NSG 2400 Complications of Prematurity

A nurse explains preterm labor to a group of nursing students. Which description of preterm labor indicates effective teaching? 1 Preterm labor is defined as contractions during the delivery. 2 Preterm labor is defined as contractions induced by prostaglandins. 3 Preterm labor is defined as contractions between 20 and 36 weeks of gestation. 4 Preterm labor is defined as contractions occurring before 20 weeks of gestation.

3

What is the percentage of total body water in a premature newborn? 1 55% 2 65% 3 75% 4 85%

4

The nurse is caring for a preterm neonate who is receiving gastric feedings. Which neonatal clinical finding unique to necrotizing enterocolitis (NEC) leads the nurse to suspect that the neonate is experiencing this complication? 1 Persistent diarrhea 2 Decreased abdominal circumference 3 Increased amount of residual gastric aspirates 4 Small amount of vomitus after each gastric feeding

3

What is an appropriate nursing intervention for a neonate with respiratory distress syndrome (RDS)? 1 Avoid handling the infant to conserve energy 2 Position the infant to promote respiratory efforts 3 Assess the infant for congenital birth defects to enable early treatment 4 Set the incubator thermostat 10° F (12° C) below body temperature to prevent shivering

2 Positioning the infant with the head slightly hyperextended and changing the position every 1 to 2 hours helps respiratory secretions drain; this will increase oxygenation by enhancing respiratory efforts. Extensive handling is not desired, but infants do need to be touched. All newborns are assessed for congenital birth defects, not just those with RDS. Ten degrees (12 degrees) below body temperature is too low; it may exacerbate the respiratory distress.

A preterm infant with respiratory distress syndrome (RDS) has blood drawn for an arterial blood gas analysis. Which test result should the nurse anticipate for this infant? 1 Increased Po2 2 Lowered HCO3 3 Decreased Pco2 4 Decreased blood pH

4

Supplemental oxygen is ordered for a preterm neonate with respiratory distress syndrome (RDS). What action does the nurse take to reduce the possibility of retinopathy of prematurity? 1 Humidifying oxygen flow to prevent dehydration 2 Uncovering the entire body to increase exposure to the oxygen 3 Applying eye patches to both eyes to protect them from the oxygen 4 Verifying oxygen saturation frequently to adjust flow on the basis of need

4

Which tocolytic agent inhibits prostaglandin activity and is given along with sucralfate to help manage preterm labor? 1 Nifidipine 2 Indomethacin 3 Calcium gluconate 4 Magnesium sulfate

2

Continuous positive-pressure ventilation therapy by way of an endotracheal tube is started in a newborn with respiratory distress syndrome (RDS). The nurse determines that the infant's breath sounds on the right side are diminished and that the point of maximum impulse (PMI) of the heartbeat is in the left axillary line. How should the nurse interpret these data? 1 These findings are expected because infants with this disorder often have some degree of atelectasis. 2 The inspiratory pressure on the ventilator is probably too low and needs to be increased for adequate ventilation. 3 These findings indicate that the infant may have a pneumothorax and that the health care provider should be contacted immediately. 4 The endotracheal tube needs to be pulled back to ventilate both lungs because it has probably slipped into the left main stem bronchus.

3

The nurse is caring for a preterm infant who is receiving oxygen therapy. What should the nurse do to prevent retinopathy of prematurity (ROP)? 1 Cover the neonate's eyes with a shield 2 Place the neonate in an elevated side-lying position 3 Assess the neonate every hour with a pulse oximeter 4 Support the neonate's oxygen saturation while providing minimal FiO2

4

What is the focus of nursing care for a newborn with respiratory distress syndrome (RDS)? 1 Tapping the toes to stimulate respirations 2 Turning the infant frequently to prevent apnea 3 Maintaining oxygen concentration at 40% to support respiration 4 Keeping the infant warm to maintain body temperature at 98° F (37° C)

4

What maternal condition would cause the nurse to expect signs of respiratory distress syndrome (RDS) in a neonate? 1 Has type 1 diabetes 2 Has been hypertensive during pregnancy 3 Was preeclamptic during the labor and birth

1 Infants of mothers with diabetes are at risk for respiratory distress syndrome as a result of delayed synthesis of surfactant caused by a high serum level of insulin. The infant of a mother with hypertension may be small for gestational age but not necessarily preterm and at risk for RDS. Preeclampsia does not predispose the full-term newborn to the development of RDS. The mother's use of heroin or other opioids does not necessarily predispose the newborn to RDS.

A pregnant woman is administered medication to treat preterm labor that requires a prescription for calcium gluconate to counter the effects of the drug. Which drug was administered? 1 Nifedipine 2 Indomethacin 3 Betamethasone 4 Magnesium sulfate

4

Because preterm infants are at risk for respiratory distress syndrome, immediate nursing intervention is required when a preterm infant exhibits what sign? 1 Supraventricular retractions 2 Tachycardia of 160 beats/min 3 Respirations of 50 to 60 breaths/min 4 Neonatal Infant Pain Scale (NIPS) score of three

1

Which component of nursing care is most important for a newborn with respiratory distress syndrome (RDS)? 1 Keeping the infant in a warm environment 2 Turning the infant frequently to prevent apnea 3 Tapping the infant's toes to stimulate deep breathing 4 Maintaining the infant's oxygen administration level at the same rate

1

A woman in premature labor is prescribed betamethasone to enhance fetal lung maturity. The prescription reads: "Administer betamethasone 12 mg IM daily for 3 days." The betamethasone comes in a vial labeled "6 mg/mL." How many milliliters should the nurse administer each day? Record your answer using a whole number. ___ mL

2

Respiratory distress syndrome (RDS) develops 6 hours after birth in a neonate born at 33 weeks' gestation. What would the nurse's assessment of the newborn at this time reveal? 1 High-pitched cry 2 Intercostal retractions 3 Heart rate of 140 beats/min 4 Respirations of 30 breaths/min

2

The nurse is caring for a client with a diagnosis of necrotizing fasciitis. Which is the priority concern of the nurse when caring for this client? 1 Fluid volume 2 Skin integrity 3 Physical mobility 4 Urinary elimination

2

Which drug is used to prevent preterm labor? 1 Oxytocin 2 Nifedipine 3 Raloxifene 4 Clomiphene

2

Which statements relate to preterm labor? Select all that apply. 1 A premature baby has good cognitive development. 2 The treatment for preterm labor includes bed rest and hydration. 3 Preterm labor before the 20th week is indicative of a nonviable fetus. 4 It is not desirable to stop the delivery in the case of preterm labor. 5 Preterm labor refers to uterine contractions progressing to delivery before the 27th week of pregnancy.

2 3

A newborn with respiratory distress syndrome (RDS) is receiving continuous positive airway pressure (CPAP) therapy by way of an endotracheal tube. The nurse determines that the infant's breath sounds on the right side are diminished and that the point of maximum impulse (PMI) of the heartbeat is in the left axillary line. What is the interpretation of these assessment data and the appropriate nursing action? 1 Inspiratory pressure on the ventilator is probably too low and should be increased for adequate ventilation. 2 Infants with RDS often have some degree of atelectasis, and there should be no change in treatment. 3 The endotracheal tube has slipped into the left main stem bronchus and should be pulled back to ventilate both lungs. 4 The infant may have a pneumothorax, and the health care provider should be called so that corrective therapy can be started immediately.

4

A nurse is caring for a preterm infant with necrotizing enterocolitis (NEC). Which nursing intervention is most important for this infant? 1 Measuring abdominal girth frequently 2 Diluting the formula mixture as prescribed 3 Administering oxygen before the gastric feeding 4 Using half-strength formula for gavage feeding

1