A nurse is beginning a newborn's physical assessment and notes that the infant is jumpy and seems irritable when being handled and when the nurse or parents speak.What action by the nurse is best?
A) Ask the mother to attempt to breastfeed the infant.
B) Conduct the assessment quickly then swaddle the baby.
C) Increase the heat in the room so the baby won't get chilled.
D) Postpone the assessment until the infant has calmed.

Question

Quizplus · Accepted Answer

An infant who seems irritable and overreacts to voices,touch,or movement is displaying disorganized behavior.The nurse should postpone the physical examination until the infant has been calmed.To continue the assessment would risk increasing the baby's behavioral disorganization and would be disruptive for the infant.The other actions are not appropriate in this situation,although swaddling can help calm the baby,as can cuddling,rocking,and gentle holding.

A Nurse Is Beginning a Newborn's Physical Assessment and Notes