Ch. 26 PrepU OB

In an infant who has hypothermia, what would be an appropriate nursing diagnosis? You Selected:

Impaired tissue perfusion

When preparing to resuscitate a preterm newborn, the nurse would perform which action first?

Place the newborn's head in a neutral position.

Which assessment finding is identified as a sign of increased intracranial pressure in an infant?

Seizures

A 20-year-old client gave birth to a baby boy during the 43rd week of gestation. What might the nurse observe in the newborn during routine assessment?

The newborn may look wrinkled and old at birth.

Which finding is indicative of hypothermia of the preterm infant?

nasal flaring

A newborn with high serum bilirubin is receiving phototherapy. Which is the most appropriate nursing intervention for this client?

Application of eye dressings to the infant

Which condition may cause intrauterine asphyxia? Select all that apply.

cord compression placenta abruption intrauterine growth restriction

When examining a neonate, which characteristic would indicate to the nurse that the infant is preterm? Select all that apply.

extended extremities covered with vernix caseosa absence of sole creases

A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the baby is being born. Which intervention should the nurse implement as a result of this finding?

intubation and suctioning of the trachea

The nurse is weighing a newborn and documents AGA (appropriate for gestational age) on the newborn record. Which weight percentile is anticipated?

20th

An LGA newborn has a blood glucose level of 30 mg/dL and is exhibiting symptoms of hypoglycemia. Which action would the nurse do next?

Administer intravenous glucose immediately.

A nurse is providing care to a large for gestational age newborn. The nurse checks the newborn's blood glucose level and finds it to be 23 mg/dL. Which action would the nurse do first?

Administer intravenous glucose.

A newborn is receiving bag and mask ventilation and cardiac compression. The resuscitation is paused, and the nurse reassesses the infant. The infant's heart rate is 70 bpm with irregular gasping respirations. What is the appropriate action in this situation?

Continue bag and mask ventilation only.

The nurse in the NICU is caring for preterm newborns. Which guidelines are recommended for care of these newborns? Select all that apply.

Dress the newborn in ways to preserve warmth. Take the newborn's temperature often. Supply oxygen for the newborn, if necessary.

An 18-year-old client has given birth in the 28th week of gestation, and her newborn is showing signs of respiratory distress syndrome (RDS). Which statement is true for a newborn with RDS?

RDS is caused by a lack of alveolar surfactant.

At birth, the newborn was at the 8th percentile with a weight of 2350g and born at 36 weeks gestation. Which documentation is most accurate?

The infant was a preterm, low birth weight and small for gestational age Explanation:

The nurse observes a neonate born at 28 weeks' gestation. Which finding would the nurse expect to see?

The pinna of the ear is soft and flat and stays folded.

Preterm infant deaths account for 80% to 90% of infant mortality in the first year of life.

True

What action by the nurse provides the neonate with sensory stimulation of a human face?

assisting the mother to position the infant in an enface position

When discussing heat loss in newborns, placing a newborn on a cold scale would be an example of what type of heat loss?

conduction

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

greater surface area in proportion to weight

A client asks the nurse what surfactant is. Which explanation would the nurse give as the main role of surfactant in the neonate?

helps the lungs remain expanded after the initiation of breathing

A newborn is being monitored for retinopathy of prematurity. Which condition predisposes an infant to this condition?

respiratory distress syndrome

A woman gives birth to a newborn at 36 weeks' gestation. She tells the nurse, "I'm so glad that my baby isn't premature." Which response by the nurse would be most appropriate?

"We still need to monitor him closely for problems."

A nurse is caring for a preterm newborn who has developed rapid, irregular respirations with periods of apnea. Which additional assessment finding should the nurse identify as an indication of respiratory distress syndrome (RDS)?

Sternal retraction

Which statement by the parents is evidence of meeting the desired outcome for a nursing diagnosis of impaired parenting?

"I'm so happy to hold you; I think you like it too."

A preterm newborn has just received synthetic surfactant through an endotracheal tube by a syringe. Which intervention should the nurse implement at this point?

Tip the infant into an upright position.

The nurse begins intermittent oral feedings for a small-for-gestational-age newborn to prevent which occurrence?

hypoglycemia

In pulse oximetry for a newborn, what is the percentage of oxygen that is considered abnormal?

75%

A newborn is identifies as extremely low birth weight placing the newborn's weight at which level?

Less than 1,000 g.

The nurse examines a 26-week-old premature infant. The skin temperature is lowered. What could be a consequence of the infant being cold?

apnea

The nurse frequently assesses the respiratory status of a preterm newborn based on the understanding that the newborn is at increased risk for respiratory distress syndrome because of which factor?

deficiency of surfactant

The nurse is caring for a large-for-gestational-age newborn (also known as macrosomia). What maternal condition is the usual cause of this condition?

diabetes

After an extended resuscitation, the infant's body temp is 35.8°C. What assessment finding would the nurse anticipate as a consequence of a temperature of 35.8°C? Select all that apply.

heart murmur hypoglycemia decreasing oxygen saturation

An obese woman with diabetes has just given birth to a term, large for gestational age (LGA) newborn. Which condition should the nurse most expect to find in this infant?

hypoglycemia

An infant that is diagnosed with meconium aspiration displays which symptom?

intercostal and substernal retractions

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn?

meconium aspiration in utero or at birth

While caring for a preterm newborn receiving oxygen therapy, the nurse monitors the oxygen therapy duration closely based on the understanding that the newborn is at risk for which condition?

retinopathy of prematurity

A nurse is caring for a baby girl born at 34 weeks' gestation. Which feature should the nurse identify as those of a preterm newborn?

shiny heels and palms

A newborn girl who was born at 38 weeks of gestation weighs 2000 g and is below the 10th percentile in weight. The nurse recognizes that this girl will be placed in which classification?

term, small for gestational age, and low-birth-weight infant