Sudden Infant Death Syndrome (SIDS)
When communicating with the grieving family of an infant who has just died from SIDS, which information should the nurse include? A) Instructing the parents to place future infants on their backs to sleep B) Stressing that the death isn't the parents' fault C) Stressing that nothing can be done to confirm the diagnosis D) Reminding the parents that they are still young and can have more children
B) Stressing that the death isn't the parents' fault Rationale: It is important for the nurse to stress that death from SIDS isn't predictable or preventable and that it isn't the parents' fault. Reassure the parents that they are not responsible for the infant's death. For families with multiple children, it may also be necessary to reassure older children that they are not in danger of SIDS. Instructing the parents about future children is not therapeutic at this time.
The nurse is caring for parents whose infant has died from SIDS. Which nursing intervention is appropriate for the nurse to implement? SATA A) Calling the police to begin the death investigation B) Calling the parent's church leader after a request from the parents C) Offering to contact a grief counselor to help the parents D) Offering to contact the parents' other children to discuss the infant's death E) Calling the hospital chaplain and requesting her presence immediately
B, C Rationale: 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.
The nurse includes information in a presentation that SIDS remains unexplained after other possible causes have been ruled out. The nurse understands that which procedure is used to rule out the possible causes of SIDS? A) Chest x-ray B) Genetic mapping C) Autopsy D) Lab analysis
C) Autopsy Rationale: Sudden infant death syndrome (SIDS) is the sudden death of an apparently healthy infant that remains unexplained after other possible causes have been ruled out through autopsy, death scene investigation, and review of the medical history. Lab analysis, chest x-ray, and genetic mapping are not used to rule out the possible causes of an infant death due to SIDS.
The nurse is caring for a couple whose infant has died of suspected SIDS. When asking the couple about the circumstances surrounding the infant's death, which factor should the nurse focus on? SATA A) Health of the parents B) Infant's dietary intake C) History of the infant's congenital birth defects D) History of infant reflux E) Health of the infant
B, C, E Rationale: Interviews of the family should focus on determining the circumstances surrounding the infant's death. Questions should center on the health of the infant, dietary intake, and history of congenital birth defects. The health of the parents and history of infant reflux do not help to determine the circumstances surrounding the infant's death, as these factors have not been linked to causing SIDS-related deaths.
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 of vital signs, vulnerability to stimulus, and critical developmental period of 10 to 12 months of life. B) Abnormality of vital signs, vulnerability to stimulus, and developmental age of 1 year old. C) Abnormality to autonomic responses, stressors, and critical developmental period of 1 to 6 months of life. D) Abnormality to milk intake, vulnerability to stimulus, and developmental age after the age of 1.
C) Abnormality to autonomic responses, stressors, and critical developmental period of 1 to 6 months of life. Rationale: 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.
A mother called 911 after finding her 2-month-old son unresponsive. The infant was brought to the ED and pronounced dead with the preliminary findings of 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) Investigative questions Rationale: 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.
The nurse is caring for parents who are grieving over the death of their infant who is suspected to have died of SIDS. Which response by the nurse is therapeutic? SATA A) "the infant loss support group meets every Tuesday." B) "I'm 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 Rationale: 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 is performing a health history for assessment for SIDS. The nurse should focus on which area? SATA A) Sleep patterns B) Family history of SIDS C) Breathing patterns D) Maternal history of miscarriage E) Exposure to smoke
A, B, C, E Rationale Nursing assessment for health history should include family history of SIDS, breathing patterns, sleep patterns, and exposure to smoke. Maternal history of miscarriage is not identified as a causative factor in the development of SIDS.
The nursing instructor asks a nursing student about SIDS. Which statement by the student indicates further teaching is needed? A) "Some of the interventions that are used to prevent SIDS include having infants sleep in the supine position." B) The incidence of SIDS has been found to be higher in breastfed infants and infants that use a pacifier." C) "Infants exposed to cigarette smoking during pregnancy and after birth are considered at risk for SIDS." D) "SIDS refers to Sudden Infant Death Syndrome that can occur in healthy infants under 1 year of age, and no exact cause is known."
B) "The incidence of SIDS has been found to be higher in breastfed infants and infants that use a pacifier." Rationale: The incidence of SIDS has been found to be lower in breastfed infants and infants who sleep with a pacifier.
The nurse is involved in investigating the death of an infant in which SIDS is suspected. The nurse should expect the focus of the investigation to be on which factor? A) Parental behavior B) The infant's family C) Who is to blame for the infant's death D) Cause of the infant's death
D) Cause of the infant's death Rationale: 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.
The nurse is giving discharge instructions regarding positioning for the client's newborn for sleeping. Which statement should the nurse include? A) "Always place your child on its back position while sleeping." B) "Always place your child in a fetal position while sleeping." C) "Always place your child in a side-lying position while sleeping." D) "Always place your child on its tummy while sleeping."
A) "Always place your child on its back position while sleeping." Rationale: Infants should always be placed on their back, or supine position, for sleeping until 1 year of age. Infants placed prone (face-down) while sleeping are at greatest risk for sudden infant death syndrome (SIDS). The side-lying, or fetal, position also increases the risk for SIDS.
An 8-week-old infant who is not breathing is brought to the ER and pronounced dead on arrival. A preliminary finding of SIDS is made. Which nursing intervention with the parents should be a priority? A) Collecting the infant's belongings B) Allowing them to see the infant C) Calling their priest D) Explaining SIDS
D) Explaining SIDS Rationale: 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.
A UAP is providing care for a 1 month old infant. Which observation by the nurse of the UAP requires immediate follow-up? A) Placing a stuffed animal in the crib B) Swaddling the infant C) Offering a pacifier D) Placing the infant in supine position
A) Placing a stuffed animal in the crib Rationale: The American Academy of Pediatrics recommends that no soft objects be placed in the infant's sleep area. This includes pillows, soft toys, quilts, comforters, sheepskins, crib bumpers, or loose bedding such as blankets. A pacifier may, or should be offered at bedtime or naps, but there is no need to replace it if it falls out. An infant can be swaddled at this age. Infants should always be placed on their backs for sleeping until 1 year of age
A new parent expresses concern to the nurse regarding sudden infant death syndrome. She asks the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place the infant? A) Side or prone B) Back or prone C) Stomach with face turned D) Back rather than on stomach
D) Back rather than on stomach Rationale: SIDS is the unexpected death of an apparently healthy infant younger than 1 year for whom an investigation of the death and a thorough autopsy fail to show an adequate cause of death. Several theories are proposed regarding the cause, but the exact cause is unknown. Nurses should encourage parents to place the infant on the back (supine) for sleep. Infants in the prone position (on the stomach) may be unable to move their heads to the side, increasing the risk of suffocation. The infant may have the ability to turn to a prone from the side-lying position.
The mother of a 2-month-old infant breastfeeds and thinks that it is easier to have her infant sleep with her. Which factor places the infant at an increased risk for SIDS? A) Lack of sleep B) Increased bonding C) Improper breastfeeding D) Infant suffocation
D) Infant suffocation Rationale: Concerns have been raised about the association of bed sharing, SIDS, and infant suffocation. Lack of sleep, increased bonding, and being unable to properly breastfeed are not among the risk factors associated with SIDS while sharing a bed with an infant.
Which factor should the nurse recognize as contributing to the prevention of SIDS? SATA A) Traditions and cultures B) Statistics C) Education of professionals D) Effectiveness of interventions E) Appropriate coping mechanisms of grief
A, C, D Rationale: All members of the healthcare team must work together to promote safety for infants to reduce the occurrence of SIDS. It is also important to include the expectant and new parents as well as the caregivers for the infant. Health and prevention should be focused on the effectiveness of interventions, the education of professionals, and utilizing traditions and cultures. Focusing on statistics or on appropriate coping mechanisms of grief is not of utmost importance when trying to educate and prevent the occurrence of SIDS.
The nurse is presenting on the prevention of SIDS. Which protective behavior should the nurse include? SATA A) Neutral ambient room temperature B) Breastfeeding C) Prone positioning D) Use of a pacifier while sleeping E) Use of sleeper pajamas
A, B, D, E Rationale: Protective behaviors for SIDS include supine, not prone, positioning. Use of a pacifier while sleeping, use of sleeper pajamas, breastfeeding, and neutral ambient temperature are all protective behavior for SIDS.
The nurse is teaching a pregnant client regarding the risk factors related to SIDS. Which statement by the nurse is appropriate? SATA A) "If your family has a history of SIDS, the risk for SIDS increases." B) "If your chid is exposed to smoke in the home, the risk for SIDS increases." C) "If your child is born premature, the risk for SIDS increases." D) "If your child shares your bed during sleep, the risk for SIDS increases." E) "If your child is a girl, the risk for SIDS increases."
A, B, C, D Rationale: Factors that increase the risk of SIDS include infant prematurity, infant exposure to smoke, co-sleeping, and a family history of SIDS. The incidence of SIDS-related deaths is greater among boys than among girls.
The nurse is giving discharge instructions to new parents. Which instruction should be provided to promote prevention of SIDS? SATA A) Teach about reducing risk factors for SIDS B) Provide support for smoking cessation C) Promote a safe sleep environment D) Encourage the use of formula E) Collaborate with the family to create goals
A, B, C, E Rationale: Actions that support the nurse's plan of care for the goal of preventing SIDS include providing support for smoking cessation, collaborating with family to create goals, teaching about reducing risk factors for SIDS, promoting a safe sleep environment, and encouraging breastfeeding.
The nurse is teaching a pregnant client about the prevention of SIDS. Which information should the nurse include? SATA A) Place your baby on its back to sleep B) Breastfeed your baby if possible C) Don't tuck loose blankets under your baby's shoulders during sleep D) Share a room with your baby for the first 6 months E) It is best to co-sleep with your baby
A, B, D Rationale: When implementing teaching for the prevention of SIDS, the nurse should include the importance of breastfeeding, sharing a room with the baby, and placing the infant on its back to sleep. Co-sleeping increases the risk of SIDS, as does having loose blankets in the crib, and therefore comprise inappropriate information by the nurse.
The prenatal nurse is giving an informational presentation to expectant parents and includes the topic of SIDS. Which information should the nurse include? SATA A) It is unexpected B) It can occur with co-sleeping infants C) Exposure to smoke is not a factor D) It can occur in high-birth-weight infants E) It is unpredictable
A, B, E Rationale: Sudden infant death syndrome (SIDS) is the sudden death of an apparently healthy infant that remains unexplained. At present, SIDS is unpredictable, and it is impossible to prevent in some cases. Exposure to smoke is a great risk factor, and co-sleeping with infants does pose a risk, but sharing a room with parents does not. SIDS is a risk factor for infants who are preterm and with low birth weight and not necessarily for high-birth-weight infants
