Which of the following measure is not recommended for prevention of hypothermia at birth?

RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Child Health Nursing (Pediatrics)

Medium

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2023

Explanation

Bathing a newborn immediately after birth is contraindicated as it causes significant evaporative heat loss, increasing the risk of hypothermia.
The 'Warm Chain' protocol, a standard of neonatal care, explicitly recommends postponing the first bath for at least 24 hours.
Wet skin exposed to air causes a rapid drop in the baby's core temperature, which can lead to complications like hypoglycemia and respiratory distress.

Option A: This is a recommended measure. A warm delivery room (at least 25°C) is the first step in the 'Warm Chain' to prevent convective heat loss from the newborn.
Option B: This is a highly recommended measure. Kangaroo Mother Care (skin-to-skin contact) is a key component of the 'Warm Chain' that uses the mother's body heat to keep the infant warm.
Option D: This is a recommended measure. Frequent breastfeeding provides the newborn with essential calories needed for metabolic heat production (thermogenesis), which is a vital part of the 'Warm Chain'.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of neonatal hypothermia and the 'Warm Chain' protocol as background academic context rather than a clinical decision trigger.
A nurse's primary responsibility in the delivery room is to prevent neonatal hypothermia by meticulously following all steps of the 'Warm Chain'. Failure to do so can have severe consequences for the newborn.
Hypothermia is known as a 'silent killer' in neonates because its initial signs can be subtle, but it can quickly lead to hypoglycemia, metabolic acidosis, respiratory distress, and even death.
What if the newborn is of low birth weight (LBW)? In that case, all measures of the Warm Chain, especially postponing the bath and providing Kangaroo Mother Care, become even more critical as LBW infants have less subcutaneous fat for insulation and are at a much higher risk of hypothermia.

How to Approach the Question

First, identify the negative keyword in the question: 'not recommended'. This means you are looking for the incorrect action or the intervention that should be avoided.
Next, recall the standard protocol for preventing heat loss in a newborn at birth. The core concept here is the 'Warm Chain'.
Evaluate each option against the principles of the Warm Chain.
Option A (warm room), Option B (KMC), and Option D (breastfeeding) are all essential, positive actions within the Warm Chain.
Option C (bathing) is explicitly advised against in the immediate postnatal period because it causes evaporative heat loss.
Therefore, the action that is 'not recommended' is bathing with warm water.

Concept Tested & Keywords

Concept Tested: Prevention of neonatal hypothermia and the 'Warm Chain' protocol.
Stem keywords: hypothermia at birth, prevention, newborn
Lead-in keywords: not recommended
Negative lead-in flag: Question asks for the measure that is NOT recommended.

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