Chapter 18

When instructing a new mom on providing skin care to her newborn, which statement, made by the mother, indicates additional teaching is needed? "It is not necessary to give my baby a bath daily." "I will give sponge baths until the umbilical cord falls off." " I will change my baby's diapers frequently." "I can use talc powders to prevent diaper rash."

"I can use talc powders to prevent diaper rash."

A woman who is about to be discharged after a vaginal birth notices a flea-like rash on her newborn's chest that consists of tiny red lesions all across the nipple line. What is the best response from the nurse when explaining this to the woman? "It is an indication that the woman has mistreated her newborn." "It is a sign of a group B streptococcus skin infection. " "It is a normal skin finding in a newborn." "It is a self-limiting virus that does not require treatment."

"It is a normal skin finding in a newborn."

A nursing mother calls the nurse and is upset. She states that her newborn son just bit her when he was nursing. Upon examining the newborn's mouth, two precocious teeth are noted on the lower central portion of the gums. What would be the nurse's best response? "Precocious teeth can occur at birth but we may need to remove them to prevent aspiration." "This is most unusual! Let me get the lactation specialist to assist you in breastfeeding. It should not be a problem though." "The teeth will fall out when the newborn's baby teeth come in so this is a blessing." "The teeth will fall out within the first month, so don't worry about them."

"Precocious teeth can occur at birth but we may need to remove them to prevent aspiration."

New parents are getting ready to go home from the hospital and have received information to help them learn how best to care for their new infant. Which statement indicates that they need additional teaching about how to soothe their newborn if he becomes upset? "We'll hold off on feeding him for a while because he might be too full." "We'll turn on the mobile that's hanging above his head in his crib." "We'll swaddle him snuggly to make him feel secure." "We'll lightly rub his back as we talk to him softly."

"We'll hold off on feeding him for a while because he might be too full."

A nurse is providing care to a newborn in the immediate newborn period. Which nursing intervention is priority? Perform the newborn screening. Administer vitamin K. Provide hepatitis B vaccination. Complete the hearing test.

Administer vitamin K.

A woman in scrubs enters a mother's room while the nurse is completing an assessment. The woman states the doctor is in the nursery and has requested the infant be brought back for an examination. What will the nurse do? Ask the woman to bring the infant back when the doctor finishes the examination. Call the nursery to confirm the doctor does indeed need this infant at this time. Ask how long the infant will be gone since her next feeding is in 30 minutes. Ask to see the woman' hospital identification badge.

Ask to see the woman' hospital identification badge.

The nurse explains the hospital's home visitation program for new families after discharge from the hospital. Which information will the nurse include regarding this program? The nurse can discuss parenting conflicts with the caregivers to determine which style is best. Caregivers can demonstrate competency in caring for the infant and ask questions. Caregivers use this time to rest or complete errands while the visiting nurse takes care of the infant. The nurse will complete any procedures the infant was not able to have performed while in the hospital.

Caregivers can demonstrate competency in caring for the infant and ask questions.

Which action would be priority for the nurse to complete immediately after the delivery of a 40-week gestation newborn? Assess the newborn's glucose level. Complete a full head-to-toe assessment. Swaddle the infant and place in the bassinet. Dry the newborn and place it skin-to-skin on mother.

Dry the newborn and place it skin-to-skin on mother.

A nurse is observing a new parent bottle feeding the newborn. The nurse notices that the newborn begins to get fussy during the feeding. Which action by the nurse would be appropriate? Urge the parent to prop the bottle for the rest of the feeding. Suggest the parent stop the feeding because the newborn is full. Encourage the parent to burp the newborn to get rid of air. Instruct the parent to stop feeding for a few minutes and then restart.

Encourage the parent to burp the newborn to get rid of air.

The mother of a newborn observes a diaper rash on her newborn's skin. Which intervention should the nurse instruct the parent to implement to treat the diaper rash? Use products such as talcum powder with each diaper change. Place the newborn's buttocks in warm water after each void or stool. Expose the newborn's bottom to air several times a day. Use only baby wipes to cleanse the perianal area.

Expose the newborn's bottom to air several times a day.

A newborn's ears are lined up below a line from the inner to outer canthus of the eye, extending past the ear. What other possible findings should the nurse be aware of in this client? Select all that apply. Deafness Hydrocephalus Cleft palate Internal organ defects Cognitive impairment

Internal organ defects Cognitive impairment

A woman wearing hospital scrubs comes to the nursery and states "Mrs. Smith is ready for her baby. I will be glad to take the baby to her." What will the nursery nurse do next? Determine which hospital unit the woman works on. Look at the woman's hospital identification badge. Ask if the client actually sent the woman. Inform the woman she cannot transport the baby.

Look at the woman's hospital identification badge.

While assessing a newborn, the nurse notes that half the body appears red while the other half appears pale. The nurse interprets this finding as: Mongolian spots. harlequin sign. stork bites. erythema toxic.

harlequin sign.

The nurse is explaining the care the newborn will be receiving right after birth to the parents. The nurse should point out the infant will receive an ophthalmic antibiotic ointment by approximately which time? Within 72 hours Any time prior to discharge Within 12 hours Within one hour

Within one hour

A nurse is conducting a refresher program for a group of nurses returning to work in the newborn clinic. The nurse is reviewing the protocols for assessing vital signs in healthy newborns and infants. The nurse determines that additional education is needed when the group identifies which parameter as being included in the assessment? temperature blood pressure pain respirations pulse

blood pressure

The nurse is admitting a 10-pound (4.5-kg) newborn to the nursery. What is important for the nurse to monitor during the transition period? Apgar score temperature blood sugar heart rate

blood sugar

On an Apgar evaluation, how is reflex irritability tested? tightly flexing the infant's trunk and then releasing it flicking the soles of the feet and observing the response dorsiflexing a foot against pressure resistance raising the infant's head and letting it fall back

flicking the soles of the feet and observing the response

The Apgar score is based on which 5 parameters? heart rate, breaths per minute, irritability, reflexes, and color heart rate, muscle tone, reflex irritability, respiratory effort, and color heart rate, breaths per minute, irritability, tone, and color heart rate, respiratory effort, temperature, tone, and color

heart rate, muscle tone, reflex irritability, respiratory effort, and color

A nurse is teaching new parents about keeping follow-up appointments and calling their health care provider if they notice signs of illness in their newborn. The nurse determines that the teaching was successful when the parents identify which signs as needing to be reported? Select all that apply. refuse feeding general fussiness abdominal distention approximately eight wet diapers a day temperature of 38.3° C (101° F) or higher

refuse feeding abdominal distention temperature of 38.3° C (101° F) or higher

The nurse is preparing discharge instructions for the parents of a male newborn who is to be circumcised before discharge. Which instruction should the nurse prioritize? Notify the primary care provider if it appears red and sore. Soak the penis daily in warm water. Cover the glans generously with petroleum jelly. Cleanse the glans daily with alcohol.

Cover the glans generously with petroleum jelly.