Prematurity- Pearson

"The baby does not have enough fat available." The two factors limiting heat production are the availability of glycogen in the liver and the amount of brown fat available for heat production. Brain development, immature liver, and increased respiratory rate do not cause neonatal hypothermia.

The mother of a preterm neonate asks, "Why does my baby's temperature keep dropping?" Which response should the nurse make? "The baby's brain is not fully developed." "The baby does not have enough fat available." "The baby is working too hard to breathe." "The baby's liver is not fully developed."

A. Thin skin B. Higher body surface to body weight ratio D. Inefficient constriction of blood vessels E. Decreased subcutaneous tissue

The nurse is caring for a neonate who is at 33​ weeks' gestation and experiencing difficulty with thermoregulation. For which reason should the nurse be concerned about this​ client's inability to maintain body​ temperature? (Select all that​ apply). A. Thin skin B. Higher body surface to body weight ratio C. Flexed body position D. Inefficient constriction of blood vessels E. Decreased subcutaneous tissue

Swaddling to keep the hands away from the face Swaddling is an intervention to promote developmentally supportive care of the infant. When swaddling, the baby's hands should be able to reach the face. Discharge teaching should include scheduling routine vaccinations, recognizing signs of an infection or illness, and administering vitamins.

The nurse is preparing discharge instructions for a preterm infant. Which information should the nurse delete when teaching the parents? Scheduling routine vaccinations Recognizing signs of infection or illness Swaddling to keep the hands away from the face Administering vitamins

Body posture Body posture is associated with thermoregulation. Extended body posture leads to a loss of body heat. Development of apnea is associated with an irregular breathing pattern. Apnea is common in the preterm infant who is less than 36 weeks of gestation and occurs between days 2 and 7 of life.

The nurse is updating the plan of care for a preterm neonate. Which factor should the nurse eliminate as being related to apnea of prematurity? Gestational age of 34 weeks Body posture Irregular breathing pattern Age of 4 days

Stopping the feeding Cyanosis is an indication of feeding difficulty, and there is a risk of a milk bolus resulting in aspiration. The heart rate and respiratory rate may be assessed after the feeding is stopped. Urine output is not related to the cyanosis.

The nurse observes a new mother bottle-feed a newborn and notes a slight bluish tinge around the baby's mouth. Which action should the nurse take? Obtaining a heart rate Stopping the feeding Determining the amount of urine output Assessing the respiratory rate

"I will assess the​ baby's ability to suck and swallow​ first." Mothers who wish to breastfeed their preterm neonates are given the opportunity to put the baby to the breast as soon as the baby has demonstrated a coordinated suck and swallow reflex. Typically babies demonstrate this ability around​ 32-34 weeks of gestation. It is not necessary for the mother to use a breast pump until the baby gains​ weight, monitor the baby for a few hours prior to​ feeding, or initially provide the baby with formula feedings to maintain a glucose level.

A client who delivered a neonate at 34​ weeks' gestation​ asks, "When can I breastfeed my​ baby?" Which response should the nurse​ make? A. ​"We would like to monitor the baby for a few hours before you begin a​ feeding." B. "I will assess the​ baby's ability to suck and swallow​ first." C. ​"We prefer you to pump your milk until the baby gains some​ weight." D. "We will initially provide the baby with formula feedings to help maintain the glucose​ level."

Metabolic acidosis A neonate suspected of having an intracranial hemorrhage may demonstrate metabolic​ acidosis, sudden drop in​ hemoglobin, and hypotension. Anemia occurs due to the​ neonate's rapid rate of​ growth, shorter red blood cell​ life, excessive blood​ sampling, decreased iron​ stores, and a deficiency in vitamin E. Tachycardia is an initial finding for the neonate that is hemorrhaging.

A neonate at 27​ weeks' gestation is suspected of having an intracranial hemorrhage. Which assessment finding should the nurse​ anticipate? A. Metabolic acidosis B. Bradycardia C. Hypertension D. Anemia

Monitor urine output The immaturity of the renal system affects the preterm neonate's ability to excrete drugs. Urine output must be carefully monitored when the neonate is receiving nephrotoxic drugs, such as gentamicin or vancomycin. If urine output is poor, drugs can become toxic much more quickly in the neonate than in the adult. Gentamicin does not affect the temperature, cardiac system, hematocrit, or hemoglobin.

A neonate is prescribed the antibiotic gentamicin for an infection. Which intervention should the nurse consider the priority? Measure temperature every 2 hours Initiate cardiac monitoring Assess hematocrit and hemoglobin levels Monitor urine output

B. ​"It enhances​ bonding." C. "It stabilizes vital​ signs." D. ​"It improves infant​ oxygenation."

A new mother of a preterm neonate asks why kangaroo care is important. Which response should the nurse​ make? (Select all that​ apply.) A. ​"It promotes​ digestion." B. ​"It enhances​ bonding." C. "It stabilizes vital​ signs." D. ​"It improves infant​ oxygenation."

Permeable skin The preterm newborn has​ thinner, more permeable skin than the term neonate. The preterm​ neonate's testes are​ undescended, extremities are not​ flexed, and activity consists of jerky generalized movements.

A preterm male newborn is admitted to the nursery. Which assessment finding should the nurse identify that supports the diagnosis of​ prematurity? A. Descended testes B. Permeable skin C. Generalized movements D. Flexed extremities

Urine output The hydration status of a preterm infant is determined by the urine output, which should be 1-3 mL/kg/hr. Abdominal girth and feeding frequency are monitored to assess the neonate's nutritional status. The respiratory rate is a reflection of gas exchange

A preterm neonate has a nursing diagnosis of Fluid Volume: Deficit, Risk for. Which assessment should the nurse use to determine the hydration status of this patient? Feeding frequency Abdominal girth Respiratory rate Urine output

Positioning the neonate under the radiant warmer The neonate should be placed under the radiant warmer. The neonate's temperature is 96.4°F (35.8°C) and is below normal. Heat loss is a major problem in premature newborns. Administering a feeding, documenting vital signs, and administering oxygen via a face mask will not correct the neonate's hypothermia.

A preterm neonate has the following vital signs: heart rate 168 beats/min, respiratory rate 56 breaths/min, temperature 96.4°F (35.8°C). Which intervention should the nurse make a priority? Administering oxygen via a face mask Initiating a feeding Positioning the neonate under the radiant warmer Documenting the vital signs

Complete blood count (CBC)

A preterm neonate is admitted to the neonatal intensive care unit​ (NICU). Which initial assessment should the nurse identify as inappropriate to​ complete? A. Gestational age determination B. Temperature assessment C. Complete blood count​ (CBC) D. Respiratory assessment

4.6 mL/hr The nurse should administer 277.5 mL/hr. The calculation of 1850 g into kilograms is 1850 ÷ 1000 = 1.85 kg. 1.85 kg x 60 mL = 111 mL/day; 111 mL ÷ 24 hours = 4.6 mL/hr.

A preterm neonate weighing 1850 g is prescribed 60 mL/kg/day of intravenous fluid. Which amount of fluid should the nurse provide to the patient every hour? 4.6 mL/hr 9.2 mL/hr 18.5 mL/hr 6.5 mL/hr

Breathing through the nose Gavage feeding (using a nasogastricor orogastric feeding tube) is the method of choice for preterm infants who are at less than 34 weeks of gestation because of nosebreathing. The use of an oral gavage feeding tube is not because of excessive mucous production, irritability, or lethargy.

During handoff communication, the nurse learns that a preterm neonate is receiving gavage feedings through the mouth. Which should the nurse expect when assessing this patient? Irritability Lethargy Excessive mucous production Breathing through the nose

"Babies are nosebreathers, so the feeding tube should be placed through the mouth." Gavage feeding (using a nasogastricor orogastric feeding tube) is the method of choice for preterm infants who are at less than 34 weeks of gestation because of nosebreathing. Gavage feedings can be administered by either a nasogastric tube or orogastric tube and by intermittent bolus or a continuous drip method. There is no indication that the neonate will require the placement of a stomach tube or that the nasal passages are misshapen.

The mother of a preterm neonate asks, "Why does the baby have to be fed through a tube that goes into the mouth?" Which response should the nurse make? "A stomach tube will eventually be placed, so until that can be done, a tube is placed through the mouth." "Babies are nosebreathers, so the feeding tube should be placed through the mouth." "There is no other way to pass a tube into the stomach to provide the feedings." "Your baby's nasal passages are misshapen, and there is no other way to provide feedings at this time."

Increases weight gain

The nurse discusses the feeding plan with the parents of a preterm neonate. For which reason should the nurse recommend beginning feedings as early as​ possible? A. Increases weight gain B. Decreases risk for respiratory distress C. Increases production of surfactant D. Prevents metabolic acidosis

Patent ductus arteriosus The ductus arteriosus of the preterm​ neonate, who is more susceptible to​ hypoxia, may respond to increasing oxygen and prostaglandin E levels by remaining open rather than by​ vasoconstriction, which is how the ductus responds in the term neonate. The gestational age of the neonate influences the amount of flexion. A neonate that is 28​ weeks' gestation is completely hypotonic and has extended extremities. The preterm neonate is at risk for aspiration due to a poorly developed gag​ reflex, incompetent esophageal cardiac​ sphincter, and poor sucking and swallowing reflexes. The preterm infant exhibits a disorganized behavioral state.

The nurse is assessing a​ 2-hour-old neonate who is 28​ weeks' gestation. Which assessment finding should the nurse​ anticipate? A. Patent ductus arteriosus B. Hypertonic flexion C. Developed gag reflex D. Organized behavioral state

"Hold the baby like a​ football." When breastfeeding the preterm​ infant, the nurse should instruct the mother to use the football​ hold, expect to feed for 45​ minutes, and gently burp the baby when alternating breasts. The​ semi-seated position is used when bottle feeding an infant.

The nurse is assisting a new mother to breastfeed a​ 2-day-old neonate who is 36​ weeks' gestation. Which information should the nurse provide to help support​ breastfeeding? A. ​"Burp the baby after offering both​ breasts." B. "Do not feed for more than 30​ minutes." C. "Hold the baby like a​ football." D. ​"Hold the baby in a​ semi-seated position."

Instructing the parents on newborn care The most appropriate action is to provide instruction on newborn care. The nurse should not leave the parents with a 1-day-old preterm newborn. The admission forms and the discussion on the extent of care the infant will need while hospitalized can take place when the neonate is not in a state of arousal.

The nurse is caring for a 1-day-old preterm newborn who is in an alert state with the parents present at the bedside. Which action should the nurse take at this time? Asking the parents to complete admission assessment forms Instructing the parents on newborn care Discussing the extent of care that the infant will require while hospitalized Leaving the parents to hold the baby

Respiratory distress syndrome The most common complication associated with prematurity is respiratory distress syndrome. Bronchopulmonary dysplasia is a chronic respiratory condition that can occur later in the premature​ infant's life. The preterm neonate is at risk for hypothermia. The nurse should monitor a postterm infant for meconium aspiration syndrome.

The nurse is caring for a 33​ weeks' gestation neonate who is 2 hours old. When assessing the​ neonate, which complication should the nurse anticipate may​ occur? A. Bronchopulmonary dysplasia B. Hyperthermia C. Respiratory distress syndrome D. Meconium aspiration syndrome

​"Your baby is doing well for a preterm​ infant." A preterm birth occurs between 20 and 37 completed gestational weeks. Late preterm is used to describe babies born between 34 and 37​ weeks' gestation. Postterm gestation is a birth that occurs after 42 weeks. Term births occur from 37 completed weeks to 42 weeks of gestation. Near term is not a term used to describe birth.

The nurse is caring for a client who gives birth to a neonate at 36​ 1/2 weeks' gestation weighing 5​ lb, 3 oz. Which statement should the nurse make about this​ infant? A. ​"Your baby is doing well for a preterm​ infant." B. ​"You delivered a​ near-term baby." C. "The baby's skin looks good for being​ postterm." D. "The baby was right on time and born at​ term."

Prevents conductive heat loss The use of the radiant warmer helps prevent conductive heat loss. The radiant heat warms the surface on which the neonate will be placed. The use of an incubator prevents radiative heat loss. A radiant warmer does not provide ambient humidity. To prevent evaporative heat loss the neonate must be dried thoroughly.

The nurse is caring for a neonate at 31 weeks of gestation. For which reason should the nurse use a radiant warmer for this patient? Provides warm ambient humidity Prevents evaporative heat loss Avoids radiative heat loss Prevents conductive heat loss

Glycosuria Glycosuria is an expected finding in a premature neonate. The kidneys of a preterm neonate begin excreting glucose at a lower serum glucose level than those of a term newborn. Oliguria occurs in the presence of diseases or conditions that decrease renal blood flow and perfusion. The preterm​ neonate's kidneys are limited in their ability to concentrate urine or to excrete excess amounts of​ fluid, therefore predisposing the neonate to hypervolemia. The buffering capacity of the neonate is​ reduced, predisposing the neonate to metabolic acidosis.

The nurse is caring for a neonate that is 27​ weeks' gestation. Which finding should the nurse expect that demonstrates this​ neonate's renal​ function? A. Glycosuria B. Hypovolemia C. Oliguria D. Metabolic alkalosis

Jerky movements The preterm neonate will have jerky generalized movements. The head size appears large in relation to the body. The cry of a preterm neonate is weak and feeble. A​ high-pitched cry could be a sign of increased intracranial pressure. Fontanels should be smooth and flat. A sunken fontanel could be a sign of dehydration.

The nurse is caring for a neonate who is 32​ weeks' gestation. Which assessment finding should the nurse​ anticipate? A. Small head B. Jerky movements C. High-pitched cry D. Sunken fontanels

Open ductus arteriosus Insufficient surfactant Incomplete muscular coat of pulmonary vessels

The nurse is caring for a neonate who is at 32​ weeks' gestation. Which reason for respiratory distress should the nurse understand occurs in the preterm​ neonate? (Select all that​ apply.) A. Open ductus arteriosus B. Decreased levels of pancreatic lipase C. Insufficient surfactant D. Incomplete muscular coat of pulmonary vessels E. Increased secretion of glucose

The preterm​ neonate's initial period of reactivity is delayed as a result of their response to extrauterine life. Absent and diminished periods of reactivity may occur in an ill neonate. Moderate periods of reactivity are an abnormal finding in a newly delivered preterm neonate.

The nurse is caring for a newly delivered neonate who is at 28​ weeks' gestation. Which initial period of neonatal reactivity should the nurse anticipate to​ observe? A. Absent B. Moderate C. Diminished D. Delayed

Inadequate surfactant The primary reason a preterm neonate requires ventilation is inadequate production of surfactant. Inadequate surfactant production results in impaired gas exchange and lessens the compliance (ability of the lung to fill with air easily), thereby increasing the inspiratory pressure needed to expand the lungs with air. The collapsed alveoli will not facilitate an exchange of oxygen and carbon dioxide. An ineffective breathing pattern in a preterm neonate is related to an immature central nervous system. The blood volume to the lungs is increased as a result of a patent ductus arteriosis. The preterm neonate does not have a decreased affinity for oxygen. The collapse of the alveoli impair the exchange of oxygen and carbon dioxide.

The nurse is caring for a preterm infant that is on a ventilator. For which reason should the nurse suspect the newborn needs ventilator assistance? Inadequate surfactant Immature autonomic system Decreased affinity for oxygen Inadequate lung perfusion

Necrotizing enterocolitis Necrotizing enterocolitis (NEC) results from diminished blood flow and tissue perfusion to the intestinal tract because of prolonged hypoxia and hypoxemia at birth. Metabolic alkalosis, elevated hematocrit, and a decreased glomerular filtration rate are not complications of hypoxia.

The nurse is caring for a preterm infant who has experienced prolonged hypoxia at birth. For which complication should the nurse closely monitor the neonate? Metabolic alkalosis Necrotizing enterocolitis Decreased hematocrit Decreased glomerular filtration rate

Laser photocoagulation The acute stages of ROP may be treated with laser photocoagulation and cryotherapy. Most acute changes with ROP regress spontaneously with no long-term visual impairment. Corrective lenses, beta blocker eyedrops, and lens replacement surgery are not used to treat ROP.

The nurse is caring for a preterm neonate diagnosed with retinopathy of prematurity (ROP). Which treatment should the nurse anticipate for the acute stages of ROP? Beta blocker eyedrops Laser photocoagulation Lens replacement surgery Corrective lenses

IgA The secretory IgA in breast milk provides immunity to the mucosal surfaces of the​ neonate's GI​ tract, protecting the baby from enteric infections. IgG is the only immunoglobulin that crosses the placenta. IgD and IgM are found in breast​ milk, but they are not significant in the protection against an enteric infection.

The nurse is caring for a preterm neonate receiving breast milk. Which immunoglobulin should the neonate receive through the breast milk that protects against enteric​ infections? A. IgD B. IgA C. IgG D. IgM

Metabolic acidosis After an hypoxic event, the buffering capacity of the kidney is reduced, predisposing the neonate to metabolic acidosis. After periods of hypoxia or insult, the preterm neonate's kidneys require a longer time to excrete the lactic acid that accumulates. The other acid-base imbalances are not likely to occur after an hypoxic event.

The nurse is caring for a preterm neonate who has experienced a period of hypoxia. Which imbalance should the nurse anticipate to treat? Respiratory acidosis Respiratory alkalosis Metabolic acidosis Metabolic alkalosis

Extension of extremities Extension of the extremities increases the amount of body surface area that is exposed to the environment, which increases heat loss. A high ratio of body surface to weight increases the loss of body heat. Flexion of the extremities decreases the amount of surface area exposed to the environment. A decreased ability to vasoconstrict superficial blood vessels results in heat loss.

The nurse is caring for a preterm neonate. Which factor should the nurse identify that contributes to this patient's inability to maintain body heat? Flexion of extremities Increased ability to vasoconstrict superficial blood vessels Extension of extremities Low ratio of body surface to weight

A. A​ 3-minute hand scrub with antibacterial solution is performed prior to providing care. B. The incubator is changed according to schedule. D. The neonate is repositioned ever hour. E. Separate equipment is used for the neonate.

The nurse is discussing preterm neonate care with a new colleague. Which action should demonstrate that the new colleague understands the principles of infection​ control? (Select all that​ apply.) A. A​ 3-minute hand scrub with antibacterial solution is performed prior to providing care. B. The incubator is changed according to schedule. C. Gastric residual is assessed prior to a scheduled tube feeding. D. The neonate is repositioned ever hour. E. Separate equipment is used for the neonate.

"IgA provides immunity to the mucosal surfaces of the GI tract." Secretory IgA does not cross the placenta but is found in breast milk in significant concentrations. The secretory IgA in breast milk provides immunity to the mucosal surfaces of the neonate's GI tract, protecting the baby from enteric infections. IgA is not present on the neonate's skin surface. In utero, the fetus receives passive immunity against a variety of infections from maternal IgG immunoglobulins, which cross the placenta.

The nurse is discussing the benefits of breast milk with the mother of a preterm newborn. Which statement should the nurse use to explain the immunological benefits of breast milk? "IgG provides prevention of reoccurring infection." "IgG provides immunity to a variety of infections." "IgA provides immunity to the mucosal surfaces of the GI tract." "IgA increases the defense of the preterm neonate's skin surface."

"The preterm neonate's kidneys are limited in their ability to concentrate urine." The preterm neonate's kidneys are limited in their ability to concentrate urine or to excrete excess amounts of fluid. The kidneys of the preterm neonate begin excreting glucose (glycosuria) at a lower serum glucose level than those of the term newborn. Glycosuria with hyperglycemia can lead to osmotic diuresis and polyuria. The glomerular filtration rate (GFR) is lower because of decreased renal blood flow.

The nurse is discussing the intake and output record for a preterm neonate with a colleague. Which statement by the nurse indicates an understanding of the importance of monitoring the fluid balance in the preterm neonate? "The preterm neonate's glomerular filtration rate is higher due to increased vascularity." "The preterm neonate's kidneys excrete excess amounts of fluid." "The preterm neonate has difficulty excreting glucose, resulting in fluid retention." "The preterm neonate's kidneys are limited in their ability to concentrate urine."

The length of feeding time The length of feeding time will be monitored so the neonate does not become fatigued or burn too many calories. The number of feedings in a 24-hour period and actual intake of formula are related to nutritional intake. The neonate's ability to suck is an assessment for the readiness to feed.

The nurse is monitoring a preterm infant for fatigue associated with feeding. Which factor should the nurse consider when monitoring the neonate? The number of feedings in a 24-hour period The length of feeding time The neonate's ability to suck The amount of nutritional intake

Bluish tinge around the baby's mouth Cyanosis is an indication of feeding difficulty, and there is a risk of a milk bolus resulting in aspiration. Fussiness and rooting are hunger cues. A flexed tone is a normal finding of neonate that is reaching term gestation.

The nurse is observing the first bottle feeding of an infant that is 36 weeks of gestation. For which observation should the nurse stop the feeding? Rooting Fussiness of the baby Flexed tone Bluish tinge around the baby's mouth

Ear cartilage remains folded over, lanugo present over much of the body, some flexion of arms and legs at rest The nurse should expect to assess ear cartilage folded over, lanugo present over much of the neonate's body, and some flexion of the arms and legs at rest. Full sole creases, nails extending beyond fingertips, testes deep in rugae-covered scrotum, 1-cm breast bud, peeling skin without visible veins, and rapid recoil of legs and arms are signs of a postterm infant.

The nurse is preparing to assess a neonate born at 33 weeks of gestation. Which characteristics should the nurse anticipate to find? 1-cm breast bud, peeling skin and veins not visible, rapid recoil of legs and arms to extension Ear cartilage remains folded over, lanugo present over much of the body, some flexion of arms and legs at rest Testes located deep in the scrotum, rugae cover the scrotum, vernix covering the entire body Full sole creases, nails extending beyond fingertips, scarf sign shows elbow beyond the midline

Neurologic defects Within the first year of​ life, low birth weight preterm neonates face higher mortality rates than term infants. The cause of death for the preterm infant includes neurologic​ defects, sudden infant death syndrome​ (SIDS), and respiratory infections. Parental​ abuse, malabsorption​ syndromes, and retinopathy of prematurity are not identified causes of death in the preterm infant.

The nurse is preparing to orient a new nurse to the neonatal intensive care unit​ (NICU). Which information should the nurse include that relates to the cause of death of the premature​ neonate? A. Malabsorption syndromes B. Neurologic defects C. Parental abuse D. Retinopathy of prematurity

Protein Protein is a primary component of formula that is necessary to meet the nutritional needs of the preterm neonate. A diet that is high in polyunsaturated fats, which preterm neonates tolerate best, increases the requirement for vitamin E. Preterm neonates who are fed iron-fortified formulas have higher red cell hemolysis and lower vitamin E concentrations and require additional vitamin E. Preterm formulas also need to contain medium-chain triglycerides and additional amino acids, such as cysteine, as well as calcium, phosphorus, and vitamin D supplements to increase mineralization of bones.

The nurse is reviewing the nutritional needs of a preterm neonate. Which component should the nurse identify as necessary to meet this patient's needs? Iron fortification Monochained triglycerides Protein Polysaturated fats

"The exchange of oxygen and carbon dioxide cannot occur across the alveoli." The physiological response that occurs due to the neonate's premature respiratory system is a result of the inability of oxygen and carbon dioxide to be exchanged across the alveoli resulting from decreased surfactant. The pulmonary arterioles do not constrict well in response to decreased oxygen levels. A patent ductus increases the blood volume to the lungs, causing pulmonary congestion, increased respiratory effort, carbon dioxide retention, and bounding femoral pulses. The lowered pulmonary vascular resistance leads to left-to-right shunting of blood through the ductus arteriosus.

The nurse is reviewing the physiology of the premature respiratory system for a neonate at 32 weeks of gestation with a colleague. Which information should the nurse include? "The exchange of oxygen and carbon dioxide cannot occur across the alveoli." "The increased pulmonary vascular resistance leads to right-to-left shunting of blood." "A decrease in blood volume to the lungs is a primary cause of respiratory distress." "The pulmonary arterioles remain constricted in response to decreased oxygenation."

Infection control practices Because infants with bronchopulmonary dysplasia are dependent on oxygen therapy and are at risk for respiratory infections during the first few years of​ life, the focus should be on infection control practices and safe use of oxygen in the home. Frequency of oral​ feedings, level of sensory​ stimulation, and parental involvement in care are important but do not specifically address the respiratory complications of the preterm infant.

The nurse is visiting the home of a preterm neonate with bronchopulmonary dysplasia. Which should be the primary focus of the​ nurse's initial​ visit? A. Level of sensory stimulation B. Frequency of oral feedings C. Infection control practices D. Parental involvement in care

Review instructions for feeding A 17% loss of body weight since discharge requires additional intervention. The intervention may include monitoring a feeding or evaluating the source of nutrition. Swaddling, diaper changes, and stool characteristics will not help determine the reason for the baby's weight loss.

The nurse notes that a newborn has lost 17% of total body weight since being discharged after birth. Which action should the nurse take with the mother at this time? Review instructions for feeding Ask the number of diaper changes being done per day Observe technique to swaddle Ask to describe the color of the baby's stool

The baby losing 17% of body weight since discharge A 17% loss of body weight since discharge requires additional intervention. The intervention may include monitoring a feeding or evaluating the source of nutrition. An en face position, the father's ability to change a diaper, and the parents taking turns comforting the infant are expected assessment findings.

The nurse visits the home of a preterm infant. Which finding should indicate the need for intervention? The parents taking turns holding the fussy baby The mother holding the baby en face The baby losing 17% of body weight since discharge The father changing the baby's diaper

"When your baby has a strong gag reflex." The infant that is showing signs of readiness for an oral feeding will have a strong gag reflex, presence of non-nutritive sucking, and rooting behavior. The neonate will then be transitioned to a gradual nipple feeding program. The preterm neonate does have periods of alert behavior and will be weighed daily to monitor for weight loss. A term neonate must have a strong gag reflex, ability to non-nutritively suck, and exhibit rooting behavior to safely feed from a nipple.

The parent of a 10-day-old preterm neonate asks when the baby will transition to a bottle. Which response should the nurse make? "When your baby begins gaining weight." "When your baby has a strong gag reflex." "When your baby is more alert." "When your baby reaches the age of a term neonate."

"This will help prevent your baby from getting an infection." The preterm neonate has an immature immune system as well as thin permeable skin. The practice of strict hand hygiene and use of separate equipment for each neonate helps minimize the preterm newborn's exposure to infectious agents. All of the neonates that are in the nursery are at risk for infection. Nurseries have strict hand hygiene policies but sharing that information does not answer the parent's question. The nursery is not a sterile environment.

The parent visiting a preterm neonate asks, "Why do I have to "scrub-in" to visit my baby?" Which response should the nurse make? "We want to maintain a sterile environment in the nursery." "Scrubbing your hands before you go into the nursery is our policy." "This will help prevent your baby from getting an infection." "There are other babies in the nursery that are at risk for infection."

"The fats cannot be increased because they are difficult for the baby to absorb." The preterm neonate has difficulty absorbing saturated fats because of the decreased bile salts and pancreatic lipase. The other answer options are incorrect.

The parents of a neonate at 31 weeks of gestation ask, "Can the fat content in the formula be increased to help our baby gain weight quicker?" Which statement should the nurse make in response? "More than fat will be added to the feedings to promote nutrition and weight gain." "The fats cannot be increased because they are difficult for the baby to absorb." "Extra lipids have been added to the feedings to promote a rapid weight gain." "There is no specific fat that can be increased."