Walkthrough: Health Promotion and Maintenance Q8 – NCLEX-RN®

00:01 An infant client is receiving phototherapy while in the parent's room.

00:05 Upon entering the client's room, which action by the nurse is performed? Okay, let's break it down. I've got an infant client, they're getting phototherapy, now, that's a treatment, can you picture what that looks like in your mind? Okay, good. Now, they're getting a phototherapy in the parent's room.

00:25 Last sentence, which is also the second sentence, upon entering the client's room, which action by the nurse is performed? Alright, so if I put this into my own words, like we always do, what's appropriate for me to do for an infant receiving phototherapy? Select all that apply.

00:46 Okay, put it in your own words. This one's pretty short and direct.

00:51 Put it in your own words, pause the video, then think through the answer choices.

00:57 You're going to see five of them. Remember the strategy, write down 1, 2, 3, 4, and 5, just the numbers, not the full words of the answer choice.

01:07 This is a strategy you can take with you to NCLEX.

01:11 Now in your nursing program, they may or may not give you a scratch piece of paper, but for sure, you'll have a write on-wipe off board during your NCLEX exam.

01:20 So go ahead, don't be shy.

01:21 This is a strategy you can use when you're studying and for sure, on the NCLEX exam.

01:26 Write those numbers down, pause the video, then ask yourself this question, the topic that you put into your own words, five separate times. Treat it as a yes/no or true/false answer.

01:47 Hi! Welcome back. Good job doing the work of answering this question on your own.

01:54 Now let's walk through it together.

01:56 We know that this baby has hyperbilirubinemia, right, that's why they're receiving phototherapy.

02:03 So, is it appropriate for a baby on phototherapy to, for the nurse to put a t-shirt on the newborn underneath the bili blanket? No, that's not appropriate so that one should be crossed-off.

02:19 Now, remember, when a baby has a hyper, that means high, bilirubin that's bilirubin, -emia in the blood, that means this little guy has a really high blood bilirubin level.

02:34 Just cause their liver can't handle what's going on in their body, so one way to help this baby process this extra bilirubin, is to use a phototherapy light.

02:44 Now a bili blanket, usually goes right around their middle on their little tummies and it helps them process.

02:50 That light, will help the baby's body process that extra bilirubin.

02:56 So if the nurse put a t-shirt on the newborn, that's going to cover the abdomen.

03:01 You don't want anything in between the light and the baby's skin, so you would not want to put a t-shirt on this newborn.

03:10 Let's look at number 2. Turn the infant from a supine to a prone position.

03:15 Is this appropriate or safe for a nurse to do this with a newborn receiving phototherapy? Okay, so first we have to look at what does this answer choice really mean.

03:24 Does turning the infant from supine, that's a position, right? So supine is on your back and do I return them from supine to prone, which is laying on your stomach.

03:38 Okay, what would that do for an infant, to take it from lying on their back to lying on their stomach? Whoa, remember, back to sleep.

03:48 That's a huge campaign that infants are supposed to stay on their back, so, no.

03:53 This is out. We don't do this in the hospital, we're not encouraged anyone to do this, to take an infant from lying on their back, supine, to making them lie on their stomach or prone. Remember, back to sleep for infants.

04:08 Let's look at number 3. Is it appropriate for the nurse for a newborn getting phototherapy to replace the eye shield due do getting it wet? Yes, we don't want an infant with an eye shield on that is wet, so it would be appropriate for the nurse to replace that.

04:26 Number 4. Allow breast feeding for 30 minutes.

04:31 No, no. We don't want, of course. This is okay.

04:35 So on number 4, yes, we will allow breastfeeding for 30 minutes, so the baby can be outside of the light 30 minutes every three hours or so.

04:46 So, you're going to want to have this decision ultimately has to be made with the healthcare provider and looking at the lab work of the baby.

04:55 So is it okay to allow breastfeeding for 30 minutes? Yes. The healthcare provider will decide how often that can be done and how often the mom is going to need to pump.

05:06 So, 1 and 2, they're out; 3 and 4, those are appropriate.

05:14 Now, let's look at 5. Is it safe or correct for a nurse to check this newborn getting phototherapy for a soiled diaper? Yes or no? Yes, that's always appropriate.

05:29 Just because the baby is receiving phototherapy, doesn't mean the other bodily functions stop.

05:35 In fact, we want the baby to poop and keep things moving through their body to help bring that hyperbilirubinemia down.

05:44 There you go. Out of the five options, we selected three.

05:49 But, you know, the last step before you go on is you always check and see, does this make sense? Does it make sense that it's not safe to put a t-shirt on the newborn? Right. Cross that off. Does it make sense that it is not a good idea to turn the infant from supine to prone? Right, I got rid of that. Does it make sense to replace a wet eye-shield? Yes, I'm going to do that. Does it make sense for the nurse to allow breastfeeding for 30 minutes? Yes, I'm going to allow that.

06:15 And does it make sense for the nurse to check and see if the baby has a soiled diaper? Yes. I'm confident in my answers, I'm going to let it go.

06:25 Click the submit button and move on to the next question.