Ob/Peds 29
The mother of a 4-month-old infant is concerned that the baby does not always want to take a bottle. What should the nurse instruct the mother about feeding the baby? A) Ensure the environment is quiet during mealtime. B) Happy and healthy babies do not always eat well. C) Force the infant to take a bottle when it is time to do so. D) Refusing a bottle means the child is ill and needs to be seen by the health care provider.
A) Ensure the environment is quiet during mealtime. If infants are fatigued or overstimulated, they also may not eat well. Providing a quiet environment away from distractions before mealtime might be the solution to this problem. Healthy happy babies will be hungry at mealtime and will eat. The mother should not force the baby to take a bottle when it is time to do so. Refusing a bottle may mean that the baby is tired, distracted, or ill. The baby does not always need to be seen by a health care provider when a bottle is refused.
A new mother asks the nurse when toothbrushing should begin for the baby. Which response is the most appropriate for the nurse to make at this time? A) Now B) At the age of 12 months C) When solid food is eaten D) When the first tooth appears
A) Now Toothbrushing can begin even before teeth erupt by rubbing a soft washcloth over the gum pads. This eliminates plaque and reduces the presence of bacteria, creating a clean environment for the arrival of first teeth. Dental care should begin before the age of 12 months, before solid food is eaten, and before the first tooth appears.
What should the nurse instruct a parent to help a child complete Erikson's developmental task during the infant period? A) Respond to the child's needs consistently. B) Keep the child stimulated with many toys. C) Talk to the child at a special time each day. D) Expose the child to many caregivers to help learn variability.
A) Respond to the child's needs consistently. Consistently responding to an infant's needs helps to build a sense of trust, which is Erikson's developmental task during the infant period. Stimulation with toys, talking at a special time each day, and exposing to many caregivers will not help the child develop a sense of trust.
A new mother asks the nurse what she should look for when the baby starts to teethe. What should the nurse explain to the mother? A) The child's gum line will be tender. B) The child will have a high temperature. C) The child will not play or eat for 2 days. D) The child will be constipated for 2 days.
A) The child's gum line will be tender. Gums are sore and tender before a new tooth breaks the surface. As soon as the tooth is through, the tenderness passes. A high temperature is not a normal expectation with teething and should be reported to the health care provider. The child may resist chewing because of the sore gum; however, it may not last for 2 days. Playing may or may not be affected. Constipation is not an expectation with teething.
The nurse is planning an educational seminar for community members that focus on the 2020 National Health Goals to promote health during the infant year. What should the nurse include in this seminar? (Select all that apply.) A) Using infant car seats B) Placing infants on back to sleep C) Continuing breastfeeding for 6 months D) Introducing solid food by age 6 months E) Receiving immunizations after the age of 1
A) Using infant car seats B) Placing infants on back to sleep C) Continuing breastfeeding for 6 months Nurses can help the nation achieve the 2020 National Health Goals to promote health during the infant year by educating parents about the importance of using infant car seats, continuing exclusive breastfeeding for 6 months, and instigating measures to prevent SIDS such as placing infants to sleep on their backs. The introduction of solid food would occur after the age of 6 months. Immunizations are provided throughout the infant year.
The nurse is concerned that a 9-month-old baby is gaining too much weight. What should the nurse instruct the parents to help control the baby's weight gain? A) Use skim milk for feedings. B) Provide whole-grain cereal for one feeding. C) Provide one bottle a day of diluted gelatin mix. D) Feed the baby a serving of pudding once a day.
B) Provide whole-grain cereal for one feeding. A way to prevent obesity is to add a source of fiber such as whole-grain cereal to the infant's diet. This prolongs the stomach-emptying time and helps reduce food intake. Nonfat milk should not be given because it contains little essential fatty acids and will not ensure cell growth. The baby should not be given refined sugars such as diluted gelatin or pudding because this will encourage weight gain.
The nurse is visiting a mother who has a 3-month-old infant that has been hospitalized for cardiac problems. Which nursing diagnosis should the nurse use to guide care for this family at this time? A) Health-seeking behaviors related to adjusting to parenthood B) Risk for impaired parenting related to hospitalization of infant C) Disturbed maternal sleep pattern related to infant's feeding schedule D) Deficient knowledge related to normal infant growth and development
B) Risk for impaired parenting related to hospitalization of infant The diagnosis appropriate for the family whose infant has been hospitalized would be risk for impaired parenting related to hospitalization. There is no evidence to suggest that the mother is not adjusting to parenthood. There is no information about the infant's feeding schedule. There is no information to suggest the mother has a knowledge deficit regarding normal infant growth and development.
The nurse is assessing an infant who is being breastfed. Which observation regarding the infant's stools is expected? A) Fewer stools B) Stool will be soft. C) Stool will be hard. D) Stool will have a strong odor.
B) Stool will be soft. Stools of breastfed infants are generally softer than those of formula-fed infants. Stools of breastfed infants are not fewer in number, hard, nor have a strong odor.
The nurse is identifying outcomes for care provided to a new mother whose infant continues to spit up after feedings. Which outcome would be the most appropriate? A) The baby will have forceful episodes of vomitus only once a day. B) The baby will have less episodes of spitting up after sitting upright after a feeding. C) The baby will spit up a large amount of vomitus only after the last feeding of the day. D) The baby will have fewer episodes of spitting up when the type of formula is changed.
B) The baby will have less episodes of spitting up after sitting upright after a feeding. Sitting a baby in an infant chair for a half an hour after a feeding can help reduce spitting up. Forceful episodes of vomitus and vomiting large amounts after feedings should be reported to the health care provider. Changing the formula will not impact the amount of spitting up the baby.
The nurse is assessing a 2-month-old formula-fed infant who is experiencing colic. Which type of bowel movements should the nurse expect to occur with this health problem? A) Hard and lumpy B) Yellow and semisoft C) Foul smelling and bulky D) Loose and mucus-streaked
B) Yellow and semisoft With colic, bowel movements are normal. For an infant who is formula-fed this means the stool will be yellow and semisoft. Colic does not affect the type of bowel movement so changes in the stool such as hard and lumpy, foul smelling and bulky, and loose and mucus-streaked should be reported to the health care provider.
During an assessment, the nurse determines that a 3-month-old baby has a Moro reflex. What does this finding indicate to the nurse? A) It usually lasts until 9 months. B) It will persist until the age of 1 year. C) Most 3-month-olds still have a Moro reflex. D) If present at 3 months of age, a neurologic exam is needed.
C) Most 3-month-olds still have a Moro reflex. The Moro reflex will begin to fade at age 5 months and disappear by age 6 months. A Moro reflex at age 9 months or 1 year indicates the need for a neurologic examination.
The mother of a 3-month-old baby is concerned because the child is not able to sit independently. What should the nurse respond to this mother's concern? A) Most babies sit steadily at 3 months. B) Most babies sit steadily at 4 months. C) Most babies do not sit steadily until 8 months. D) Sitting ability and the age of first tooth eruption are correlated.
C) Most babies do not sit steadily until 8 months. An 8-month-old child can sit securely without any additional support. Babies are not able to sit steadily at age 3 or 4 months. Sitting ability does not correspond with tooth eruption.
The nurse observes a new mother provide a bath to her 9-month-old baby. Which observation indicates that the experience is positive for both mother and infant? A) The baby is crying and screaming. B) The baby is reaching for the mother. C) The baby is moving the arms and hand and smiling. D) The baby is trying to keep the legs from touching the water.
C) The baby is moving the arms and hand and smiling. Bath time should be fun for an infant and can serve many functions. Especially during the second half of the first year, a child enjoys poking at soap bubbles on the surface of the water or playing with bath toys. Bath time also helps an infant learn different textures and sensations and provides an opportunity to exercise and kick as well as a good opportunity for a parent to touch and communicate with the child. Crying, screaming, reaching for the mother, and trying to avoid touching the water indicates that the bath experience is not positive for the baby or the mother.
During a home visit, the nurse observes a 9-month-old child bang his head against the headboard of the crib at naptime. What should the nurse explain to the mother about this observation? A) The child is eating too much protein. B) The child is not getting enough to eat. C) This action is normal up until preschool age. D) The child needs to be seen immediately by a health care provider.
C) This action is normal up until preschool age. Head banging that begins during the second half of the first year of life and continuing through to the preschool period, associated with naptime or bedtime, and lasting under 15 minutes can be considered normal. Children use this measure to relax and fall asleep. Head banging does not mean that the child is eating too much protein or is not getting enough to eat. The child does not need to be seen immediately by a health care provider.
The nurse is visiting a mother who has a 3-month-old infant. Which anticipatory guidance information should the nurse provide to the mother at this time? A) The child will have a fear of strangers. B) The child will experience many moody periods. C) The child will expect things to be done a certain way. D) The child should be able to turn over onto the back at age 4 months.
D) The child should be able to turn over onto the back at age 4 months. Infants typically turn over from the front to back at age 4 months. Fear of strangers will not occur until 7 months. The nurse has no way of knowing the infant's temperament to determine that the child will be moody or when the child will expect things to be done a certain way.
