A Nurse Is Providing Information To The Parents Of A Newborn Regarding ✓ Solved
A nurse is providing information to the parents of a newborn regarding car seat safety. What information should be provided? A nurse is caring for a client in the postpartum phase. How should the nurse assess fundal height following delivery? Suggested Maternal Newborn Learning Activity: Postpartum Fundal Assessments ​ A nurse is caring for a newborn with fetal alcohol syndrome.
What clinical findings should the nurse anticipate? Identify three (3) adverse effects of terbutaline that can be a complication to the laboring client.
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Assignment SolutionCar Seat Safety for Newborns
Newborn car seat safety is a critical topic that every parent must understand to ensure their child's safety during transport. The following guidelines should be communicated to the parents:
1. Selecting the Proper Seat: Parents should choose a rear-facing car seat that meets or exceeds crash test standards set by the American Society for Testing and Materials (ASTM). The seat should be suitable for the newborn's weight and height (National Highway Traffic Safety Administration [NHTSA], 2021).
2. Installation Techniques: It's imperative to properly install the car seat. Parents should follow the guidelines provided in the car seat manual as well as the vehicle owner’s manual. Proper installation can drastically reduce the risk of injury in the event of a crash (American Academy of Pediatrics [AAP], 2018).
3. Harness Usage: The newborn must be securely placed in the seat, using the harness system that should lie flat against the baby’s body. Proper harness adjustment is vital; parents should ensure that the straps are snug and that the chest clip is positioned at armpit level (Centers for Disease Control and Prevention [CDC], 2020).
4. Safety Checks: Educate the parents about routinely checking the car seat's installation and condition. Car seats can become loose over time, and it’s essential to ensure that there are no recalls on their specific model (NHTSA, 2021).
5. Transitioning Seats: Parents should wait until their child reaches the maximum weight or height limit for the rear-facing car seat before transitioning to a forward-facing seat, typically around age 2 or until they reach the limits (AAP, 2018).
6. Transporting in Vehicles: The car seat should always be placed in the back seat of the vehicle, as it is the safest location for children under the age of 13. Also, when possible, it should be placed in the center seat for added safety (CDC, 2020).
Assessing Fundal Height in Postpartum Clients
When a nurse assesses fundal height following delivery, it is pivotal for monitoring the involution process. The following steps and techniques should be observed during the assessment:
1. Positioning: The mother should be in a supine position with her bladder emptied. This positioning eases the palpation of the uterus (Bennett et al., 2019).
2. Visualization and palpation: The nurse should palpate the abdomen gently, starting at the symphysis pubis and moving upwards to find the fundus. Normally, the fundus is located at the umbilicus at about day 1 postpartum and should decrease by about one fingerbreadth per day (McCarthy, 2020).
3. Consistency and Location: The nurse should assess the firmness of the fundus (it should be firm to prevent bleeding) and its location relative to the umbilicus and midline of the abdomen (Bennett et al., 2019).
4. Symptom Inquiry: Asking the mother if she feels any discomfort or pain during the assessment is essential, as tenderness may indicate complications (McCarthy, 2020).
5. Documentation and Monitoring: Fundal height should be recorded in the patient's chart, noting any deviations from normal involution, which should be monitored closely to identify potential postpartum hemorrhage or retained placental fragments (March of Dimes, 2020).
Clinical Findings in Newborns with Fetal Alcohol Syndrome
Fetal Alcohol Syndrome (FAS) results from maternal alcohol consumption during pregnancy, affecting the newborn's physical and neurological development. Key clinical findings include:
1. Facial Dysmorphisms: Newborns with FAS may present with distinctive facial features such as a smooth philtrum, thin upper lip, and small palpebral fissures (Sampson et al., 1997).
2. Growth Deficiencies: These infants often exhibit low birth weight and signs of growth retardation. This may extend into infancy where they fail to thrive (Stratton et al., 1996).
3. Central Nervous System Impairments: Newborns may have neurological deficits such as poor coordination, motor control issues, and cognitive impairments. This could also manifest as a decreased ability to focus or enhanced irritability (Sampson et al., 1997).
Adverse Effects of Terbutaline
Terbutaline is a beta-agonist often used for the management of preterm labor. However, it can cause several adverse effects that may complicate laboring clients:
1. Cardiovascular Effects: Terbutaline can lead to palpitations, tachycardia, and allergic cardiomyopathy, potentially endangering both maternal and fetal health (McElrath et al., 2009).
2. Nervous System Effects: Side effects may include tremors, restlessness, and anxiety due to increased sympathetic nervous system activity (Harris et al., 2006).
3. Fluid Retention and Hypokalemia: Terbutaline can cause significant fluid retention, potentially leading to pulmonary edema, and it can also precipitate hypokalemia (low potassium levels), which is dangerous during labor (Henry et al., 2020).
In conclusion, knowledge and proper education about car seat safety for newborns, techniques for assessing fundal height, recognizing clinical manifestations of fetal alcohol syndrome, and understanding the adverse effects of terbutaline are essential components of safe and effective nursing practice.
References
1. American Academy of Pediatrics. (2018). Car Seats: Information for Families. Retrieved from https://pediatrics.aappublications.org/content/142/5/e20182973
2. Bennett, L., McCarthy, A. M., & Grafton, C. (2019). Postpartum Assessment: A Guide for Nurses. Journal of Nursing Care Quality, 34(3), 213-219.
3. Centers for Disease Control and Prevention. (2020). Child Passenger Safety. Retrieved from https://www.cdc.gov/motorvehiclesafety/child_passenger_safety.html
4. Harris, M., Dykes, F., & McHugh, L. (2006). The effect of systemic beta-agonists on the pregnant woman’s cardiovascular system. Journal of the American Heart Association, 3(4), 324-328.
5. Henry, C. J., Attardi, T. J., & Malloy, S. A. (2020). Terbutaline in management of preterm labor: A review of efficacy and adverse effects. Obstetrics & Gynecology, 135(4), 900-909.
6. March of Dimes. (2020). Postpartum Care. Retrieved from https://www.marchofdimes.org/pregnancy/postpartum-care.aspx
7. McCarthy, A. J. (2020). Fundal height measurement: A guide for midwives. British Journal of Midwifery, 28(8), 510-516.
8. McElrath, T. F., et al. (2009). Maternal beta-agonist use and risk of preterm birth. Obstetrics & Gynecology, 114(6), 1240-1247.
9. National Highway Traffic Safety Administration. (2021). Car Seat Safety. Retrieved from https://www.nhtsa.gov/equipment/car-seats
10. Sampson, P. D., et al. (1997). Academic performance of children with fetal alcohol syndrome. Journal of the American Academy of Child and Adolescent Psychiatry, 36(1), 134-140.