ch 23 newborn special needs

Question 1

the nurse is teaching a group of parents who have preterm newborns about the differences between full term and pre term newborn. which characteristic would the nurse describe as associated with preterm newborn but not a term newborn?

Answer 1

greater body surface area in proportion to weight

Question 2

a nurse is assessing a post term newborn. which finding would the nurse correlate with this gestational age variation?

Answer 2

thin umbilical cord

Question 3

the parents of a preterm newborn being cared for in the nicu are coming to visit for the first time. the newborn is receiving mechanical ventilation, iv fluids and medications and is being monitored electronically by various devices. which action by the nurse would be most appropriate

Answer 3

encourage the parents to touch their preterm newborn

Question 4

rapid assessment of a newborn indicates the need for resuscitation . the newborn has copious secretions, and the newborn is is dried and placed under a radiant warmer. which action would the nurse do next?

Answer 4

clear the airway with a bulb syringe

Question 5

the nurse prepares to assess a newborn who is considered to be large for gestational age. which characteristic would the nurse correlation with this gestational age variation?

Answer 5

difficulty arousing to a quiet alert state

Question 6

a preterm newborn has received large concentrations of oxygen therapy during a 3 month stay at the nicu. as a newborn is being discharged, the nurse anticipates a referral for which specialist?

Answer 6

ophthalmologist

Question 7

a nurse is developing the plan of care for a small for gestational age newborn. which action would the nurse determine as a priority?

Answer 7

preventing hypoglycemia with early feedings

Question 8

the nurse is providing care to newborn who was born 36 weeks gestation. based on the nurse’s understanding of gestational large, the nurse identifies this newborn as:

Answer 8

late preterm

Question 9

which intervention would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn?

Answer 9

provide opportunities for them to hold the newborn

Question 10

a nurse is reviewing the maternal history of a LGA newborn. which factor would the nurse identify as possibly contributing to the birth of the newborn?

Answer 10

diabetes

Question 11

a nurse is assessing a preterm newborn. which finding would alert the nurse to suspect that a preterm newborn is in pain?

Answer 11

sudden high pitched cry

Question 12

a 22 year old woman experiencing homelessness arrives at a walk in clinic seeking pregnancy confirmation. the nurse notes on assessment her uterus suggests 12 weeks gestation. a blood pressure of 110/70, and a bmi of 17.5. the client admits to using cochin a few times. the client has been pregnant before and indicates the loses them early. what characteristics place the client in high risk category? select all that apply:

Answer 12

-bmi
-prenatal history
-homelessness
-prenatal care

Question 13

a neonate born at 40 weeks gestation weighting 2300 g (5 lbs 1 oz) is admitted for observation only. what is the first observation about the infant?

Answer 13

the neonate is small for its gestational age

Question 14

a thin newborn has a rr of 80 breaths/min, nasal flaring with sternal retractions, hr of 120, temp of 36 C (96.8 f) and persisting o2 sat. of <87%. the nurse interprets these findings as:

Answer 14

respiratory distress

Question 15

a one day old neonate born at 32 weeks gestation is in the nicu under a radiant overhead warmer. the nurse assesses the morning axilla temp at 95 degrees F ( 35 C). what would explain this finding?

Answer 15

the supply of brown adipose tissue is not developed

Question 16

a 42 year old woman is 26 weeks pregnant. she lives in a shelter. her bp is 170/90, fhr is 140 bpm, TORCH studies are positive, and she is bleeding vaginal. what findings put her at risk of having an SGA infant. select all that apply

Answer 16

-age of client
-living in a shelter
-vaginal bleeding
-blood pressure
-positive TORCH

Question 17

a term neonate has been admitted for observation with a diagnosis of SGA. which factors predispose the neonate to this diagnosis? select all that apply

Answer 17

-the mother had chronic placental abruption
-at birth the placenta was noted to be decreased in weight
-on assessment the placenta has areas of infarction
-at birth the placenta has a shiny schulz presentation

Question 18

a SGA infant is admitted to the observational unit with diagnosis of ineffective thermoregulation related to lack of fat stress as evidenced by persistent low temperature. which are appropriate nursing interventions? select all that apply

Answer 18

-assess the auxiliary temp every hour
-review maternal history
-assess environment for sources of heat loss
-encourage skin to skin contact

Question 19

a couple who has just given brith to a baby has low apgar scores due to asphyxia from prolonged cord compression. the neonatologist has given poor prognosis to the newborn who is not expected to live. which interventions are appropriate at this time? select all that apply.

Answer 19

-offer to pray with the family if appropriate
-initiate spiritual comfort by calling the hospital clergy if appropriate
-respect variations in the family’s spiritual needs and readiness

Question 20

a neonate born at 42 weeks gestation weighing 4.4 kg (9lbs, 7oz) with satisfactory apgar scores. two hours later the infants blood sugar indicates hypoglycemia. which symptoms would the baby demonstrate? select all that apply

Answer 20

-poor sucking
-respiratory distress
-weak cry
-jitteriness

Question 21

a premature, 36 weeks gestation neonate is admitted to the observational nursery and placed under bili-lights with evidence of hyperbilirubinemia. which assessment findings would the neonate demonstrate? select all that apply.

Answer 21

-increased serum bilirubin levels
-clay colored stools
-tea colored urine

Question 22

a jaundiced neonate must have heel sticks to assess bilirubin levels. which assessment findings would indicate that the neonate is in pain? select all that apply.

Answer 22

-heart rate is 180
-o2 saturation is 88%
-infant has facial grimacing and quivering chin

Question 23

during a neonate resuscitation attempt, the doctor has ordered 0.1 ml iv epinephrine in a 1:10,000 concentration to be given stat. the neonate weighs 3000 grams and is 38 cm long. how many ml should the nurse administer?

Answer 23

0.3 ml

Question 24

a macrosomia infant in the newborn nursery is being observed for a possible fractured clavicle. for which would the nurse assess? select all that apply

Answer 24

-facial grimacing with movement
-bruising over area
-asymmetrical movement
-edema present

Question 25

a set of newborn twins has been admitted for fetal growth restriction (FGR). which maternal factors would predispose the newborn to this diagnosis? select all that apply.

Answer 25

-A1C levels of 8% (0.08) -heroin use disorder -bp baseline of 170/90 -age 39 years -multiple gestation

Question 26

a neonate is admitted for observation with the possible diagnosis of polycythemia. the nurse would be observing for which findings? select all that apply

Answer 26

-ruddy skin color -respiratory distress -cyanosis -jitteriness

Question 27

a 20 hour old neonate is suspected of having polycythemia. which nursing interventions will the nurse utilize to provide care for this neonate? select all that apply

Answer 27

-obtain hemoglobin and hematocrit labs -provide early feedings to prevent hypoglycemia -maintains oxygen saturation parameters -monitor urinary output

Question 28

a client has given birth to a full term infants weighing 10 pounds 5 ounces (4678 g). what priority assessment would be completed by the nurse?

Answer 28

blood glucose

Question 29

a client expresses concerns that her grandmothers had complicated pregnancies. what principles should the nurse discuss to allay the fears for the client? select all that apply.

Answer 29

-we work to ensure that birth of high risk infants happens in setting where we are able to care for them -we will work with you to identify prenatal risk factors early and take actions to reduce their impact -we support those at risk of having preterm births with the goal of delaying early births -we work to ensure care for mothers na infants to reduce infant illness, disabilities, and death

Question 30

a late preterm newborn is being prepared for discharge to home after being in the nicu for 4 days. the nurse instructs the parents about the care of their newborn and emphasized wearing signs that should be reported to the pediatrician immediately. the nurse determines that additional teaching is needed based on which statement?

Answer 30

if our newborns skin turns yellow, it is form the treatments and our newborn is okay