PNC III - Test 2 - SIDS

The nurse educating on sudden infant death syndrome gives which of the following explanations to parents regarding what this diagnosis means? A. "The sudden, unexplained death of infants less than 12 months old" B. "The sudden death of an infant caused by neglect" C. "The sudden, unexplained death of infants less than 6 months old" D. "The sudden death of an infant caused by suffocation in soft bedding"

A

What is disenfranchised grief?

Grief or mourning that persons experience when they incur a loss that is not or cannot be openly acknowledged, publicly mourned, or socially supported. Situations in which this occur often relate to a socially unacceptable loss that cannot be spoken about, such as suicide, abortion, or giving a child up for adoption.

What season is most common for SIDS?

Winter

Is it ok for the infant to use a pacifier when sleeping?

Yes

What race is more prone to SIDS?

Alaskans and Native Americans

What is anticipatory grief?

the experiencing of the grief process before the actual loss occurs

What are the high risk conditions for SIDS?

Prone position Use of soft bedding Sleeping in a non-infant bed (IE sofa) Overheating (thermal stress) Cosleeping Mother who smoked or used drugs during pregnancy Exposure to tobacco smoke after birth

At what age can you place a baby to sleep on their stomach?

1 year

What are Elizabeth Kubler-Ross's stages of grief?

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

What age is the most common for SIDS?

2-4 months old

What are the 3 types of loss?

3 types of Loss 1.Actual 2. Potential 3. Perceived

What are the 3 types of grief:

3 types of grief: 1. Anticipatory 2. Disenfranchised 3. Complicated/dysfunctional

Sudden infant death syndrome (SIDS) is one of the most common causes of death in infants. At what age is the diagnosis of SIDS most likely? A. At 1 to 2 years of age. B. At 1 week to 1 year of age, peaking at 2 to 4 months. C. At 6 months to 1 year of age, peaking at 10 months. D. At 6 to 8 weeks of age.

Answer: B. At 1 week to 1 year of age, peaking at 2 to 4 months. Options B: SIDS can occur anytime between 1 week and 1 year of age. Options A, C, D: The incidence peaks at 2 to 4 months of age.

What are the S&S of SIDS?

Apneic Cyanotic Lifeless Frothy blood tinged fluid in nose and mouth Diaper wet and full of stool Usually blankets over head.

An​ 8-week-old infant who is not breathing is brought to the emergency department and pronounced dead on arrival. A preliminary finding of sudden infant death syndrome​ (SIDS) is made. Which nursing intervention with the parents should be the priority​? A. Calling their priest B. Explaining SIDS C. Collecting the​ infant's belongings D. Allowing them to see the infant

B. The priority intervention would be to provide the parents with an explanation of SIDS.​ After, the parents need time with their infant to assist with the grieving process. Calling their priest and collecting the​ infant's belongings are also important steps in the plan of care but are not the priority.

Are girls or boys more likely to develop SIDS?

Boys

The parents of a newborn are concerned about placing their baby on it's back to sleep for fear of choking on spit up. The nurse addresses their concern by making which of the following statements? A. "I understand your concern, but you should be more worried about SIDS than choking" B. "I understand your concern. Perhaps you should place a pillow under their head to prevent choking" C. "I understand your concern. You can place them on their stomach if you want to" D. "I understand your concern, but research shows there is no increased risk for choking when placed on their back"

D

*What should the nurse educate the parents on in regards to SIDS?

Educate on positioning her baby and making sure all family members know that there should be no smoking in the house or around the baby, the baby should be placed on a firm surface, the baby should be in its own bed, the baby should not be too hot, and breast feeding is best for her baby.

What is EAP?

Employee assistance program. This provides mental health counseling access.

What are some myths that are the reasons for SIDS?

NOT CAUSED BY: •Same as suffocation •Caused by immunizations and vaccines •Result of neglect/abuse •Caused by cribs •Caused by vomiting/choking •Completely preventable

What ethnicity is at higher risk for SIDS?

Native Americans African Americans Hispanics Lower income

References:

Nursing: A Concept-Based Approach to Learning (Vol. 1 & 2). (3rd ed.). (2019). Pearson Education, Inc. RegisteredNurseRN.com. (n.d.). NCLEX Review. https://www.registerednursern.com/?s=NCLEX+review

Sudden infant death syndrome (SIDS) is confirmed by which of the following procedures? a) Autopsy b) Chest X-ray c) Skeletal survey d) Laboratory analysis

Rationale: (A) Autopsies reveal consistent pathological findings, such as pulmonary edema and intrathoracic hemorrhages that confirm the diagnosis of SIDS. Chest X-rays are used to diagnose respiratory complications. Skeletal surveys are used with cases of suspected child abuse. Laboratory analysis will show no characteristics to confirm the diagnosis of SIDS.

What resources could a nurse recommend to the family of an infant who died of SIDS in your community?

The nurse might recommend that the family connect with a grief counselor, chaplain, religious or spiritual leader, social worker, psychotherapist, support group, or local hospice organization.

What is positional plagiocephaly?

This is the flattening of the occipital area of the skull from being on their back a lot because the weight of the head flattens the occiput area.

What is the definition for SIDS?

Unexpected death of a healthy newboen younger than 1 year. No known reason.

What gender is more prone to SIDS?

boys

What should the nurse teach the parents to do to prevent SIDS?

•Interventions: "SAFE TO SLEEP" •Baby back to sleep •Firm/flat surface •Breastfeeding •No objects near baby •Keep baby cool •Tummy time when parents watch/observe infant

What are the RISK FACTORS for SIDS?

•The "S" factors: Sleep on stomach soft surface soft bedding covers exposure to smoke from cigarettes (during pregnancy and after birth) •Hot while sleep •Co-sleeping with parent •Male •2-4 months •Preterm •Racial groups • History of siblings with SIDS

Which of the following actions is NOT appropriate in the care of a 2-month-old infant? A. Place the infant on her back for naps and bedtime. B. Allow the infant to cry for 5 minutes before responding if she wakes during the night as she may fall back asleep. C. Talk to the infant frequently and make eye contact to encourage language development. D. Wait until at least 4 months to add infant cereals and strained fruits to the diet.

Answer: B. Allow the infant to cry for 5 minutes before responding if she wakes during the night as she may fall back asleep. Option B: Infants under 6 months may not be able to sleep for long periods because their stomachs are too small to hold adequate nourishment to take them through the night. Option A: Infants should always be placed on their backs to sleep. Research has shown a dramatic decrease in sudden infant death syndrome (SIDS) with back sleeping. Option C: Eye contact and verbal engagement with infants are important to language development. Option D: The best diet for infants under 4 months of age is breast milk or infant formula.

During a community visit, volunteer nurses teach stress management to the participants. The nurses will most likely advocate which belief as a method of coping with stressful life events? A. Avoidance of stress is an important goal for living. B. Control over one's response to stress is possible. C. Most people have no control over their level of stress. D. Significant others are important to provide care and concern.

Answer: B. Control over one's response to stress is possible. Options B: When learning to manage stress, clients find it helpful to believe that they have the ability to control their response to it. It is impossible to avoid stress, which is a normal life experience. Options A: Stress can be positive and growth-enhancing as well as harmful. Options C: The belief that one has some control is the significant factor in minimizing stress response. Options D: Significant others are a good source of support, but coping with the utmost self-dedication is the most helpful.

The nurse is caring for parents whose infant has died from sudden infant death syndrome​ (SIDS). Which nursing intervention is appropriate for the nurse to​ implement? (Select all that​ apply.) A. Offering to contact a grief counselor to help the parents B. Offering to contact the​ parents' other children to discuss the​ infant's death C. Calling the police to begin the death investigation D. Calling the hospital chaplain and requesting her presence immediately E. Calling the​ parents' church leader after a request from the parents

A, E The nurse who is implementing appropriate nursing interventions for a grieving couple may offer to contact a grief counselor to help the parents.​ Also, the nurse may call the​ parents' church leader after a request from the parents. Calling and requesting the immediate presence of the hospital chaplain is not culturally​ sensitive, because not all grieving clients would like this. The nurse is not responsible for calling the police to begin the death investigation following an​ infant's death from SIDS. The nurse should not contact the grieving​ parents' other children to discuss the​ infant's death.

A nurse is providing education to pregnant couples at a newborn basics class. Which of the following statements by one of the clients would require further teaching? A. "He needs to be placed on his back at night in the crib" B. "We got him a little stuffed bear for his crib and not a big one" C. "I am so glad my husband quit smoking" D. "This little guy is going to love his crib at night"

B

The nurse caring for a newborn is educating the parents on risk factors for sudden infant death syndrome. Which of the following should be included as risk factors? Select all that apply. Co-sleeping Maternal smoking Female gender Male gender Prone sleeping

A. B. D. E.

The nurse educating a group of parents on sudden infant death syndrome knows that which of the following are considered to be protective factors? Select all that apply. A. Dressing the baby warmly B. Using crib bumper pad C. Placing the baby on its back to sleep D. Placing the baby on their stomach to sleep E. Breastfeeding

A. C. E.

The nurse is involved in investigating the death of an infant in which sudden infant death syndrome​ (SIDS) is suspected. The nurse should expect the focus of the investigation to be on which​ factor? A. The​ infant's family B. Cause of the​ infant's death C. Who is to blame for the​ infant's death D. Parental behavior

B The focus of the investigation involves determining the cause of infant death. The investigation does not focus on parental behavior or blame for the​ infant's death. The investigation does involve the​ infant's family.

* What are the nursing interventions after a newborn has passed away from SIDS?

1. Allow expression of feelings. The immediate reaction of the staff should be to allow the family to express their grief, encouraging them to say goodbye to their infant, and providing a quiet, private place for them to do so. 2. Appropriate referrals. Referrals should be made to the local chapter of the National SIDS Foundation immediately; Sudden Infant Death Alliance is another resource for help. 3. Encourage use of community resources. In some states, specially trained community health nurses who are knowledgeable about SIDS are available; these nurses are prepared to help families and can provide written materials, as well as information, guidance, and support in the family's home. 4. Monitoring subsequent infants. Caregivers are particularly concerned about subsequent infants; recent studies have indicated that the risk for these infants for the first few months of life to help reduce the family's stress; monitoring is usually maintained until the new infant is past the age of the SIDS infant's death.

How would the nurse suggest to tell a 10-year-old sibling what has happened?

A 10-year-old understands the concept of death and he/she can be told the reality of what happened.

The parents of an infant who has died of SIDS ask the emergency department nurse for ideas on how they can tell the 2-year-old sibling that the baby has died. How would the nurse's suggestions differ if the family asks for ideas for how to tell a 10-year-old sibling what has happened?

A 10-year-old understands the concept of death and he/she can be told the reality of what happened.

What is complicated/dysfunctional grief?

A form of grief in which the individual's strategies to cope with the loss are maladaptive. The disorder may be said to exist if the preoccupation lasts for more than 6 months and leads to a reduced ability to function formally.

The nurse is caring for parents who are grieving over the death of their infant who is suspected to have died of sudden infant death syndrome​ (SIDS). Which response by the nurse is​ therapeutic? (Select all that​ apply.) A. ​"The infant loss support group meets every​ Tuesday." B. ​"I am sorry you are going through this. Would you like to talk to me about your​ child?" C. ​"I will provide you with a list of local grief​ counselors." D. ​"Is there a pastor or clergy member you would like me to​ call?" E. ​"Which funeral home would you like me to​ contact?"

A, B, C, D The nurse who is supporting the​ couple's psychosocial needs and providing the couple with collaborative therapy resources will assist the family in contacting the​ family's pastor or clergy​ member, provide the family with resources on grief counselors and support​ groups, and provide empathy toward the​ infant's family. Asking the family about funeral homes is not​ supportive, and the family may not be ready to discuss this.

The nurse providing care for a client suspected to have a diagnosis of sudden infant death syndrome knows which of the following statements would be most appropriate to make when speaking with the parents? A. "Was your baby wrapped in a lot of blankets? B. "Why did you wait so long to check on your baby?" C. "Was your baby born prematurely?" D. "Could you not hear your baby crying?"

C

The nurse teaches the mother of a newborn that in order to prevent sudden infant death syndrome (SIDS) the best position to place the baby after nursing is (select all that apply): A. Prone. B. Side-lying. C. Supine. D. Fowler's.

C

A mother called 911 after finding her​ 2-month-old son unresponsive. The infant was brought to the emergency department and pronounced dead with the preliminary findings of sudden infant death syndrome​ (SIDS). Which type of questions should the nurse ask the​ parents? A. Insurance coverage questions B. Health history questions about the father C. Investigative questions D. Personal questions

C The nurse needs to ask investigative and​ open-ended questions to determine the cause and manner of the​ infant's death. Personal questions and insurance coverage questions are not the priority. Health history questions are asked about the infant and the pregnancy history of the mother but not about the father.

***Sudden infant death syndrome​ (SIDS) is called a syndrome because it does not identify any disease as a cause of death. Which factors can lead to the sudden death of an​ infant? A. Abnormality to milk​ intake, vulnerability to​ stimulus, and developmental age after the age of 1 B. Abnormality of vital​ signs, vulnerability to​ stimulus, and critical developmental period of 10 to 12 months of life C. Abnormality to autonomic​ responses, stressors, and critical developmental period of 1 to 6 months of life D. Abnormality of vital​ signs, vulnerability to​ stimulus, and developmental age of 1 year old

C Three factors that occur simultaneously may lead to SIDS.​ First, the infant must have​ vulnerability, an abnormality in the​ brainstem, which controls respiratory and autonomic responses to stressors during sleep.​ Second, significant stressors that contribute to SIDS must be​ present, such as​ side-lying or prone​ (face-down) sleeping, and bed sharing with smoking parents. When infants are in the prone or​ side-lying position, the brainstem abnormality compromises their protective​ reflexes, such as arousal and head​ turning, against asphyxia.​ Third, infants must be in a critical developmental period within the first 6 months of life.

The nurse is caring for a couple whose infant has died of suspected sudden infant death syndrome​ (SIDS). When asking the couple about the circumstances surrounding the​ infant's death, which factor should the nurse focus​ on? (Select all that​ apply.) A. Health of the parents B. History of infant reflux C. History of the​ infant's congenital heart defects D. ​Infant's dietary intake E. Health of the infant

C, D, E Interviews of the family should focus on determining the circumstances surrounding the​ infant's deathQuestions should center on the health of the​ infant, dietary​ intake, and history of congenital birth defects

Which of the following children has an increased risk of sudden infant death syndrome (SIDS) a) Premature infant with low birth weight b) A healthy 2-year-old c) Infant hospitalized for fever d) Firstborn child.

Rationale: (A) Premature infants, especially those with low birth weight, have an increased risk for SIDS. Hospitalization for fever is insignificant. Infants with apnea, central nervous system disorders, or respiratory disorders have a higher risk of SIDS. Peak age for SIDS is 2 to 4 months. There's an increase risk for SIDS in subsequent siblings of two or more SIDS victims.

The nurse is teaching a family with a newborn about infant safety during sleep. What information is the most important for the family to understand? a) The infant should be placed on his back to sleep b) Small pillows should be used to support the infant c) The infant should be covered loosely with a blanket d) A stuffed animal may be placed in the crib for comfort

Rationale: (A) Research has demonstrated that placing an infant on hi back to sleep reduces the incidence of sudden infant death syndrome (SIDS). To decrease the risk of suffocation, pillows, stuffed animals, and loose blankets should be placed in the crib with the infant.

When communication with the grieving family after a death from sudden infant death syndrome (SIDS), the nurse should: a) Instruct the parents to place other infants on their backs to sleep b) Stress that the death isn't the parent's fault c) Stress that an autopsy must be done to confirm diagnosis d) Stress that the parents are still young and can have more children

Rationale: (B) It's important for the nurse to stress that death from SIDS isn't predictable or preventable and that it isn't the parents' fault. Although it's important to inform the parents that an autopsy is necessary, that's secondary. Instructing the parents to place other infants on their backs to sleep implies that the parents did something wrong to cause the infant's death. Stressing that the parents are still young and can have other children minimizes their grief.

Which of the following client histories is most consistent with the diagnosis of sudden infant death syndrome (SIDS)? a) The child was physically abused in the past b) The infant had a history of many medical problems c) The infant was healthy and was found shortly after being put down to sleep d) The infant was described as lethargic, irritable, and feeding poorly before being put down to sleep

Rationale: (C) Children who are diagnosed with SIDS are typically described as healthy with no previous medical problems. They are usually found dead sometime after being put down to sleep. Depending on how long the infant has been dead, the infant may have a mottled complexion with extreme cyanosis of the lips, fingertips, or pooling of blood in the legs and feet that may be mistaken for bruising.

Which of the following definitions best describe the etiology of sudden infant death syndrome (SIDS)? a) Cardiac arrhythmias b) Apnea of prematurity c) Unexplained death of an infant d) Apparent life-threatening event

Rationale: (C) SIDS can best be defined as the sudden death of an infant under age 1 that remains unexplained after autopsy. Apnea of prematurity occurs in infants less then 32 weeks' gestation who have periodic breathing lapses for 20 seconds or more. Apparent life-threatening events usually have some combination of apnea, color change, marked in muscle tone, choking, or gagging.

A 6-week-old infant is brought to the emergency department no breathing. A preliminary finding of sudden infant death syndrome (SIDS) is made to the parents. Which of the following interventions should the nurse take initially? a) Call their spiritual advisor b) Explain the etiology of SIDS c) Allow them to see their infant d) Collect the infant's belongings and give them to the parents

Rationale: (C) The parents need time with their infant to assist with the grieving process. Calling their pastor and collection the infant's belongings are also important steps in the plan of care but aren't priorities. The parents will be too upset to understand an explanation of SIDS at this time.

An infant is brought to the emergency department (ED) and pronounced dead with the preliminary finding of sudden infant death syndrome (SIDS). Which question to the parents is appropriate? a) Did you hear the infant cry out? b) Was the infant's head buried in a blanket? c) Were any of the siblings jealous of the new baby? d) How did the infant look when you found him?

Rationale: (D) Only factual questions should be asked during the initial history in the emergency department. The other questions imply blame, guilt, or neglect.

Which of the following risk factors is related to sudden infant death syndrome (SIDS)? a) Feeding habits b) Gestational age of 42 weeks c) Immunizations d) Low birth weight

Rationale: (D) Prematurity, low birth weight, and multiple births are important risk factors associated with SIDS. Immunizations have been disapproved to be associated with the disorder. Feeding habits and gestational age of 42 weeks aren't significant.

*What is a nursing diagnosis related to SIDS?

Risk for SIDS due to family history, Knowledge deficit related to risk factors associated with SIDS, and Enhanced parenting related to preventative measures associated with SIDS.

What are some preventative measures?

Sleep on back Breastfeeding reduces risk Sleeping with a pacifier

Are the newborns sleeping or awake when they pass from SIDS?

Sleeping

How can the nurse help the family respond to a sibling's response to loss?

The nurse can help the family cope with a sibling's response to loss by providing the parents with information about the potential reactions of siblings based on each sibling's developmental stage. For example, older children may need reassurance that SIDS will not happen to them. They may also require reassurance that negative thoughts or feelings about their baby brother or sister did not cause the infant's death. The nurse also can assist the parents with locating a support group that serves children who have lost a sibling to SIDS.

How would the nurse suggest to tell a 2-year-old sibling what has happened?

The nurse might suggest telling the 2-year-old that the baby was very sick and couldn't get better. A 2-year-old has no concept of death.

The parents of an infant who has died of SIDS ask the emergency department nurse for ideas on how they can tell the 2-year-old sibling that the baby has died. Based on the typical developmental stages of a 2-year-old's language, what suggestions might the nurse make?

The nurse might suggest telling the 2-year-old that the baby was very sick and couldn't get better. A 2-year-old has no concept of death.

What coping strategies might you suggest to a mother to help her reduce her anxiety related to a reoccurrence of SIDS with her new daughter?

The nurse will help support the mother in her anxiety by focusing on prevention, providing referrals to support groups, encouraging breast feeding, and making sure the baby is always placed on its back.

What strategies might the nurse suggest to help the family of an infant who died from SIDS who are displaying unhealthy coping strategies?

The nurse would suggest that this family see their primary doctor for a referral for psychiatric assistance. They may need some psychiatric help to prevent them from getting any sicker.

What does supine mean?

lying on the back

*What nursing interventions will be in place for a parent that has lost a child from SIDS and they are wanting to have another baby.

support the mother in her anxiety by focusing on prevention, providing referrals to support groups, encouraging breast feeding, and making sure the baby is always placed on its back.

A nurse is discharging a mother and baby to home and providing education on sudden infant death syndrome (SIDS). The nurse knows that the parents need more education when they make which of the following statements? A. "We got him a puppy to grow up with, it's going to be the cutest pictures and they are going to be best friends" B. "We need to make sure the baby is sleeping on his back at night" C. "I cannot wait to take this little guy home and snuggle with him all night in bed" D. "I'm bummed that I have to take out all the stuffed animals from his crib"

C.

The nurse is assessing a mother's understanding of SIDS prevention and knows that teaching has been successful when which of the following statements are made? Select all that apply. A. "We need to place pillows around him to keep him laying on his back at night" B. "We have soft bumpers to keep his legs from getting stuck" C. "I'm bummed that I have to take out all the stuffed animals from his crib" D. "There won't be anyone who smokes around our peanut" E. "This little guy is going to love his crib at night"

C. D. E.

What interventions can the nurse implement to help a family who has lost an infant because of SIDS?

In the aftermath of the infant's death, the nurse should gently encourage the parents to seek help and support. To promote this process, the nurse may offer to facilitate referrals to sources of support (such as support groups, social workers, and community resources). The nurse also may contact the family at appropriate intervals to express continued support.