Chap 29: The Normal Newborn: Needs and Care
Before the newborn and mother are discharged from the birthing unit, the nurse teaches the parents about newborn screening tests that includes which of the following?
Hearing screening
The nurse assesses a sleeping 1-hour-old, 39-weeks'-gestation newborn. The assessment data that would be of greatest concern would be which of the following?
Respirations 68 breaths/minute
The nurse assesses the newborn and notes the following behaviors: nasal flaring, facial grimacing, and excessive mucus. What is the nurse most concerned about?
Respiratory distress
The nurse initiates newborn admission procedures and evaluates the newborn's need to remain under observation by assessing which of the following?
Respiratory rate Airway clearance Ability to feed
The nurse is analyzing various teaching strategies for teaching new mothers about newborn care. To enhance learning, which teaching method should the nurse implement?
Schedule time for one-to-one teaching in the mother's room.
The nurse has instructed a new mother on quieting activities for her newborn. The nurse knows that the mother understands when she overhears the mother telling the father to do what?
Swaddle the newborn in a blanket.
The nurse tells a mother that the doctor is preparing to circumcise her newborn. The mother expresses concern that the infant will be uncomfortable during the procedure. The nurse explains that the physician will numb the area before the procedure. Additional methods of comfort often used during the procedure include which of the following?
Talking to the infant Providing a pacifier Stroking the head
The nurse should inform the parents of a newborn that they should call their healthcare provider when which of the following occurs?
Absence of breathing longer than 20 seconds Lethargy Refusal of two feedings in a row continual increase in temperature
A mother and her newborn are being discharged 2 days after delivery. The general discharge instructions provided by the nurse include which of the following?
Always place the infant in a supine position in the crib. Use a bulb syringe to suction mucus from the infant's nostrils as necessary.
New parents decide not to have their newborn circumcised. What should the nurse teach regarding care for the uncircumcised infant?
Avoid retracting the foreskin.
To maintain a healthy temperature in the newborn, which of the following actions should be taken?
Encourage the mother to snuggle with the newborn under blankets. Keep the newborn's clothing and bedding dry. Reduce the newborn's exposure to drafts.
In planning care for a new family immediately after birth, which procedure would the nurse most likely withhold for 1 hour to allow time for the family to bond with the newborn?
Eye prophylaxis medication
Which instructions should the nurse include when teaching parents of a newborn about caring for the umbilical cord?
Fold the diaper down to prevent covering the cord stump. Keep the umbilical stump clean and dry to avoid infection. Observe for signs of infection such as foul smell, redness, and drainage.
The nurse is working with new parents who have recently immigrated to the United States. The nurse is not familiar with the family's cultural background. Which approach is most appropriate when discussing the newborn?
"Could you explain your preferences regarding childrearing?"
The nurse is discussing parent-infant attachment with a prenatal class. Which statement indicates that teaching was successful?
"Giving the baby his first bath can really give me a chance to get to know him."
A newborn delivered at term is being discharged. The parents ask the nurse how to keep their baby warm. The nurse knows additional teaching is necessary if a parent states which of the following?
"A quick cool bath will help wake up my son for feedings."
To promote infant security in the hospital, the nurse instructs the parents of a newborn to do which of the following?
Check the identification of all personnel who transport the newborn.
The nurse is discharging a 15-year-old first-time mother. Which statement should the nurse include in the discharge teaching?
"Your infant should wet a diaper at least 6 times per day."
The parents of a newborn male ask the nurse whether they should circumcise their son. What is the best response by the nurse?
"Circumcision can sometimes cause complications. What questions do you have?"
A postpartum mother is concerned that her newborn has not had a stool since birth. The newborn is 18 hours old. What is the nurse's best response?
"Passage of the first stool within 48 hours is normal."
The nurse is instructing the parents of a newborn about car seat safety. Which statement indicates that the parents need additional information?
"We can bring the baby home from the hospital without a car seat as it is only a short drive home."
The nurse is working with an adolescent parent. The adolescent tells the nurse, "I'm really scared that I won't take care of my baby correctly. My mother says I'll probably hurt the baby because I'm too young to be a mother." What is the best response by the nurse?
"We can give the baby's bath together. I'll help you learn how to do it."
The nurse is instructing a new mother on circumcision care with a Plastibell. The nurse knows the mother understands when she states that the Plastibell should fall off within how long?
8 days
The nurse is providing discharge teaching to the parents of a newborn. The nurse should instruct the parents to notify the healthcare provider in case of which of the following?
A bluish discoloration of the skin with or without a feeding. Refusal of two feedings in a row. Development of eye drainage. More than one episode of forceful vomiting.
The nurse teaches the parents of an infant who recently was circumcised to observe for bleeding. What should the parents be taught to do if bleeding does occur?
Apply gentle pressure to the site with gauze.
A nurse is instructing nursing students about the procedure for vitamin K administration. What information should be included?
Gently massage the site after injection. Inject in the vastus lateralis muscle. Cleanse the site with alcohol prior to injection.
Prior to conducting the initial assessment of a newborn, the nurse reviews the mother's prenatal record and the delivery record to obtain information concerning possible risk factors for the infant and to anticipate the impact of these factors on the infant's ability to successfully transition to the extrauterine environment. Which information is pertinent to this assessment?
Infectious disease screening results Maternal history of gestational diabetes Prolonged rupture of the membranes
The nurse is instructing parents of a newborn about voiding and stool characteristics. Which of the following would be considered an abnormal pattern?
Large amounts of uric acid crystals in the first days of life
Appropriate nursing interventions for the application of erythromycin ophthalmic ointment (Ilotycin) include which of the following?
Massaging eyelids gently following application
The nurse is caring for a newborn who was recently circumcised. Which nursing intervention is appropriate following the procedure?
Observe for urine output.
Which of the following activities allows the nurse to provide individualized parent teaching on the maternal-infant unit?
Teach by example and role modeling when caring for the newborn in the client's room. Teach at every opportunity, even during the night shift, if the occasion arises. Teach using one-to-one instruction while in the client's room.
The nurse has just assisted the father in bathing the newborn 2 hours after birth. The nurse explains that the newborn must remain in the radiant warmer. This is based on which assessment data?
Temperature 96.8degreesF
The nurse has received the shift change report on infants born within the previous 4 hours. Which newborn should the nurse see first?
Term male, nasal flaring
The nurse is administering erythromycin (Ilotycin) ointment to a newborn. What factors are associated with administration of this medication?
The medication should be instilled in the lower conjunctival sac of each eye. The eyelids should be massaged gently to distribute the ointment. The medication can interfere with the baby's ability to focus.
At birth, an infant weighed 8 pounds 4 ounces. Three days later, the newborn is being discharged. The parents note that the baby now weighs 7 pounds 15 ounces. The nurse explains that the change in the newborn's weight is which of the following?
Within normal limits
The nurse is caring for four newborns who have recently been admitted to the newborn nursery. Which labor event puts the newborn at risk for an alteration of health?
The infant's mother has group B streptococcal (GBS) disease.
The nurse is preparing to give an injection of vitamin K to a newborn. Which considerations would be appropriate?
Use a 25-gauge, 5/8-inch needle for the injection. Protect the medication bottle from light. Give vitamin K prior to a circumcision procedure. Administer a dose of 0.5 to1 mg within 1 hour of birth.
Placing the baby at mother's breast facilitates early latch and promotes successful breastfeeding. When should breastfeeding be initiated?
Within 1 hour of birth
A postpartum client calls the nursery to report that her newborn's umbilical cord stump is draining, and has a foul odor. What is the nurse's best response?
"Take your newborn to the pediatrician."
The nurse is planning home visits to the homes of new parents and their newborns. Which client should the nurse see first?
6-day-old female with greenish discharge from the umbilical cord site