A pre-eclampsia woman's baby is lying with her mother. Neonate is born in 37 weeks. After 57 hours, when nurse is monitoring vital signs of baby, temperature is low as 35°What will be the intervention?

1. A

   Give punishment for mother for not caring baby

2. B

   Separate the baby from mother

3. C

   Place baby under radiant warmer

4. D

   Cover the baby and check the vitals after 30 minutes

Appeared in: AIIMS Delhi NO- 2019

Explanation

• A newborn's normal temperature is 36.5°C to 37.5°C. A temperature of 35°C is classified as moderate hypothermia.
• Moderate hypothermia requires active rewarming to safely and efficiently raise the body temperature and prevent complications.
• A radiant warmer is the standard medical device for providing controlled, active external rewarming for neonates.
• This intervention allows for continuous monitoring and easy access to the baby while correcting the life-threateningly low temperature.

Why Other Options Were Wrong

• Option A: This is an unethical, unprofessional, and abusive action. It is never an appropriate response in any healthcare setting.
• Option B: Separating the baby from the mother is generally contraindicated. Skin-to-skin contact is a key intervention for thermoregulation and bonding.
• Option D: This is passive rewarming and is insufficient for moderate hypothermia. The baby's temperature is low enough to require a more active and rapid method of warming.

Related Visual

Clinical Relevance

• Nursing practice connection: Knowing Management of Neonatal Hypothermia helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
• Thermoregulation is a critical aspect of newborn care. Hypothermia can lead to hypoglycemia, metabolic acidosis, respiratory distress, and increased mortality.
• Nurses must be able to quickly identify signs of hypothermia (e.g., cool skin, lethargy, poor feeding) and initiate appropriate rewarming protocols immediately.
• What if the baby's temperature was 36.2°C? In that case of mild hypothermia (cold stress), the first and best intervention would be to initiate skin-to-skin contact (Kangaroo Mother Care) with the mother and cover them both with warm blankets, then recheck the temperature in 30 minutes. A radiant warmer would be the next step if this fails.

How to Approach the Question

• First, identify the key clinical information in the scenario: the patient is a neonate, and the vital sign is a temperature of 35°C.
• Recall the normal temperature range for a newborn (36.5-37.5°C). Recognize that 35°C is significantly low and indicates moderate hypothermia.
• Evaluate the options based on the severity of the condition. Eliminate options that are clearly inappropriate or harmful (punishment).
• Differentiate between interventions for mild versus moderate/severe hypothermia. Passive warming (covering) is for mild cases, while active warming (radiant warmer) is for more severe cases.
• Select the intervention that directly and effectively addresses the life-threatening problem, which in this case is active rewarming with a radiant warmer.

Concept Tested & Keywords

• Concept Tested: Management of Neonatal Hypothermia
• Stem keywords: neonate, pre-eclampsia, 37 weeks, temperature 35°C, intervention
• Lead-in keywords: What will be the intervention?
• Clinical cues: A temperature of 35°C is a critical finding indicating moderate hypothermia in a newborn.

Question ID

QBNvYQNWvufNgkN5_-NTe3

Copy ID

Reference Book

E6 Ghai Essential Pediatrics(pp 26-904 of 913) pp. 138-140, 139-141, 808-810