Which of the following is NOT a nursing intervention to maintain the temperature of a newborn?

AIIMS BBSR SNO - 2019

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS BBSR SNO - 2019

Explanation

Placing a newborn near draughts or air vents is not a therapeutic intervention; it is a cause of significant heat loss.
This action exposes the infant to moving cool air, which strips heat away from the body through convection.
Exposing a newborn to drafts directly counteracts the goal of maintaining a stable body temperature and increases the risk of hypothermia.
All established newborn care protocols, like the 'warm chain', emphasize creating a draught-free environment.

Option A: This is a critical and correct nursing intervention. A newborn is wet with amniotic fluid at birth, and drying them immediately prevents significant heat loss through evaporation.
Option B: This is a correct nursing intervention. Wrapping the newborn in pre-warmed blankets reduces heat loss through both conduction (contact with cold air) and convection.
Option C: This is a correct nursing intervention. Placing an unclothed newborn on a cold weighing scale would cause rapid heat loss through conduction. Using a warmed cloth provides a barrier.

Clinical Relevance

Nursing practice connection: Knowing Thermoregulation and prevention of hypothermia in the newborn helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Preventing hypothermia is a primary nursing goal in newborn care. A drop in temperature can cause a cascade of metabolic problems, including increased oxygen consumption, respiratory distress, and hypoglycemia.
Nurses must be vigilant in controlling the infant's environment, ensuring the delivery room is warm and free of drafts, and that all items touching the baby (blankets, stethoscopes, hands) are warm.
What if the newborn is premature? The risk of hypothermia is even greater due to less subcutaneous fat for insulation and a larger surface area to body mass ratio. In this case, interventions become more critical, often requiring the use of a radiant warmer or incubator and placing the infant in a polyethylene bag immediately after birth (before drying) to prevent evaporative and convective heat loss.

How to Approach the Question

First, identify the negative keyword 'NOT' in the question stem. This tells you that three of the options are correct actions, and one is an incorrect or harmful action.
Your goal is to find the option that does NOT help maintain a newborn's temperature or actively causes heat loss.
Evaluate each option based on basic principles of thermoregulation.
Ask yourself for each option: 'Does this action help keep the baby warm or make the baby cold?'
Option A (drying), B (warm blankets), and C (warmed cloth) all clearly help keep the baby warm.
Option D (placing near draughts) exposes the baby to moving, cool air, which would make the baby cold. This is the action that should NOT be done, making it the correct answer.

Concept Tested & Keywords

Concept Tested: Thermoregulation and prevention of hypothermia in the newborn.
Stem keywords: newborn, nursing intervention, maintain temperature
Lead-in keywords: NOT
Negative lead-in flag: This question uses a negative lead-in ('NOT'), asking you to identify the action that is incorrect or should be avoided. The correct answer is the option that describes a harmful action, while the other three options are correct nursing interventions.

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