LPN Nursing · Newborn Complications · Practice question
The nurse is caring for a preterm infant diagnosed with necrotizing enterocolitis (NEC). Which nursing intervention is most important in managing this condition?
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Encouraging frequent feedings with sterile water and sugar to promote gut health.
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Administering oral antibiotics to prevent the viral infection from spreading.
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Initiating nasogastric feedings to stimulate the digestive system.
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✓
Monitoring for signs of abdominal distention, tenderness, and changes in stool pattern.
Answer & explanation
Correct: Monitoring for signs of abdominal distention, tenderness, and changes in stool pattern.
Necrotizing enterocolitis (NEC) is a serious gastrointestinal emergency in preterm infants characterized by intestinal ischemia, inflammation, and potential perforation of the bowel wall. The most important nursing intervention is vigilant monitoring for abdominal distention, tenderness, changes in stool pattern (such as bloody or absent stools), residual gastric contents, and systemic signs of sepsis such as temperature instability and apnea. Early detection of these signs allows prompt medical intervention, including bowel rest, nasogastric decompression, intravenous antibiotics, and possible surgical consultation. Option A is incorrect and dangerous — frequent oral feedings are contraindicated in NEC; enteral feeding is typically withheld to rest the bowel. Option B is incorrect because NEC is not caused by a viral infection; it involves bacterial translocation across an ischemic gut wall, and oral antibiotics are not the standard of care. Intravenous antibiotics and bowel rest are used. Option C is incorrect because initiating nasogastric feedings to stimulate the digestive system would worsen NEC; the bowel must be rested, and if a nasogastric tube is placed it is for decompression, not feeding. Careful, systematic assessment remains the cornerstone of nursing management in NEC.
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