Exemplar 15.F Sudden Infant Death Syndrome (SIDS)
The nurse is evaluating care provided to a new mother whose infant is at risk for sudden infant death syndrome (SIDS). Which statement by the mother indicates teaching has been effective? A) "I need to purchase loose-fitting sheets and blankets for the bed." B) "I plan to quit smoking." C) "I will place my baby in a side-lying position for sleep." D) "I will bottle-feed my baby since breastfeeding is a risk factor for SIDS."
B If the mother of an infant at risk for SIDS expresses her plan to quit smoking, the nursing care has been effective. Loose-fitting sheets and blankets are associated with an increased risk for the syndrome. The prone and side-lying positions increase the risk for the syndrome. The feeding method is not implicated with the syndrome and would not be used to evaluate the plan of care for an infant at risk for SIDS.
The nurse is providing parenting teaching regarding reducing the risk of sudden infant death syndrome (SIDS). Which teaching point is a priority for the nurse to include? A) Instruct on side-lying and face-down positions when in the crib. B) Instruct on face-up position when in the crib. C) Ensure adequate nutritional intake for the mother and newborn. D) Encourage good hand washing.
B The nurse should instruct the mother to place the baby in the face-up position when in the crib. Side-lying and face-down positions are associated with a higher risk of the syndrome and should not be instructed. Although important, good hand washing and adequate nutrition are not interventions that would assist in preventing SIDS.
How does a brainstem abnormality contribute to the risk of SIDS when an infant is placed on his stomach to sleep? A) It decreases the infant's arousal and head turning responses during times of asphyxia. B) It decreases the infant's respiratory drive during NREM sleep. C) It increases periods of apnea, resulting in hypoxia and unconsciousness. D) It increases the risk of aspiration and airway obstruction.
A A brainstem abnormality, when combined with a stressor such as sleeping in the prone position in a child in the first 6 months of life, will often result in SIDS due to a decreased arousal and head turning response during times of asphyxia. A brainstem abnormality does not decrease the respiratory drive during NREM sleep, increase periods of apnea, or increase the risk of aspiration and airway obstruction.
The student nurse attends a workshop on culture and diversity with regard to sudden infant death syndrome (SIDS) and is now aware that the rate of occurrence is highest among which group of infants? A) American Indians B) Caucasians C) Asians D) Hispanics
A Rates of SIDS are highest for American Indians and Alaska Natives and lowest for Asians and Hispanics.
The nurse is planning care for a baby born to a mother who smoked during the pregnancy. The mother states that she believes in bed sharing. Which nursing diagnosis would be appropriate for this baby? A) Risk for Sudden Infant Death Syndrome (SIDS) B) Readiness for Enhanced Parenting C) Anxiety D) Deficient Knowledge
A The most important nursing diagnosis for the baby at this time is Risk for SIDS. Both bed sharing and the mother smoking during pregnancy are risk factors for SIDS. Deficient Knowledge, Readiness for Enhanced Parenting, and Anxiety are appropriate nursing diagnoses for the mother, not the baby.
The nurse is placing a newborn baby in the nursery crib with the baby's back down. The mother tells the nurse that she doubts the baby will be able to sleep that way, as all the family members sleep on their stomachs. Which action by the nurse is appropriate? A) Instruct the mother that placing the baby on the back will reduce the risk of sudden infant death syndrome (SIDS) and it will not interfere with sleep. B) Place the baby on the stomach. C) Suggest the mother place the baby on the stomach when at home. D) Instruct the mother that babies do not really care in which position they are in but placing on the back is easier to provide care.
A The nurse should instruct the mother that placing the baby on the back will reduce the risk of sudden infant death syndrome, and it will not interfere with the baby's ability to sleep. The nurse should not place the baby on the stomach or suggest that the mother place the baby on the stomach when at home. Placing the baby on the back does not necessarily make it easier to provide care.
A nurse is preparing to educate a group of parents on sudden infant death syndrome (SIDS). Which intervention is appropriate to decrease an infant's risk for SIDS? A) Using firm bedding B) Ensuring the room temperature is at least 80°F at all times C) Recommending bed sharing D) Placing the infant in a prone position for sleeping
A Using firm bedding is an appropriate intervention to decrease the risk of SIDS. Other interventions that are appropriate include reducing exposure to secondhand smoke, avoiding overheating, educating on the risk of bed sharing, and placing the infant in a supine position, not a prone position, for sleeping.
The nurse is planning care for the parents of an infant who died as the result of sudden infant death syndrome. Which collaborative interventions does the nurse plan for when providing care to these parents? Select all that apply. A) A psychosocial assessment B) A grief counselor referral C) A psychotherapist referral D) A visit from the chaplain E) A respiratory therapist referral
A, B, C, D A) Collaborative care for the parents may include grief counselors, chaplains and religious leaders, nurses (including school nurses working with older children who lose a sibling), and psychotherapists. In particular, the parents' grief will be acute, and they should receive a psychosocial assessment at each healthcare interaction. A respiratory therapist referral is inappropriate for this situation. B) Collaborative care for the parents may include grief counselors, chaplains and religious leaders, nurses (including school nurses working with older children who lose a sibling), and psychotherapists. In particular, the parents' grief will be acute, and they should receive a psychosocial assessment at each healthcare interaction. A respiratory therapist referral is inappropriate for this situation. C) Collaborative care for the parents may include grief counselors, chaplains and religious leaders, nurses (including school nurses working with older children who lose a sibling), and psychotherapists. In particular, the parents' grief will be acute, and they should receive a psychosocial assessment at each healthcare interaction. A respiratory therapist referral is inappropriate for this situation. D) Collaborative care for the parents may include grief counselors, chaplains and religious leaders, nurses (including school nurses working with older children who lose a sibling), and psychotherapists. In particular, the parents' grief will be acute, and they should receive a psychosocial assessment at each healthcare interaction. A respiratory therapist referral is inappropriate for this situation.
A nurse is preparing to educate a group of parents on sudden infant death syndrome (SIDS). Which variables should the nurse highlight as contributing to increased risk of SIDS? Select all that apply. A) Prone sleeping B) Side sleeping C) Loose bedding D) Bed sharing E) Supine sleeping
A, B, C, D A) Significant stressors contributing to SIDS are prone or side sleeping, loose bedding, and bed sharing. Infants in the prone or side-lying positions are vulnerable because the brainstem abnormality compromises their protective reflexes, such as arousal and head turning, when experiencing asphyxia. Supine sleeping is a method to decrease the risk for SIDS. B) Significant stressors contributing to SIDS are prone or side sleeping, loose bedding, and bed sharing. Infants in the prone or side-lying positions are vulnerable because the brainstem abnormality compromises their protective reflexes, such as arousal and head turning, when experiencing asphyxia. Supine sleeping is a method to decrease the risk for SIDS. C) Significant stressors contributing to SIDS are prone or side sleeping, loose bedding, and bed sharing. Infants in the prone or side-lying positions are vulnerable because the brainstem abnormality compromises their protective reflexes, such as arousal and head turning, when experiencing asphyxia. Supine sleeping is a method to decrease the risk for SIDS. D) Significant stressors contributing to SIDS are prone or side sleeping, loose bedding, and bed sharing. Infants in the prone or side-lying positions are vulnerable because the brainstem abnormality compromises their protective reflexes, such as arousal and head turning, when experiencing asphyxia. Supine sleeping is a method to decrease the risk for SIDS.
When assessing the risk of a newborn for sudden infant death syndrome (SIDS), which are risk factors that the nurse should consider? Select all that apply. A) Race B) Gender C) Father's age D) Age E) Eye color
A, B, D A) SIDS is most common in American Indians and Alaska Natives, followed by non-Hispanic Blacks, non-Hispanic Whites, Hispanics, and Asian or Pacific Islanders. It is more common in males than in females. SIDS is most common in infants under 6 months of age. Father's age and infant eye color are not related to the risk of SIDS. B) SIDS is most common in American Indians and Alaska Natives, followed by non-Hispanic Blacks, non-Hispanic Whites, Hispanics, and Asian or Pacific Islanders. It is more common in males than in females. SIDS is most common in infants under 6 months of age. Father's age and infant eye color are not related to the risk of SIDS. D) SIDS is most common in American Indians and Alaska Natives, followed by non-Hispanic Blacks, non-Hispanic Whites, Hispanics, and Asian or Pacific Islanders. It is more common in males than in females. SIDS is most common in infants under 6 months of age. Father's age and infant eye color are not related to the risk of SIDS.
The pediatric nurse is providing education to a new mother regarding ways to decrease the risk of sudden infant death syndrome (SIDS). Which statement by the nurse is appropriate? A) "You should keep the baby with you at all times to assess for apnea." B) "Make sure the baby has a soft blanket and pillow when sleeping." C) "It is recommended that you place your baby on his back for sleep." D) "SIDS has been linked to immunizations. I recommend that you avoid immunizing your baby."
C A side-lying or prone position increases the infant's risk of SIDS, so the mother should be taught to always place the baby on his back for sleep. Soft pillows and blankets also increase the risk for SIDS, so they should not be used. Keeping the infant with the mother at all times is unreasonable and will not prevent SIDS. Immunizations have no known link to SIDS.
Sudden infant death syndrome is diagnosed A) when an autopsy reveals a brainstem defect. B) when an infant dies after being shaken violently. C) when an autopsy fails to find a cause of death. D) when an infant is found dead in their crib.
C SIDS is only diagnosed after a review of the child's clinical history, an examination of the scene of death, and an autopsy that fails to find a cause of death. Infants who die after being shaken violently have shaken baby syndrome, not SIDS. An infant found dead in their crib may have died from other causes rather than SIDS. Although a brainstem defect related to respiratory and autonomic responses must be present, this is not usually found through autopsy.
The nurse is providing supportive care for the parents of an infant who died from sudden infant death syndrome (SIDS). Which action by the nurse is appropriate? A) Advising the parents that an autopsy is not necessary B) Refraining from recommending support groups until after the investigation C) Interviewing the parents to determine the cause of the SIDS incident D) Contacting the family's spiritual leader for support
D The family will need emotional support during this time, including support from the family's spiritual leader and support groups for parents who have lost children. This support should not be delayed for the investigation. An autopsy will be necessary, and interviews to determine the cause of death will be the responsibility of the medical examiner and law enforcement agents, not the nurse.
The nurse is planning care for a new mother who smoked during the pregnancy and whose sister lost a child to sudden infant death syndrome (SIDS). Which interventions are appropriate for the nurse to include in the plan of care for the new mother and baby? Select all that apply. A) Information on bottle-feeding the infant B) Reasons why the child should sleep with others C) Ages at which the child should receive immunizations D) Using bedding that is firm E) Smoking cessation information
D, E D) The plan of care to decrease the child's risk of SIDS should include habits to lower the risk of SIDS, one of which is smoking cessation. The nurse should also instruct the mother to use bedding that is firm. The method of feeding is not associated with the syndrome; however, the risk is decreased with breastfeeding, not bottle feeding. While age-appropriate immunizations are important for the overall health of the baby, this intervention does not specifically reduce the risk for SIDS. Sleeping with others will increase the child's risk of the syndrome and should not be in the plan of care. E) The plan of care to decrease the child's risk of SIDS should include habits to lower the risk of SIDS, one of which is smoking cessation. The nurse should also instruct the mother to use bedding that is firm. The method of feeding is not associated with the syndrome; however, the risk is decreased with breastfeeding, not bottle feeding. While age-appropriate immunizations are important for the overall health of the baby, this intervention does not specifically reduce the risk for SIDS. Sleeping with others will increase the child's risk of the syndrome and should not be in the plan of care.
The nurse is instructing new parents on ways to decrease the risk of sudden infant death syndrome (SIDS) with their newborn son. What should be included in these instructions? Select all that apply. A) There is nothing that can be done, so requirements for toys and bedding are of no consequence. B) Instruct that it is more common in babies from ages 6 months to 18 months. C) Avoid placing the baby in the prone or side-lying position for sleep. D) Remind the parents that the syndrome is more common in females than males, and that they have a male child. E) Do not smoke near the child and reduce all exposure to secondhand smoke.
C, E C) The nurse should instruct the parents to not smoke and to reduce all exposure to secondhand smoke to reduce the child's risk of SIDS. Sleeping in the prone or side-lying position is a risk factor for the syndrome. Other risk factors for SIDS include being male, being under 6 months of age, having loose bedding and toys that could occlude the airway, and being exposed to smoke or having a mother who smoked during pregnancy. E) The nurse should instruct the parents to not smoke and to reduce all exposure to secondhand smoke to reduce the child's risk of SIDS. Sleeping in the prone or side-lying position is a risk factor for the syndrome. Other risk factors for SIDS include being male, being under 6 months of age, having loose bedding and toys that could occlude the airway, and being exposed to smoke or having a mother who smoked during pregnancy.