ch. 24: nursing care of the newborn & family

Question 1

What does EYE PROPHYLAXIS PREVENT?

Answer 1

OPTHALMIA NEONATORUM (conjunctivitis of newborn)

Question 2

What OPTHALMIC OINTMENT and DOSE is used for eye prophylaxis?

Answer 2

ERYTHROMYCIN 0.5% OINTMENT

Question 3

When should the OPTHALMIC OINTMENT be administered?

Answer 3

within 1 HR after birth

Question 4

What are possible ADVERSE REACTIONS to the eye ointment?

Answer 4

• blurred vision

- chemical conjunctivitis

Question 5

What is the PARENT REFUSES the ointment?

Answer 5

they have to sign a form

Question 6

What does VIT K PROPHYLAXIS PREVENT?

Answer 6

vit. k deficiency bleeding (hemorrhagic disease)

Question 7

What is the DOSE and ROUTE for Vit. K administration?

Answer 7

0.5 to 1.0 mg IM

Question 8

When should the VIT. K INJECTION be administered?

Answer 8

1 to 2 hrs after birth

Question 9

What are some ADVERSE REACTIONS to the VIt. K injection?

Answer 9

edema, erythema, pain at injection site

Question 10

Why is the HEPATITIS B VACCINE indicated?

Answer 10

to Prevent infection caused by HPV

Question 11

What is the DOSE and ROUTE of RECOMBIVAX HB?

Answer 11

0.5 ML IM

Question 12

When should the HEPATITIS B VACCINE be ADMINISTERED?

Answer 12

• 1st dose: 24 after birth
• 2nd dose: 1 to 2 months
• 3rd dose: 6 to 18 months

Question 13

What are possible ADVERSE REACTIONS to the hepatitis B vaccine?

Answer 13

edema, erythema, and pain at injection site

Question 14

When would HEPATITIS B IMMUNE GLOBULIN (HBIg) be administered?

Answer 14

administer to infant 12 hrs after birth if mother is HPV positive

Question 15

When is a newborn SCREENED for JAUNDICE?

Answer 15

EVERERY 8 to 12 hrs

Question 16

How do you ASSESS for JAUNDICE?

Answer 16

-blanch bony area and see if skin is yellow

Question 17

What is the treatment for HIGH BILIRUBIN levels?

Answer 17

phototherapy: lamp/lights

Question 18

How long do infants stay under PHOTOTHERAPY?

Answer 18

about 24 HRS until BILIRUBIN decreases to normal

Question 19

What should infants WEAR while under the LIGHTS?

Answer 19

PROTECTIVE EYEWARE and DIAPER

Question 20

Why is the UNIVERSAL NEWBORN SCREENING performed?

Answer 20

for EARLY DETECTION of GENETIC DISORDERS

Question 21

How many disorders are screened in the UNIVERSAL NEWBORN SCREENING?

Answer 21

• 35 CORE
• 26 SECONDARY
• 61 total

Question 22

How is the UNIVERSAL NEWBORN SCREENING performed?

Answer 22

heel stick

Question 23

When are HEEL STICK samples for the UNIVERSAL NEWBORN SCREENING collected?

Answer 23

after 24 HRS of birth

Question 24

What happens to the HEEL STICK SAMPLE after screening is completed?

Answer 24

hospital keeps residual dry blood filter spots

Question 25

Why is a HEARING SCREENING indicated?

Answer 25

early detection of newborn hearing loss

Question 26

When should a HEARING SCREENING be performed?

Answer 26

before discharge or NO LATER than 1 month

Question 27

How is the AUDITORY BRAINSTEM RESPONSE test conducted?

Answer 27

sensors attached to the infant's FOREHEAD and BEHIND THE EARS measure the ACOUSTIC NERVE

Question 28

What happens is an infant FAILS the HEARING SCREENING?

Answer 28

- REPEAT TEST | - if FAILED AGAIN, conduct a comprehensive audiologic evaluation

Question 29

Why is the CRITICAL CONGENITAL HEART DISEASE (CCHD) SCREENING performed?

Answer 29

to detect SERIOUS HEART DEFECTS that may require surgery

Question 30

When should the CCHD screening be performed?

Answer 30

at 24 to 48 hrs of age

Question 31

How is the CCHD SCREENING PERFORMED?

Answer 31

through noninvasive measuring of O2 saturation | -pulse ox placed on RIGHT HAND AND RIGHT FOOT

Question 32

How does an infant PASS the CCHD SCREENING?

Answer 32

> 95% O2 sat w/ <3% absolute difference between upper and lower extremities

Question 33

How many CHANCES do infants get to pass the CCHD SCREENING?

Answer 33

2 chances

Question 34

What is the PURPOSE of SECURITY ALARM BANDS?

Answer 34

to prevent abduction, ALARM GOES OFF if baby is taken out of unit

Question 35

What should mothers do when an employee comes to take their baby out of the room?

Answer 35

- question WHERE and WHY | - CHECK ID

Question 36

What needs to be done every time a baby is brought BACK to the MOMS ROOM?

Answer 36

match ID band from baby to mom

Question 37

What happens if a mother DOES NOT believe the ID of the nurse taking the baby out of the room?

Answer 37

they can call another nurse or charge nurse to verify

Question 38

What is CIRCUMCISION?

Answer 38

removal of foreskin

Question 39

What are the HEALTH BENEFITS of CIRCUMCISION?

Answer 39

- prevent UTIs in babies - decrease risk of PENILE CANCER - decrease risk of hetero STIs

Question 40

When is CIRCUMCISION PERFORMED?

Answer 40

NOT immediately after birth | -first few days or can be delayed

Question 41

When should EMLA cream (numbing cream) be applied to the penis?

Answer 41

at least 1 HR BEFORE procedure

Question 42

When/how often should the site be assessed after circumcision?

Answer 42

check for bleeding every 15 to 30 min for first hour then every hr -there should be no bleeding and infant should be able to void before discharge

Question 43

What are some nonpharmacologic methods to manage neonatal pain?

Answer 43

- swaddling - breastfeeding - distraction - massage - non nutritive sucking - sucrose