NEONATE

A nurse is reviewing the treatment plan with the parents of a newborn infant with hypospadias. Which statement by the parents indicates their understanding of the plan?

"Circumcision has been delayed to save tissue for surgical repair." The infant should not be circumcised because the dorsal foreskin tissue will be used for surgical repair of the hypospadias

A nurse is instructing a postpartum client with endometritis about preventing the spread of infection to the newborn.

"Hands should be washed thoroughly before holding the infant." Transmission of infectious diseases can occur through contaminated items such as hands and bed linens in clients with endometritis. An important method of preventing infection is to break the chain of infection. Handwashing is one of the most effective methods of preventing the transmission of infectious diseases

Cleft lip repair

Cleft lip repair is usually performed around 6 to 12 weeks of age. Early repair may improve bonding and makes feeding much easier. Cleft palate repair is individualized and based on the degree of deformity and the size of the child. Closure of the cleft palate is completed between ages 12 to 18 months. Although repair of a cleft lip makes feeding easier and improves bonding, it is not necessary to perform the surgical procedure immediately.

hiatal hernia

A portion of the stomach protrudes through the esophageal hiatus of the diaphragm.

What is the priority of the nurse plan of care for a newborn with FAS- Fetal Alcohol Syndrome?

A primary nursing goal for the neonate diagnosed with FAS is to establish nutritional balance following delivery.

Subdural Hematoma

A subdural hematoma is a collection of blood outside the brain. Subdural hematomas are usually caused by severe head injuries. The bleeding and increased pressure on the brain from a subdural hematoma can be life-threatening.

fetal alcohol syndrome

Abnormal palmar creases

teaching cord card to new mothers

Apply alcohol to the cord, ensuring that all areas around the cord are cleaned two or three times a day.

A nurse discusses infant feeding options with a client following a vaginal delivery of a 6-pound full-term infant. The client has been diagnosed with human immunodeficiency virus (HIV) HIV. What is the appropriate method of feeding for this client?

Bottle-feeding with a tolerated formula Perinatal transmission of HIV can occur during the antenatal period(before something is born), during labor and birth, or in the postpartum period if the client is breast-feeding. This information will assist the client to choose a feeding method that will support parenting and the normal physiological development of her infant. Bottle-feeding represents the best choice when considering current knowledge of HIV transmission during pregnancy. A fortified formulation is not indicated by the item.

A newborn infant has coarctation of the aorta (COA). The nurse would expect to note which of the following findings in the infant?

Bounding radial pulses and absent or weak femoral and pedal pulses

A nurse discovers an unresponsive breathing newborn infant. To assess circulatory status, the nurse should palpate which arterial pulse area?

Brachial

Circulatory status: Child older than 1 year old

Carotid pulse is palpates

newborn infant with a diagnosis of a hiatal hernia. Which finding would the nurse expect to note in the infant?

Coughing, wheezing, and short periods of apnea Clinical manifestations associated with hiatal hernia specifically include vomiting, coughing, wheezing, short periods of apnea, and failure to thrive.

A nursing instructor is observing a nursing student caring for a newborn with a diagnosis of bladder exstrophy. The nursing student provides appropriate care to the infant by:

Covering the bladder with a sterile, non-adhering(Nonstick) moist dressing

Newborn with respiratory distress syndrome may present with....

Cyanosis, tachypnea or apnea, nasal flaring, chest wall retraction or audible expiratory grunts

Metabolic Acidosis

Decrease pH and decrease HCO mEq/L

Respiratory Acidosis

Decrease pH with increase PaC02

Instruction for newborn males regarding penis

In newborn males, the foreskin is continuous with the epidermis of the glans and is not retractable. If retraction is forced, adhesions can develop. It is best to allow separation of the foreskin to occur naturally, which usually occurs between 3 years and puberty. Most foreskins are retractable by 3 years of age and should be pushed back gently at this time for cleaning once a week.

Respiratory Alkalosis

Increase pH and Decrease PaC02

Metabolic Alkalosis

Increase pH and increase HCO

Which of the following actions is recommended for a newborn who is being breast-fed when diagnosed with hyperbilirubinemia?

Increase the frequency of breast-feeding.

A nurse is caring for a newborn diagnosed with hyperbilirubinemia. Which of the following actions is recommended for a newborn who is being breast-fed when diagnosed with hyperbilirubinemia?

Increase the frequency of breast-feeding. The greater the number of breast-feedings, the lower the bilirubin. Breast-feeding should be initiated early and frequently. Supplementation with water does not reduce hyperbilirubinemia. Water, glucose, or formula supplements should be discouraged.

Endometritis

Inflammation of the endometrium

After circumcision to a newborn infant

Observing for bleeding and monitoring for pain. common protocol is to assess the site every hour for 8 to 12 hours. Assessing for pain by looking at the infant's facial expression, body movements, and character of crying will indicate the need to minimize or lessen pain. Nutrition is important.

A nurse is admitting a newborn infant to the nursery and notes that the health care provider has documented that the newborn has an omphalocele. The nurse collects data, knowing that in this condition, the viscera are:

Outside of the abdominal cavity but covered with a translucent sac

Which technique does the nurse anticipate will be used to check for evidence of birth trauma?

Palpating the clavicles for a fracture Because of the neonate's large size, there is an increased risk for shoulder dystocia

Phototherapy

Phototherapy is the most common treatment for reducing high bilirubin levels that cause jaundice in a newborn

Purpose of erythromycin ointment?

Prevent ophthalmia neonatorum from occurring after delivery to a neonate born to a woman with an untreated gonococcal infection.

Preterm Newborn are at risk for developing RDS-Respiratory Distress Syndrome. What signs includes?

Tachypnea and retractions

Sign of RDS in infants

Tachypnea and retractions

A nurse is collecting data on a newborn admitted to the nursery with a diagnosis of subdural hematoma after a difficult vaginal delivery. The nurse demonstrates an understanding of the major symptoms associated with subdural hematoma when:

Testing for equality of extremities when stimulating reflexes

special characteristics of a preterm newborn skin

Thin and gelatinous skin with decreased amounts of subcutaneous fat and an open posture

When do you treat a newborn with phototherapy?

Until their bilirubin is above 12 mg/dL

A nurse in the delivery room is caring for a newborn delivered 10 minutes ago. The nurse assists to prepare which medications that will be prescribed to be given within the first hour of life

Vitamin K and Erythromycin eyedrops

Vitamin K

Vitamin K plays a key role in helping the blood clot, preventing excessive bleeding. Unlike many other vitamins, vitamin K is not typically used as a dietary supplement.

A nurse in the delivery room is assisting with the delivery of a newborn. The nurse prepares to prevent heat loss in the newborn due to conduction by:

Warming the crib pad before placing the newborn in the crib

Normal Blood glucose level for a newborn infants.

is 40 mg/dL to 60 mg/dL

gastroschisis

is a birth defect of the abdominal (belly) wall. The baby's intestines stick outside of the baby's body, through a hole beside the belly button. The hole can be small or large and sometimes other organs, such as the stomach and liver, can also stick outside of the baby's body

Why newborn baby needs an injection of vitamin K

"Newborns are deficient in vitamin K. This injection prevents your baby from abnormal bleeding."

Cephalhematoma

A cephalhematoma is a hemorrhage (a collection of blood) found between the skull and periosteum of a newborn baby as a result of birth trauma. The periosteum is a membrane lining the outer surface of all bones (except at the joints of long bones).

omphalocele

An omphalocele (British English: omphalocoele) is a rare abdominal wall defect in which the intestines, liver, and occasionally other organs remain outside of the abdomen in a sac because of a defect in the development of the muscles of the abdominal wall

postterm neonate, The priority nursing action would be to monitor:

BLOOD GLUCOSE

Pregnancy Terms

Early Term: Between 37 weeks 0 days and 38 weeks 6 days Full Term: Between 39 weeks 0 days and 40 weeks 6 days Late Term: Between 41 weeks 0 days and 41 weeks 6 days Postterm: Between 42 weeks 0 days and beyond

A nurse is reviewing the record of a newborn infant and notes that the health care provider has documented the presence of a cephalhematoma. Based on this documentation, the nurse expects to observe which of the following on data collection of the infant?

Edema caused from bleeding below the brain's periosteum

A nurse observes slight facial jaundice in a 2-day-old full-term neonate. The nurse interprets this finding using which of the following guidelines?

Jaundice is visible on the skin of a neonate at bilirubin levels from 4 to 6 mg/dL, which are not abnormal in a 2-day-old neonate.

meconium aspiration

MAS can happen before, during, or after labor and delivery when a newborn inhales (or aspirates) a mixture of meconium and amniotic fluid (the fluid in which the baby floats inside the amniotic sac). Meconium is the baby's first feces, or poop, which is sticky, thick, and dark green and is typically passed in the womb during early pregnancy and again in the first few days after birth.

What to include in the plan of care, while caring for a neonate born to a mother with AIDS?

Maintain standard precaution at all times while caring for the neonate.

A nurse is assisting in developing a plan of care for a newborn infant with spina bifida (myelomeningocele type). The nurse includes data collection measures in the plan to monitor for increased intracranial pressure (ICP). Which action will best detect the presence of an increase in ICP?

Monitoring the anterior fontanel for bulging A bulging or taut anterior fontanel would indicate the presence of increased ICP

hyperbilirubinemia

Newborn jaundice. Newborn jaundice occurs when a baby has a high level of bilirubin in the blood. Bilirubin is a yellow substance that the body creates when it replaces old red blood cells. The liver helps break down the substance so it can be removed from the body in the stool.

NORMAL

Normal pH: 7.35-7.45 Pa02: 80 to 100 mm hg PaC02: 35-45 mm hg HCO: 22 to 27 mEq/L

A nurse is changing the diaper of a 1-day-old, full-term female newborn and notes that the genitalia are red and swollen and that a thick white mucoid vaginal discharge is present. Based on these findings, the nurse determines that the best action would be to:

The best action is to document the findings because it is normal in the first week of life. The genitalia of a newborn female are frequently red and swollen. This edema disappears in a few days. A vaginal discharge of thick white mucus is seen in the first week of life. The mucus is occasionally blood tinged by about the third or fourth day and stains the diaper. The cause of the pseudomenstruation, like that of breast engorgement, is the withdrawal of maternal hormones.

What is the highest priority for a postterm newborn?

The most common metabolic complication in the postterm newborn is hypoglycemia(CHECK GLUCOSE) which can produce central nervous system abnormalities and mental retardation if it is not corrected immediately

Vitamin K injection Site for infants.

The preferred injection site for vitamin K in the newborn is the lateral aspect of the middle third of the vastus lateralis muscle in the newborn's thigh

hypospadias

is a condition in which the opening of the urethra is on the underside of the penis, instead of at the tip

large-for-gestational age (LGA)

meaning that they weigh more than 90 percent of all babies of the same gestational age. The average baby weighs about 7 pounds at birth.

Features associated with FAS- Fetal Alcohol Syndrome

- Craniofacial Abnormalities - Cleft Lip or palate - ABNORMAL PALMAR CREASES - irregular air distribution - Microcephaly - Limb anomalies - Increase respiratory effort during transition to extrauterine life also are noted frequently in the neonate with FAS

The nurse is preparing to care for a newborn who is receiving phototherapy. What should be done while newborn is receiving phototherapy?

- Monitor the skin temperature closely - Reposition the newborn every 2 hours - Cover the newborns eyes with shield or patches Rationale: Phototherapy is the use of intense fluorescent lights to reduce serum bilirubin levels in the newborn. Injury from treatment (e.g., eye damage, dehydration, sensory deprivation) can occur. Interventions include exposing as much of the newborn's skin as possible; however, the genital area is covered. The newborn's eyes are also covered with shields or patches to ensure that the eyelids are closed. The shields or patches are removed at least once per shift to inspect the eyes for infection or irritation and to allow for eye contact. The nurse measures the quantity of light every 8 hours, monitors the skin temperature closely, and increases fluids to compensate for water loss. The newborn will have loose green stools and green-colored urine. The newborn's skin color is monitored with the fluorescent light turned off every 4 to 8 hours, and he or she is monitored for bronze baby syndrome, which is a grayish-brown discoloration of the skin. The newborn is repositioned every 2 hours, and stimulation is provided. After treatment, the newborn is monitored for signs of hyperbilirubinemia, because rebound elevations are normal after therapy is discontinued.

What finding would the nurse expect to note in a healthy breast-feeding mother and newborn?

A mother breast-feeding with the newborn in a tummy-to-tummy position every 3 to 4 hours without signs of cracked nipples; the baby demonstrates bursts of sucking followed by a pause and swallow

Neonate born to a mother who is addicted to drugs

A neonate born to woman who is addicted to drugs is irritable, may cry incessantly, and be difficult to console. The neonate would hyperextend and posture rather than cuddle when being held.

Coarctation of the aorta

aortic coarctation — is a narrowing of the aorta, the large blood vessel that branches off your heart and delivers oxygen-rich blood to your body. When this occurs, your heart must pump harder to force blood through the narrow part of your aorta

How to bathe Newborn

Bathing should start at the eyes and face, which are usually the cleanest areas. Next, the external ears and behind the ears are cleansed. The newborn's neck should be washed, because formula, breast milk, or lint will often accumulate in the folds of the neck. The hands and arms are then washed. The baby's legs are washed, with the diaper area being washed last.

Ophthalmia neonatorum

also known as ophthalmia neonatorum, is a form of conjunctivitis and a type of neonatal infection contracted by newborns during delivery. The baby's eyes are contaminated during passage through the birth canal from a mother infected with either Neisseria gonorrhoeae or Chlamydia trachomatis.

Sign of infection of the umbilical cord?

cord are moistness, oozing, discharge, and a reddened base.

Circulatory status: Infant Younger than 1 year old

nurse should check the brachial pulse

Viscera

the internal organs in the main cavities of the body, especially those in the abdomen, e.g., the intestines.