NUR 420 MATERNITY PREPU

Assessment of a 26-week-old premature newborn reveals that the newborn is having problems with thermoregulation. The nurse would be alert for the development of which of the following?

Apnea

A ventilated 33 weeks' gestation newborn in the neonatal intensive care unit (NICU) receives surfactant therapy. Which would the nurse expect to assess as a positive response to this therapy?

Oxygen saturation levels are at 98%.

A nurse is caring for an infant. A serum blood sugar of 40 was noted at birth. What care should the nurse provide to this newborn?

a sudden drop in hemocrit

During the newborn's assessment, which finding would lead the nurse to suspect that a large-for-gestational-age newborn has experienced birth trauma?

asymmetrical movement

What is a consequence of hypothermia in a newborn?

holds breath 25 seconds

The nurse assesses a post-term newborn. What finding corresponds with this gestational age diagnosis?

meconium-stained skin and fingernails

A nurse suspects that a preterm newborn is having problems with thermal regulation. Which findings would support the nurse's suspicion? Select all that apply.

shallow, slow respirations cyanotic hands and feet feeble cry

What is a typical feature of a small-for-gestational-age (SGA) newborn that differentiates it from a preterm baby with a low-birth-weight?

ability to tolerate early oral feeding

At an amniocentesis just prior to birth, a fetus's lecithin/sphingomyelin ratio was determined to be 1:1. Based on this, she is prone to which type of respiratory problem following birth?

Alveolar collapse on expiration

The nurse has admitted a small for gestational age infant (SGA) to the observation nursery from the birth room. Which action would the nurse prioritize in the newborn's care plan?

Closely monitor temperature.

A nurse is reviewing a journal article about newborn pain prevention and management. Which information would the nurse most likely find discussed in the article?

Pain is frequently mistaken for irritability or agitation.

An 18-year-old client has given birth to a very-low-birth-weight preterm infant. Which intervention should the nurse consider to prevent the newborn from losing body temperature?

Provide isolette or radiant warmer care to the newborn.

Which sign appears early in a neonate with respiratory distress syndrome?

Tachypnea more than 60 breaths/minute

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

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

The experienced RN will interviene if the new graduate is noted to complete which action while caring for newborns?

Wearing artificial nails while caring for multiple newborns.

The nurse places a newborn experiencing respiratory difficulty under a radiant warmer to prevent which complication?

acidosis

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

apnea

A group of pregnant women are discussing high-risk newborn conditions as part of a prenatal class. When describing the complications that can occur in these newborns to the group, which would the nurse include as being at lowest risk?

appropriate-for-gestational-age (AGA) newborns

A nurse is developing a plan of care for a preterm newborn to address the nursing diagnosis of risk for delayed development. Which measures would the nurse include? Select all that apply.

clustering care to promote rest using kangaroo care providing nonnutritive sucking

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is:

expiratory grunting.

What would be appropriate for the nurse to document in a child suffering from meconium aspiration syndrome?

respirations as increased and high

The mother of a preterm infant tells her nurse that she would like to visit her newborn in the neonatal intensive care unit (NICU). Which response by the nurse would be most appropriate?

"Certainly. You will need to wash your hands and gown before you can hold him, however."

A nurse is assisting the anxious parents of a preterm newborn to cope with the situation. Which statement by the nurse would be least appropriate?

"Forget about what's happened in the past, and focus on the now."

At a prenatal class the nurse describes the various birth weight terms that may be used to describe a newborn at birth. The nurse feels confident learning has has occurred when a participant makes which statement?

"Newborns who are appropriate for gestational age at birth have lower chance of complications than others."

A nursing student, observing care of a 30-week-gestation infant in the neonatal intensive care unit, asks the nurse, "Are premature infants more susceptible to infection as I have to wash my hands so often in this department?" What is the nurse's best response?

"That is correct; a 30-week-gestation infant lacks the protective antibody called IgG."

A premature infant is admitted to the neonatal intensive care unit with respiratory distress syndrome and requires assisted ventilation. The parents asks the nurse, "Why won't our baby breath on its own?" What is the nurse's best response?

"Your infant cannot sustain respirations yet due to the lack of assistance from surfactant."

At what day of life does jaundice peak in a newborn?

3 to 5 days

The nurse is concerned that a newborn is hypoglycemic. Which blood glucose level would support the nurse's intervention?

30 mg/dl (1.67 mmol/l)

A newborn is exhibiting signs and symptoms of hypoglycemia. The nurse prepares to administer IV glucose based on which blood glucose level?

36 mg/dL

The health care provider has determined that the source of dystocia for a woman is related to the fetus size. The nurse understands that macrosomia would indicate the fetus would weigh:

4,000 g to 4500 g

Hypoglycemia in a mature infant is defined as a blood glucose level below which amount?

40 mg/100 ml whole blood

The results of an amniocentesis conducted just prior to birth showed a fetus's lecithin/sphingomyelin ratio as being 1:1. From this information, for which respiratory problem should the nurse anticipate providing care once the baby is delivered?

Alveolar collapse on expiration

The neonate's respirations are gasping and irregular with a rate of 24 bpm. Which circulatory alteration will the nurse assess for in this infant?

Blood flows from the aorta to the pulmonary artery.

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.

A newborn is diagnosed with hemolytic disease of the newborn. When developing the plan of care for this child, the nurse would expect which of the following to be included as part of the treatment plan?

Exchange transfusion

A nurse is caring for a neonate of 25 weeks' gestation who is at risk for intraventricular hemorrhage (IVH). Which assessment finding should be reported immediately?

Exchange transfusion

A nurse assists with immediate interventions when a newborn is unable to initiate and maintain adequate respiratory function based on the understanding that these interventions are important to prevent which event(s)? Select all that apply.

Hypoxia Hypoxemia Acidosis Hypercarbia

What is the best rationale for trying to decrease the incidence of cold stress in the neonate?

If the neonate becomes cold stressed, it will eventually develop respiratory distress.

The health care provider is reluctant to provide pain medication to a patient delivering a preterm fetus. What should the nurse explain to the patient as the reason for the preterm fetus being more affected by medication?

Inability of the immature liver to metabolize or inactivate drugs

The nurse cares for preterm infants and assesses them for potential complications to provide adequate countermeasures to prevent futher complications. Which complication should the nurse prioritize and initiate proper measures to protect the newborn?

Loss of body heat

At 40 weeks' gestation and after 26 hours of labor a woman gives birth by cesarean section to a neonate weighing 4550 grams. The nurse implements which standard of care for this infant?

Macrosomic infant

The nurse is admitting a newborn into the nursery and notes the newborn was born at 42 weeks' gestation. Which action should the nurse prioritize when caring for this infant?

Monitor the newborn's blood glucose levels.

A preterm infant is receiving indomethacin. What is a priority assessment following administration of indomethacin? Select all that apply.

Monitor urine output. Observe for bleeding.

A nurse assesses a premature newborn and suspects hypothermia based on which of the following?

Nasal flaring

A nurse is implementing measures to prevent hypothermia in a premature newborn. The nurse determines that the newborn is experiencing an effect of hypothermia based on which assessment finding?

No breathing for 15 seconds

The parents of a 2-day-old newborn are preparing for discharge from the hospital. Which teaching is most important for the nurse to include regarding sleep?

Place the infant on the back when sleeping.

A nurse is assessing a newborn and notifies the primary health care provider because the nurse suspects increased intracranial pressure. When reporting the findings, which of the following would the nurse most likely include?

Seizure activity

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

Seizures

The nurses at a local free clinic are concerned there may be an increase in small-for-gestational age infants in the community. When collecting data to research the situation, the nurses will exclude infants above which category?

The 10th percentile for gestational age

When checking the infant's hip movements the nurse documents crepitus. What would that indicate?

The hips make a clicking sound.

The nurse is caring for a preterm neonate and has chosen the following goal: improvement of the neonate's respiratory function. Which expected outcome is most appropriate for the first week?

The neonate will not use accessory muscles when breathing.

The nurse is caring for a large-for-gestational-age infant born to a patient with diabetes mellitus. Why should the nurse schedule routine blood glucose measurements for the infant?

To detect rebound hypoglycemia

When documenting the newborn's weight on a growth chart, the nurse recognizes the newborn is large-for-gestational-size based on which percentile on growth charts?

above 90th percentile

A preterm infant is experiencing cold stress after birth. For which symptom should the nurse assess to best validate the problem?

apnea

Which maternal factors should the nurse consider contributory to a newborn being large for gestational age? Select all that apply.

diabetes mellitus postdates gestation prepregnancy obesity

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 12-hour-old infant is receiving IV fluids for polycythemia. For which complication should a nurse monitor this client?

fluid overload

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 who is diagnosed with meconium aspiration displays which symptom?

intercostal and substernal retractions

A nurse is assessing a preterm newborn. The nurse determines that the newborn is comfortable and without pain based on which finding?

lack of body posturing

The nurse is reviewing the medical record of a newborn born 2 hours ago. The nurse notes that the newborn was born at 35 weeks' gestation. How would the nurse classify this newborn?

late preterm

A 2-month-old infant is admitted to a local health care facility with an axillary temperature of 96.8° F (36° C). Which observed manifestation would confirm the occurrence of cold stress in this client?

lethargy and hypotonia

A nurse is conducting a class for expectant parents about newborns. As part of the class, the nurse describes newborns with birth weight variations. The nurse determines that the teaching was successful when the class identifies which variation if a newborn weighs 5.2 lb (2,358 g) at any gestational age?

low birth weight

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

A client has just given birth at 42 weeks' gestation. What would the nurse expect to find during her assessment of the neonate?

peeling and wrinkling of the neonate's epidermis

The newborn nursery nurse is admitting a small-for-gestational-age (SGA) infant and is reviewing the maternal history. What factor in the maternal history would the nurse correlate as a risk factor for a SGA infant?

placental factors

The small-for-gestational-age neonate is at increased risk for which complication during the transitional period?

polycythemia, probably due to chronic fetal hypoxia

At birth, the infant has dry, cracked skin, absence of vernix, lack of subcutaneous fat, fingernail extending beyond the fingertips, and poor skin turgor. Based on these findings, how would the nurse would classify this neonate?

postterm

A newborn girl who was born at 38 weeks' 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

A premature infant develops respiratory distress syndrome. With this condition, circulatory impairment is likely to occur because, with increased lung tension,:

the ductus arteriosus remains open.

The nurse determines a newborn is small-for-gestational age based on which characteristics?

wasted appearance of extremities, thin umbilical cord, and reduced subcutaneous fat stores

A nurse is assessing a newborn who has been classified as small for gestational age. Which characteristics would the nurse expect to find? Select all that apply.

wasted extremity appearance sunken abdomen narrow skull sutures