighs 7 pounds, 15 ounces. What explanation should the nurse give for the change in this newborn's weight?

His weight loss is:
1. Excessive.
2. Within normal limits.
3. Less than expected.
4. Unusual.

blakeserpa · **Reply #1 on:** Jun 28, 2018

Answer to Question 1

Correct Answer: 2
Rationale 1: The umbilical cord clamp should be removed between 24 and 48 hours after birth to reduce the chance of tension injury to the area.
Rationale 2: If the infant has not voided since the circumcision procedure, further assessment should be done to determine if a penile injury and/or edema is preventing urinary flow.
Rationale 3: This is a positive action that represents the mother's readiness to care for her infant at home.
Rationale 4: The infant should be able to maintain body temperature without the presence of the radiant warmer.

Answer to Question 2

Correct Answer: 2
Rationale 1: This newborn's weight loss is within normal limits. During the first 510 days of life, caloric intake often is insufficient for weight gain. Therefore, there might be a weight loss of 510 in term newborns.
Rationale 2: This newborn's weight loss is within normal limits. During the first 510 days of life, caloric intake often is insufficient for weight gain. Therefore, there might be a weight loss of 510 in term newborns.
Rationale 3: This newborn's weight loss is within normal limits. During the first 510 days of life, caloric intake often is insufficient for weight gain. Therefore, there might be a weight loss of 510 in term newborns.
Rationale 4: This newborn's weight loss is within normal limits. During the first 510 days of life, caloric intake often is insufficient for weight gain. Therefore, there might be a weight loss of 510 in term newborns.