A nurse in a delivery room is assisting with the delivery of a newborn. After delivery, the nurse prepares to prevent heat loss in the new born resulting from evaporation by?

Appeared in: PGIMER Chandigarh NO - 2015

Explanation

The question asks for the specific intervention to prevent heat loss via evaporation.
Evaporation is the loss of heat that occurs when a liquid is converted to a vapor. In a newborn, this happens as amniotic fluid dries on the skin.
The most direct and effective nursing action to prevent this type of heat loss is to thoroughly dry the infant's skin with a warm blanket immediately after birth.
This action removes the liquid (amniotic fluid), thus stopping the process of evaporation and conserving the infant's body heat.

Option A: Closing doors and windows prevents heat loss due to convection, which is the transfer of heat to the surrounding air currents (drafts), not evaporation.
Option B: Turning on an overhead radiant warmer primarily prevents heat loss due to radiation, which is the transfer of heat to cooler objects in the vicinity that are not in direct contact with the infant (like walls or windows).
Option C: Warming the crib pad prevents heat loss due to conduction, which is the transfer of heat through direct contact with a cooler surface.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Thermoregulation in newborns and mechanisms of heat loss in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Preventing hypothermia is a critical nursing responsibility in the immediate newborn period. Failure to maintain a neutral thermal environment can lead to cold stress.
Cold stress increases the infant's oxygen consumption and metabolic rate, which can rapidly lead to hypoglycemia, metabolic acidosis, and respiratory distress.
What if the newborn is premature? The risk of hypothermia is significantly higher in premature infants due to their larger surface area-to-body mass ratio, decreased subcutaneous fat, and immature thermoregulatory center. All warming interventions, especially drying, must be performed even more rapidly and efficiently.

How to Approach the Question

First, identify the key concept in the question stem: 'prevent heat loss... resulting from evaporation'.
Recall the four mechanisms of heat loss in a newborn: evaporation, conduction, convection, and radiation.
Define 'evaporation' in the context of a newborn: heat loss from wet skin (covered in amniotic fluid).
Analyze each option to determine which nursing action specifically targets the removal of moisture from the skin.
Option A (closing doors) relates to air currents (convection).
Option B (radiant warmer) relates to heat transfer to distant objects (radiation).

Concept Tested & Keywords

QWkAiG8SiSk4BZ_xgp0wW3

E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 139-141

E6 Text Book Of Pediatric Nursing 3rd Panchali Pal — Part 3 (pp 477-702 of 713) p. 191-193

Practise the full PGIMER Chandigarh NO - 2015

Attempt every question from this paper in a timed mock, then review the full solution for each one.