[Exam 2] Chapter 17 – Newborn Transitioning Flashcards
1
Q
What is the neonatal period?
A
The first 28 days of life.
2
Q
Circulation through the heart changes: Fetus vs Newborn?
A
FEtus: Pressure in right atrium are greater than left
Newborn: Pressure in the left atrium are greater then right
3
Q
The newborn’s most dramatic and most rapid extrauterine transitions occur in what areas?
A
Respiratory, Circulatory, Thermoregulation, and Ability to stabilize blood glucose levels
4
Q
(N) Cardiovascular System Adaptations: What do the umbilical veins do?
A
Carries oxygenated blood from the placenta to the fetus
5
Q
(N) Cardiovascular System Adaptations: What does the ductus venosus allow?
A
The majority of the umbilical vein blood to bypass the liver and merge with blood moving through the vena cava
6
Q
(N) Cardiovascular System Adaptations: What does the foramen ovale allow?
A
For more than half the blood entering the right atrium to cross immediately to the left atrium bypassing pulmonary circulation
7
Q
(N) Cardiovascular System Adaptations: Change from fetal to postnatal circulation requires what?
A
Increased pulmonary bloow flow, removal of placenta, and closure of the intracardiac and extracardiac shunts
8
Q
(N) Cardiovascular System Adaptations: What stimulates increased cardiac output and contractility, surfacant release, and promotion of pulmonary fluid clearance?
A
Increase in epinephrine and norepinephrine
9
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: What happens to the systemic vascular system when placenta clamped?
A
REsistance increases and blood return to the heart via the inferior vena cava decreases
10
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: Why does the foramen ovale close?
A
Due to decrease in pulmonary vascular resistance, which leads to decrease in right-sided heart pressures
11
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: Changes in the atrial after birth?
A
Left atrial pressure increases and right atrial pressure decrease
12
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: Where is the ductus arteriosus and what does it do?
A
Between aorta and pulmonary artery. Protects lungs against overload by shunting blood (right to left) into the descending aorta, bypassing pulmonary circulation
13
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: When does the ductus arteriosus close?
A
Within a few hours after birth. Oxygen important in closing closure. Depends on high oxygen content of the aortic blood that results from aeration of lungs at birth
14
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: What happens to pulmonary vascular resistance at birth?
A
Decreases, which allows pulmonary blood flow to increase and oxygen exchange to occur in the lungs
15
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: What did the ductus venosus do?
A
Shunted blood from the left umbilical vein to the inferior vena cava during intrauterine life .
16
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: When does the ductus venosus close?
A
Within a few days after birth. Not needed because liver takes over functions of placenta
17
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: What happens to the two arteries and vein at birth?
A
Constrict at birth, because of placental expulsion and blood flow ceases.
18
Q
(N) Cardiovascular System Adaptations - Fetal to Neonatal Circul. Changes: Normal path of blood flow in the heart now?/
A
Pulmonary Veins -> Right Atrium -> right Ventricle -> lungs -> left atrium ->left ventricle -> aorta
19
Q
(N) Cardiovascular System Adaptations - Heart Rate: HR a few minutes after birth? An decreases to what average?
A
110 to 160
120 to 130 bpm is the average after it decreases
20
Q
(N) Cardiovascular System Adaptations - Heart Rate: When is blood pressure highest?
A
After birth and reaches plateau within a week after birth
21
Q
(N) Cardiovascular System Adaptations - Heart Rate: Tachycardia may be found with what?
A
Volume depletion, cardiorespiratory disease, drug withdrawal, and hyperthyroidism
22
Q
(N) Cardiovascular System Adaptations - Heart Rate: Bradycardia may be found with what
A
Apnea and Hypoxia
23
Q
(N) Cardiovascular System Adaptations - Blood Volume: Usually estimated to be what?
A
80-85 mL/kg. May vary by as much as 25-40%
24
Q
(N) Cardiovascular System Adaptations - Blood Volume: Early (before 30 seconds) or late (after 3 mins) clamping of the umbilical cord changes what?
A
Circulatory dynamics during transition
25
(N) Cardiovascular System Adaptations - Blood Volume: Benefits of delayed cord clamping clude ?
Improved newborn cardiopulmonary adaptation, preventing iron-deficient anemia in full-term newborns without increasing hypervolemia, and increased iron stores, increasing oxygen transport
26
(N) Cardiovascular System Adaptations - Blood Volume: What physiological benefits are there for delaying cord clamping?
30% increase in blood volume
Improvement of blood pressure
Increase in cererbral oxygen
Higher hemoglobin levels
27
(N) Cardiovascular System Adaptations - Blood Volume: What did a Cochrane review say about delaying umbilical cord clamping?
Had 60% increase in rbcs, high hemoglobin levels, and higher iron levels at 4-6 months
28
(N) Cardiovascular System Adaptations - Blood Components: How are the red blood cells here?
has more RBCs than adult, and have greater affinity for oxygen. They are larger in size as well, and carry more oxygen.
29
(N) Cardiovascular System Adaptations - Blood Components: What happens after birth to RBcs?
RBC count gradually increases as teh cell size decreases, because cells now live in environment with higher O2
30
(N) Cardiovascular System Adaptations - Blood Components: Life span of RBCs?
80-100 days versus 120 in adults
31
(N) Cardiovascular System Adaptations - Blood Components: Why does hemoglobin initially decline?
As a result of decrease in neonatal red cell mass
32
(N) Cardiovascular System Adaptations - Blood Components: What to know for leukocytosis?
Present as a result of birth trauma after birth
33
(N) Cardiovascular System Adaptations - Blood Components: Normal hemoglobin range?
16-18
34
(N) Cardiovascular System Adaptations - Blood Components: Normal Hematocrit range?
46-68%
35
(N) Cardiovascular System Adaptations - Blood Components: Normal platelet range?
150,000 - 350,000
36
(N) Cardiovascular System Adaptations - Blood Components: Normal RBC range?
4.7-7.0
37
(N) Cardiovascular System Adaptations - Blood Components: Normal WBc range?
10-30,000
38
(N) Respiratory System Adaptations: What happens here as they progress into life?
Aeration of lungs, establishment of pulmonary gas exchange, and changing the fetal circulation into the adult type
39
(N) Respiratory System Adaptations: What does lung aeration lead to?
Establishment of functional residual capacity, allowing pulmonary gas exchange to start
40
(N) Respiratory System Adaptations: What happens when baby takes first breath?
increase in transpulmonary pressure and results in diaphragmatic descent
41
(N) Respiratory System Adaptations: What is Surfactant?
A surface tension, and reduces the lipoprotein found in the newborns lung that prevents alveolar collapse. Lines teh alveoli.
42
(N) Respiratory System Adaptations: How does Surfactant help at the eend of expiration?
Permits decrease in surface tnesion and an increase in surface tension during lung expansion
43
(N) Respiratory System Adaptations: How does the passageway through the birth canal help this system?
Because passage allows intermittent compression of thorax, which helps eliminate fluids in the lungs.
44
(N) Respiratory System Adaptations: What happens if fluid is removed too slowly or incompletely?
Transient Tachypnea (respiratory rate above 60 breaths per minute)
45
(N) Respiratory System Adaptations: What do you need to do if infant has transient tachypnea?
Need thoracic compression.
46
(N) Respiratory System Adaptations - Lungs: What must happens before lungs can work?
Initiation of resp movement
Expansion of lungs
Establishment of functional residual capacity
Increased pulmonary blood flow
Redistribution of CO
47
(N) Respiratory System Adaptations - Lungs: What causes the initial breathing?
Combo of reflex triggered by changes, noises, lights and high CO2 and low O2 concentrations in newborns blood
48
(N) Respiratory System Adaptations - Respirations: What is the nornmal range here?
30-60 bpm with short periods of apnea (< 15 seconds)
49
(N) Respiratory System Adaptations - Respirations: Signs of respiratory distress to look for?
Cyanosis, tachypnea, expiratory grunting, sternal retractions, and nasal flaring
50
(N) Respiratory System Adaptations - Respirations: Periodic breathing may occur, which is what
Cessation of breathing that lasts 5-10 seconds without changes in color or heart rate.
51
(N) Body Temperature Regulation: What is the newborns average temperature?
97.9-99.7
52
(N) Body Temperature Regulation: What is recommended to maintain infants temperature after birth?
Skin-to-skin contact with the mother. Should be first treatment for hypothermia
53
(N) Body Temperature Regulation: What is thermoregulation?
Process of maintaining the balance between heat loss and heat production in order to maintain its core internal temperature
54
(N) Body Temperature Regulation - Heat Loss: What predisposes the infant to heat loss?
Thin skin, and lack of shivering ability
Limited stores of metabolic substrates
Limited use of voluntary movements to generate heat
55
(N) Body Temperature Regulation - Heat Loss: How much will the temperature drop minutes after leaving the mothers uterus?
305 degrees
56
(N) Body Temperature Regulation - Heat Loss: Heat can be lost in what four ways?
Conduction, convection, evaporation, and radiation
57
(N) Body Temperature Regulation - Heat Loss and Conduction: What is this?
Involves the transfer of heat from one object to another when the two objects are in direct contact with each other
58
(N) Body Temperature Regulation - Heat Loss and Conduction: Example of this?
When the newborns body surface makes contact with a cold mattress, scale, or circumcision restraining board .
Or when touching a newborn with cold hands.
59
(N) Body Temperature Regulation - Heat Loss and Convection: What is this?
Involves the flow of heat from the body surface to cooler surrounding air to air circulating over a body surface
60
(N) Body Temperature Regulation - Heat Loss and Convection: Example of this?
A cool breeze that flows over the newborn
61
(N) Body Temperature Regulation - Heat Loss and Convection: How to prevent heat loss in this method?
Keep the newborn out of direct cool drafts (open doors, windows, fans, air conditioners) in the environmen. Warm any oxygen that comes into contact with the infant
62
(N) Body Temperature Regulation - Heat Loss and Evaporation: What is this?
Involves the loss of heat when a liquid is converted to a vapor. May be insensible (from skin adn respiration) or sensible (from sweating)
63
(N) Body Temperature Regulation - Heat Loss and Radiation: What is this?
Involves the loss of body heat to cooler, solid surfaces that are in proximity but not in direct contact with the newborn
64
(N) Body Temperature Regulation - Heat Loss and Radiation: Example of this?
When a newborn is placed in a single-wall isolette next to a cold window.
65
(N) Body Temperature Regulation - Heat Loss and Radiation: How to reduce heat loss?
Keep cribs and isolettes away from outside walls , cold windows, and air conditioners
66
(N) Body Temperature Regulation - Overheating: Why is this a problem?
Because infants are prone to overheating easily
67
(N) Body Temperature Regulation - Overheating: Example of this?
If an isolette is too warm or one is left too close to a sunny window
68
(N) Body Temperature Regulation - Thermoregulation: How does a newborn attempt to conserve heat and increase heat production?
By increasing metabolic rate, increasing muscular activity through movement, increasing vasoconstriction and assuming fetal position
69
(N) Body Temperature Regulation - Thermoregulation: What is neutral thermal environment?
An environment in which body temperature is maintained wihtout an increase in metabolic rate
70
(N) Body Temperature Regulation - Thermoregulation: What does a neutral thermal environment promote?
Growth and stability, conserves energy for basic bodile functions, and minimizes heaat and water loss
71
(N) Body Temperature Regulation - Thermoregulation: How does the newborn respond to the environmental temperature decreasing?
By consuming more oxygen, with respiratory rate increasing
72
(N) Body Temperature Regulation - Thermoregulation: Primary method of heat production?
Nonshivering thermogenesis, when brown fat is oxidized in response to cold exposure.
73
(N) Body Temperature Regulation - Thermoregulation: when does brown fat disappear?
About 3-5 weeks after birth adn is vital for thermogenesis
74
(N) Body Temperature Regulation - Thermoregulation: What is cold stress?
Excessive heat loss that requires a newborn to use compensatory mechanisms (such as nonshivering thermogenesis) to maintaon core body temperature
75
(N) Body Temperature Regulation - Thermoregulation: Greatest time for risk for cold stress?
Within first 12 hours of life
76
(N) Body Temperature Regulation - Thermoregulation: What problems can cold stress lead to?
Depleted brown fat stores, increased O2 needs, respiratory distress, and increased glucose consumption leading to hypoglycemia
77
(N) Body Temperature Regulation - Thermoregulation: How to best maintain a neutral thermal environment?
Prewarming blankets and hats
Keep infact transported fully charged
Dry newborn completely after birth
Encourage skin-to-skin contact
78
(N) Hepatic System Function: Liver has essential role in what?
synthesis, degradation, and regulation of pathways involved in the metabolism of carbohydrates, proteins, lipids, and trace elements
79
(N) Hepatic System Function: What enzymatic pathways are actived by 3 months?
Blood coagulation and also iron storage, carb metabolism, and conjugation of bilirubin
80
(N) Hepatic System Function - Iron Storage: What happens when red blood cells destroyed after birth?
Iron is released and stored by liver until new red cells need to be produced.
81
(N) Hepatic System Function - Iron Storage: Iron storage determined by what?
total body hemoglovin content and length of gestation. If mothers inake adequate during pregnancy, sufficent iron stored for 6 months
82
(N) Hepatic System Function - Carbo Metabolism: What is essential for brain metabolism?
Glucose
83
(N) Hepatic System Function - Carbo Metabolism: What must infants do after birth in regards to glucose?
Must learn to regulate blood glucose concentration . If not, can lead to hypoglycemia
84
(N) Hepatic System Function - Carbo Metabolism: Glucose levels after birth?
Are usually lower than later in life
85
(N) Hepatic System Function - Carbo Metabolism: Main source of energy sseveral hours after birth?
Glucose
86
(N) Hepatic System Function - Carbo Metabolism: What stabilizes neonates glucose levels?
Initiating early breast or bottle feedings
87
(N) Hepatic System Function - Bilirubin Conjugation: What is this?
A yellow to orange bile pigment produced by the breakdown of red blood cells.
88
(N) Hepatic System Function - Bilirubin Conjugation: What usually happens to bilirubin in infant?
Normally circulates in plasma, taken up by liver cells, and is changed to a water soluble pigment that is excreted in the bile
89
(N) Hepatic System Function - Bilirubin Conjugation: Primary source of bilirubin in newborn?
Hemolysis of erythrocytes , such as when the red blood cells die after 80 days of life
90
(N) Hepatic System Function - Bilirubin Conjugation: Bilirubin is released in an unconjugated form called what
indirect bilirubin, which is fat soluble.
91
(N) Hepatic System Function - Bilirubin Conjugation: What proccesses the unconjugfated bilirubin?
Enzymes, proteins, and different cells and liver process it into conjugated bilirubin or direct bilirubin
92
(N) Hepatic System Function - Bilirubin Conjugation: How much bilirubin is produced?
At a rate of 6-8 mg/kg/day
93
(N) Hepatic System Function - Bilirubin Conjugation: Bilirubin production declines to adult levels when?
After 10-14 days
94
(N) Hepatic System Function - Bilirubin Conjugation: If liver cannot breakdowna dn excrete bilirubin, what does this lead to
Jaundice. Bilirubin is extremely toxic to the body
95
(N) Hepatic System Function - Bilirubin Conjugation: What is total bilirubin?
Combination of indirect (unconjugateD) and direct (conjugated) bilirubin
96
(N) Hepatic System Function - Bilirubin Conjugation: What happens when unconjugated bilirubin pigemetn deposited in the skin?
Jaundice develops with a yellowing of the skin , sclera, and mucous membranes
97
(N) Hepatic System Function - Bilirubin Conjugation: common risk factors for development of jaundice include
Fetal -maternal blood group imcompatibility, prematurity, asphyxia at birht, and insufficent intake of milk during breast-feeding
98
(N) Hepatic System Function - Bilirubin Conjugation: Causes of newborn jaundice can be classified into what three groups?
Bilirubin overproduction
Decreased bilirubin conjugation
Impaired bilirubin excretion
99
(N) Hepatic System Function - Bilirubin Conjugation: Examples of bilirubin overproduction?
Blood incompatibility, drugs, trauma at birth, and delayed cord clamping
100
(N) Hepatic System Function - Bilirubin Conjugation: Examples of decreased bilirubin conjugation?
Physiologic jaundice, hypothyroidism, and breast feeding
101
(N) Hepatic System Function - Bilirubin Conjugation: Examples of impaired bilirubin excretion
Biliary obstruction, sepsis, hepatitis, chromosomal abnormality
102
(N) GI System Adaptations - Mucosal Barrier Production: Important adaptation of the GI system is what?
Development of a mucosal barrier to prevent the penetration of harmful substance present within the intestinal lumen
103
(N) GI System Adaptations - Mucosal Barrier Production: What plays a major role in early colonization patterns in the neonatal gut?
Nutrition, be it breast milk or formula and occurs within 24 hours of age and is required for production of Vit K
104
(N) GI System Adaptations - Stomach/Digestion: Researchers have found hat for the first 24 hours after birth, the newborns small stomach does not do what?
Does not stretch to hold more, as it will within a day or two later
105
(N) GI System Adaptations - Stomach/Digestion: How often should feedings occur?
They should be small, and frequent . You don't want them to think that the feelings of eating too much is the norm
106
(N) GI System Adaptations - Stomach/Digestion: Why do infants have a problem with regurgitation?
Because the cardiac sphincter and nervous control of the stomachis immature. Avoid overfeeding to avoid this
107
(N) GI System Adaptations - Stomach/Digestion: How much weight do infants lose 1 week after being born?
Lose 5-10% of their birth weight as a result of insufficient caloric intake
108
(N) GI System Adaptations - Stomach/Digestion: How many calories do they need for the first six months?
108 kcal/kg/day
109
(N) GI System Adaptations - Bowel Elimination: What is meconium?
The infants first stool. Composed of amniotic fluid, shed mucosal cells, intestinal secretions and blood
110
(N) GI System Adaptations - Bowel Elimination: Appearance of Meconium and how long to pass?
Greenish black, and has a tarry consistency and is usually passed within 12-24 hours of birth
111
(N) GI System Adaptations - Bowel Elimination: Appearance of stool after feedings initiated?
Transitional stool develops, which is greenish brown to yellowish brown, thinner in consistency and seedy
112
(N) GI System Adaptations - Bowel Elimination: Appearance of stool after being breast-fed?
Light mustard with seed like particles
113
(N) GI System Adaptations - Bowel Elimination: Appearance of stool after being formula-fed?
Stools with be tan or yellow in color and firmer
114
(N) GI System Adaptations - Bowel Elimination: Appearance of breast-fed milk stool?
Yellow-gold, loose, and stringy to pasty and typically sour smelling
115
(N) GI System Adaptations - Bowel Elimination: Appearance of formula-fed milk stool?
Yelllow, yellow-green, or greenish and loose, party or formed in consistency
116
(N) Renal System Changes: Why is the GFR reduced at birth?
Because the glomeruli and nephrons are functionally immature at birth
117
(N) Renal System Changes: Decreased GFR and limited ability to concentrate urine what happens to newborn?
Susceptible to both dehydration and fluid overload
118
(N) Renal System Changes: SpG of newburns?
1.001 to 1.020 ,
119
(N) Renal System Changes: How many voidings occur in a day?
6-8
120
(N) Renal System Changes: When does renal cortex reach maturity?
At 12-17 months of age.
121
(N) Immune System Adaptations: How long is infant protected by moms antibodies?
Lasts about 6 months.
122
(N) Immune System Adaptations: What antibodies do the newborn receive from the mother?
IgE, IgA, IgM, and IgG
123
(N) Immune System Adaptations: When do healthy infants begin to produce their own antibodies?
Starting at 2-3 months of age
124
(N) Immune System Adaptations: REsponses of immune system serve what three purposes?
Defense
Homeostasis
Surveillance
125
(N) Immune System Adaptations - Natural immunity: What does this include?
Responses or mechanisms that do not require previous exposure to the microorganism or antigen to operative efficienty. Includes physical, chemical, and resident nonpathologic organisms
126
(N) Immune System Adaptations - Natural immunity: What basic host defense response occurs?
Ingestion and killing of microorganisms by phagocytic cells
127
(N) Immune System Adaptations - Acquired immunity: Involves what two processes?
Development of circulating antibodies or immunoglobulins capable of targeting specific invading agents
Formation of activated lymphocytes designed to destroy foreign invadors
128
(N) Immune System Adaptations - Acquired immunity: This is absent until when
First invasion by a foreign organism or toxin
129
(N) Immune System Adaptations - Acquired immunity: What is the most abundant antibody?
IgG, making up about 80% of all circulating antibodies. Only class able to cross the placenta
130
(N) Immune System Adaptations - Acquired immunity: What does IgA do?
found in GI and is beleived to protect mucous membranes from viruses and bacteria
131
(N) Immune System Adaptations - Acquired immunity: What is IgM?
Found in blood and lymph. First one to respond to infection
132
(N) Neurologic System Adaptations: Continues to develop until when?
By 1 year of age. Brain increases in size 3x but end of first year.
133
(N) Neurologic System Adaptations: How is newborns hearing?
Well develop at birth, responds to noise by turning to sound
134
(N) Neurologic System Adaptations: How is newborns taste
ability to distinguish between sweet and sour by 72 hours old
135
(N) Neurologic System Adaptations: How is newborns smell
ability to distinguish between mothers breast milk and breast milk from others
136
(N) Neurologic System Adaptations: How is newborns touch?
sensitivity to pain, responds to tactile stimuli
137
(N) Neurologic System Adaptations: How is newborns vision?
incomplete at birth. Can only see close objects. Vision of 20/140
138
(N) Behavioral Adaptations - First Period of Reactivity: How long does this last?
Begins at birth, and may last from 30 mins to 2 hours
139
(N) Behavioral Adaptations - First Period of Reactivity: Characterized by what?
myoclonic movements of the eyes, spontaneous moro reflexes, sucking motions, chewing, rooting, and fine tremors of the extremities
140
(N) Behavioral Adaptations - First Period of Reactivity: How is muscle tone and respiration and hr?
All are increased
141
(N) Behavioral Adaptations - Period of Decreased Responsiveness: When do they enter this stage?
At 30 to 120 minutes of age. This is the sleep period or a decrease in activity
142
(N) Behavioral Adaptations - Period of Decreased Responsiveness: How are movements?
Less jerky and less frequent
143
(N) Behavioral Adaptations - Period of Decreased Responsiveness: How are muscles, heart, and RR?
They are all decreased and become relaxed. No interest in sucking shown.
144
(N) Behavioral Adaptations - Second Period of Reactivity: When does this begin?
When newborn awakens and shows interest in environmental stimuli. Lasts 2-8 hours.
145
(N) Behavioral Adaptations - Second Period of Reactivity: What happens here?
Heart and RR increase, along with peristalsis. Meconium or void passed here. Motor activity/tone increase.
146
(N) Behavioral Responses: What is neurobehavioral response?
How newborns react to the world around them
147
(N) Behavioral Responses - Orientation: What is this?
Reflects newborns' response to auditory and visual stimuli, demonstrated by their movement of head and eyes to fucos on that stimulus
148
(N) Behavioral Responses - Habituation: What is this?
Newborns ability to process and respond to visual and auditory stimuli. Measure of howe well adna ppropriately an infant responds to environment . This is the ability to block out external stiuli
149
(N) Behavioral Responses - Self-Quieting Ability: What are the five things (Five S's) parents can do to calm a fussy infant?
Swaddling tightly
Side/Stomach positon
shushing loudly or continuous white noise
Swinging using any rhhythmic movement
Sucking
150
When assessing the term newborn, the following are observed: newborn is alert, heart and respiratory rates have stabilized, and meconium has been passed. The nurse determines that the newborn is exhibiting behaviors indicating:
Initial period of reactivity
Second period of reactivity
Decreased responsiveness period
Sleep period for newborns
Second period of reactivity
151
A nurse observes a 3-day-old term newborn that is starting to appear mildly jaundiced. What might explain this condition?
Physiologic jaundice secondary to breast-feeding
Hemolytic disease of the newborn due to blood incompatibility
Exposing the newborn to high levels of oxygen
Overfeeding the newborn with too much glucose water
Physiologic jaundice secondary to breast-feeding
152
After teaching a group of nursing students about thermoregulation and appropriate measures to prevent heat loss by evaporation, which of the following student behaviors would indicate successful teaching?
Transporting the newborn in an isolette
Maintaining a warm room temperature
Placing the newborn on a warmed surface
Drying the newborn immediately after birth
Drying the newborn immediately after birth
153
After birth, the nurse would expect which fetal structure to close as a result of increases in the pressure gradients on the left side of the heart?
Foramen ovale
Ductus arteriosus
Ductus venosus
Umbilical vein
Foramen Ovale
154
Which of the following newborns could be described as breathing normally?
Newborn A is breathing deeply, with a regular rhythm, at a rate of 20 bpm.
Newborn B is breathing diaphragmatically with sternal retractions, at a rate of 70 bpm.
Newborn C is breathing shallowly, with 40-second periods of apnea and cyanosis.
Newborn D is breathing shallowly, at a rate of 36 bpm, with short periods of apnea.
Newborn D is breathing shallowly, at a rate of 36 bpm, with short periods of apnea.
155
When assessing a term newborn (6 hours old), the nurse auscultates bowel sounds and documents recent passing of meconium. These findings would indicate:
Abnormal gastrointestinal newborn transition and needs to be reported
An intestinal anomaly that needs immediate surgery
A patent anus with no bowel obstruction and normal peristalsis
A malabsorption syndrome resulting in fatty stools
A patent anus with no bowel obstruction and normal peristalsis
156
A nursing student questions the nursery nurse why they don’t bathe the newborn immediately upon admission to the nursery observation area after birth. The nurse states that this would increase the risk of:
Jaundice
Infection
Hypothermia
Anemia
Hypothermia
157
Because the newborn’s red blood cells break down much sooner than those of an adult, what might result?
Anemia
Bruising
Apnea
Jaundice
Jaundice
158
The nurse performs a physical examination on a newborn 2 hours after birth. Which of the following findings indicate a need for a pediatric consultation? Select all that apply:
Respiratory rate of 50 breaths per minute
Intermittent episodes of apnea, lasting <10 seconds each
Absent Moro reflex when startled
Preauricular skin tag noted on left ear
White raised bumps noted on nose and face
Yellow blanching of the skin when pressure applied to the nose
Absent moro reflex and yellow blanching of the skin when pressure applied to the nose
