Old Interview Question help

[Nyah Nicole]

Hey everyone!

Ive been sitting on this questions for a couple years now, however it's really been in my head lately. I'm a registered practical nurse currently working as a community paediatric nurse, and I aspire to be in a hospital on a paediatric unit. I graduated two years ago, and closer to when I was a new grad I had my very first interview for a paediatric general inpatient unit. I found the interview a little challenging as I wasn't prepared enough for it. The question that stuck with me goes as follows ( I don't remember it word for word, but I remember the gist of it). By the way before I continue, I've researched to try and get the best answer for this question, but I want to see if anyone else has any different answers.

"A two week old child was admitted to the paediatric inpatient unit with an infection. The child is febrile, currently on antibiotics, the respiration's were in normal range. The child is lethargic. Mom has been with the baby, a little anxious and concerned about wanting to breastfeed. What should you say to the mother"

I don't get scenarios like this in my current job so I'm not 100% on my steps to take next. Thanks a million in advance!!

[NotReady4PrimeTime, RN]

There are a few key points in the scenario - the baby's age, respiratory status and LOC. Infants this young who are septic can decompensate very quickly. While his respiratory rate is within normal limits and would meet criteria for oral feeding, he's already lethargic, which means latch might be difficult and the baby will fatigue more quickly from the effort required to nurse effectively. I'm assuming the child has IV fluids, because being febrile and lethargic means dehydration is a significant possibility. My response would be that I'd need to check if the physician is okay with breastfeeding, and explain how the baby's condition might make it difficult for him to nurse effectively, while becoming more and more tired. I'd give her information about how fluid is more important than calories in the first hours after admission, and that if he can't feed orally, we do have options for providing nutrition while he recovers. Then I'd tell her that if the doc isn't okay with the baby going to the breast, that I'd arrange for a breast pump and supplies so she can maintain her milk supply (and be more comfortable!). Her milk would be frozen for use when we are able to feed again.