Fundamentals · chapter 39 · Conception Through Adolescence
The Nurse’s Role in Preventing Illness
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 4 practice questions with the reasoning.
Key points
Nurses in contraception teaching
Although a midlevel provider, physician assistant, nurse practitioner, or physician is required to write a prescription for contraception, registered nurses play a key role in instructing patients how to use contraception.
Prenatal folic acid advice
The most important nutritional advice is to emphasize the importance of taking adequate folic acid throughout pregnancy.
Pregnancy warning signs
The pregnant person should be taught to seek medical attention for vaginal bleeding, persistent headaches, or unusual swelling in the hands or face. Vaginal bleeding is a sign of miscarriage, while persistent headaches and unusual swelling are associated with preeclampsia.
Supporting newborn bonding
Parents need to be supported through this process and be reassured that they are not bad parents if bonding takes longer than expected.
Newborn weight monitoring
Both breastfed infants and formula-fed newborns should have frequent weight checks to ensure that they are getting enough nutrition. Newborns should regain their birth weight by 2 weeks of age and then gain an average of 1.1 oz (30 g) per day (Desiraju, 2018).
Formula preparation safety
Parents need to be advised to follow the instructions to prepare the formula and to avoid leaving the formula at room temperature for more than two hours. Formula can be safely stored in the refrigerator for up to twenty-four hours.
Cow’s milk timing
At age 1 year, children can transition from breast milk or formula to cow’s milk. Cow’s milk should not be introduced before age 1 year because it does not provide balanced nutrition and may not be tolerated by the infant (CDC, 2023e).
Infant immunization protection
Giving recommended immunizations throughout infancy and childhood is the best way to protect infants from infection. Most infants receive their first hepatitis B immunization prior to leaving the hospital after birth.
Toddler mobility safety
The gross motor skills of toddlers develop rapidly, and toddlers are on the go. With the increase in their mobility comes concerns with protecting them from harm.
Toddler supervision needs
Parents need to give toddlers the space to explore their environment while constantly keeping an eye on them so they do not get hurt.
Toddler language milestones
By age 2 years, children should have a fifty-word vocabulary and should use two-word sentences. As they continue to develop, their vocabulary grows, and they begin using plural words, saying things in the past tense, and adding inflection to questions.
Preschool home safety
More than one-third of child injuries and deaths happen at home. Teaching parents how to make the home environment safe is crucial for keeping kids safe.
Cyberbullying parent guidance
Cyberbullying is becoming more prevalent, and schools and school nurses need effective strategies to educate parents about the risks children may face and ways to help protect children with parental controls and open conversation.
Adolescent communication approach
The best approach is to provide factual education and engage with adolescents using open-ended questions that allow them to express their feelings.
Terms to know
- bonding
- When a caregiver and a baby feel a strong attachment to each other, this is known as bonding.
- colostrum
- The first three days after birth, the breast makes a thick, yellowish liquid called colostrum, a nutrient-dense liquid that also helps bolster the newborn’s immune system.
- phenylketonuria (PKU)
- However, phenylketonuria (PKU), a rare metabolic disorder that can cause intellectual disabilities but is highly treatable with diet modification, is tested for in all fifty states.
- self-esteem
- One’s self-esteem, or the feeling of self-appreciation, is an important building block in childhood development.
- School violence
- School violence is violence that happens at school.
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
The graded version needs JavaScript. Every question is below anyway, with the answer and why.
Every question here, with the answer
A pregnant patient calls the prenatal clinic and reports persistent headaches and unusual swelling in the hands and face. What should the nurse advise?
- Reassure the patient that fatigue and swelling are expected in the first trimester.
- Encourage the patient to begin a new exercise regimen to reduce swelling.
- Advise the patient to seek medical attention for these symptoms.
- Tell the patient to wait until the next scheduled prenatal visit unless vaginal bleeding occurs.
Answer: Advise the patient to seek medical attention for these symptoms.
Persistent headaches and unusual swelling in the hands or face are pregnancy warning signs that require medical attention. The section links these findings with preeclampsia, so reassurance or waiting for the next visit would not be appropriate.
A newborn has been unexpectedly admitted to the NICU. The parents are crying and say they feel guilty because they do not feel bonded with the baby yet. What is the nurse’s best response?
- Explain that only feeding the baby will create bonding.
- Reassure the parents that bonding can take time and support them in finding ways to interact with the newborn.
- Tell the parents that bonding should happen immediately after birth.
- Encourage the parents to stay away from the bedside until they feel less emotional.
Answer: Reassure the parents that bonding can take time and support them in finding ways to interact with the newborn.
Bonding is a process for many parents and may take days, weeks, or longer, especially when a newborn is hospitalized. The nurse should provide emotional support and reassure parents that delayed bonding does not mean they are bad parents.
A nurse is teaching new parents about safely preparing and storing infant formula. Which instructions should the nurse include? Select all that apply.
- Avoid leaving formula at room temperature for more than two hours.
- Switch to a specialty formula without contacting the pediatrician if the newborn spits up frequently.
- Follow the instructions to prepare the formula.
- Formula can be safely stored in the refrigerator for up to twenty-four hours.
- Use homemade formula when parents prefer not to use commercial formula.
Answer: Avoid leaving formula at room temperature for more than two hours., Follow the instructions to prepare the formula., Formula can be safely stored in the refrigerator for up to twenty-four hours.
Parents should follow preparation instructions, avoid leaving formula at room temperature for more than two hours, and refrigerate formula for up to twenty-four hours. Homemade formula is not recommended, and infants should not be switched to a specialty formula without speaking to the pediatrician.
A school-age child reports receiving online messages that include physical threats of harm. After listening without judgment and saving documentation, what should the nurse advise?
- Report the physical threats to the police immediately.
- Tell the child to delete the messages so the bullying will stop.
- Focus only on positive reinforcement to improve the child’s self-esteem.
- Wait for the next parent-teacher conference before taking action.
Answer: Report the physical threats to the police immediately.
The section states that physical threats of harm should be reported to police immediately. Saving documentation and involving the school are important, but threats of physical harm require immediate law enforcement involvement.
Where every quote comes from
Section 39.4 The Nurse’s Role in Preventing Illness of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.