Prep-U with Explanations

What should the nurse expect for a full-term newborn's weight during the first few days of life?

There is a loss of 5% to 10% of birth weight in formula-fed AND breastfed newborns.

Post partum depression vs baby blues

When It's the Baby Blues - Your mood swings quickly from happy to sad. One minute, you're proud of the job that you're doing as a new mom. The next, you're crying because you think you're not up to the task. - You don't feel like eating or taking care of yourself because you're exhausted. - You feel irritable, overwhelmed, and anxious. When It's Postpartum Depression - You feel hopeless, sad, worthless, or alone all the time, and you cry often. - You don't feel like you're doing a good job as a new mom. - You're not bonding with your baby. - You can't eat, sleep, or take care of your baby because of your overwhelming despair. - You could have anxiety and panic attacks.

A newborn has a 5-minute Apgar score of 9. What intervention should the nurse take for this client?

Wrap the infant in a blanket and hand to the mother for bonding. Explanation: Apgar scores of 7-10 at 5 minutes of age indicate a newborn is adapting well to extrauterine life and can be safely placed with the mother. A 5-minute Apgar score of 4-6 would mean that the newborn might have respiratory distress and need oxygen or requires more vigorous stimulation. Hypothermia can also cause distress and lower the Apgar score.

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?

blood sugar Explanation: Most facilities have protocols to guide nursing care in the treatment of hypoglycemia. Many pediatricians have preprinted orders that can be initiated if the glucose level falls below a predetermined level (usually 40-50 mg/dL).

Ortolani maneuver on a newborn

for hip dislocation Ortolani maneuver is used to assess the possibility of a dislocated hip in an infant.

A nurse is analyzing a journal article that explains the changes at birth from fetal to newborn circulation. The nurse can point out the closure of the ductus arteriosus is related to which event after completing the article?

higher oxygen content of the circulating blood Explanation: The first few breaths greatly increase the oxygen content of circulating blood. This chemical change (i.e., higher oxygen content of the blood) contributes to the closing of the ductus arteriosus, which eventually becomes a ligament. A drop in the pressure results in a reversal of pressures in the right and left atria, causing the foramen ovale to close, which redirects blood to the lungs. A drop in blood pressure and higher oxygen levels at the respiratory centers of the brain do not result in the closure of the foramen ovale.

All the options are signs of respiratory distress in the newborn except:

respiratory rate >50 breaths/minute. Explanation: Coughing and sneezing are normal reflexes present in newborns. The expected respiratory rate of newborn is 40 to 60 breaths per minute. pg 569

A neonate born by cesarean birth required oxygen after the birth. The mother expresses concern because this was not a factor with her previous vaginal birth. What response by the nurse is most appropriate?

"Neonates born by cesarean do not benefit from the squeezing of the contractions which help to clear the lungs." Explanation: During labor and delivery, the contractions provide pressue on the fetus. These forces "squeeze" the fetus's thoracic cavity. This aids the fetus in forcing the amniotic fluid from the lungs. The neonate born by cesaren does not have this experience, which may result in some initial periods of tachypnea and a need for oxgen supplementation. Maternal age and the uterine incision do not impact this phenomenon.

A nurse does an initial assessment on a newborn and notes a pulsation over the anterior fontanelle that corresponds with the newborn's heart rate. How would the nurse interpret this?

- Feeling a pulsation over the ANTERIOR fontanel correlating to the newborn's heart rate is normal. - The pulsation should NOT be felt in the posterior fontanel. - The fontanel should not be bulging under any circumstance in a newborn.

What measures can a nurse take to reduce the risk of hypoglycemia in a newborn? Select all that apply.

- Initiate early and frequent breast-feeding. - Dry the newborn off immediately after birth to prevent chilling. - Begin kangaroo care for the newborn. Explanation: - By preventing hypothermia in a newborn, the chance of hypoglycemia is lessened since cold stress causes a newborn to burn more calories. - Feedings should also begin early, with either breast milk or formula. - Kangaroo care allows skin-to-skin contact between the newborn and the parent while maintaining the newborn in a thermoneutral environment. - Glucose water will NOT help prevent hypoglycemia because it does not provide enough glucose for the newborn.

During the early postpartum period, a new mother is displaying dependent behaviors. What behaviors would the nurse recognize as normal for this period? Select all that apply.

- Needing assistance with changing her peripad - Telling the nurse about her delivery experience. - Asking the nurse to take the newborn away so she can rest. Explanation: In the early postpartum period, the new mother is focused upon herself and concerned about her needs. She is very dependent, having difficulty making decisions and requesting help with self-care. She relives the delivery experience and wants to it with others. This period may last several hours or several days.

Cephalocaudal vs. Proximodistal

- cephalocaudal: development that moves from the head downwards - proximodistal: development that moves from the center of the body outwards (starts with gross motor movements to fine motor movements)

The nurse is teaching infant security to a group of new nurses on a labor and delivery unit. Which characteristic fits the profile of the typical newborn abductor in the United States?

12 to 50 years of age Explanation: The profile of a newborn abductor in the United States is female, married or in a relationship, and 12 to 50 years of age. These typical abductors also intend to keep the child for their own.

Neonatal screening is done before the infant leaves the hospital. Blood is drawn through a heel stick and tested for several disorders that can cause lifelong disabilities. When is the ideal time to collect this specimen?

24 hours after the newborn's first protein feeding Explanation: The laws in most states require this initial screening, which is done within 72 hours of birth. The ideal time to collect the specimen is after the newborn is 36 hours old and 24 hours after he has his first protein feeding.

How long is the neonatal period for a newborn?

28 Explanation: The neonatal period is the first 28 days of life.

A newborn is born and, at 1 minute of life, is acrocyanotic, HR is 110, is floppy with some flexion, has a weak cry and grimaces. What Apgar score would the nurse assign this infant?

6

While making rounds in the nursery, the nurse sees a 6-hour-old baby girl gagging and turning bluish. What would the nurse do first?

Aspirate the oral and nasal pharynx with a bulb syringe. Explanation: The nurse's first action would be to suction the oral and nasal pharynx with a bulb syringe to maintain airway patency. Turning the newborn to her right side will not alleviate the blockage due to secretions. Administering oxygen via positive pressure is not indicated at this time. Lowering the newborn's head would be inappropriate.

Attachement vs Bonding

Attachment and bonding are both ways to describe the feelings between you and your baby, but attachment has a broader meaning than bonding. Attachment is about both you and your baby. ... Bonding is all about you. It's about the surge of love and tenderness you feel for your baby.

A newborn's vital signs are documented by the nurse and are as follows: HR 144, RR- 36, BP- 128/78, and T- 98.6℉ (37℃). Which finding would be concerning to the nurse?

Blood Pressure Explanation: The blood pressure of a newborn should be quite low—around 60-70 over 35 to 50. The heart rate and respiratory rate are both high, which are normal findings. The temperature falls within a normal range of 97.7℉ to 99.5℉ (36.5℃ to 37.5℃).

A 30-minute-old newborn starts crying in a high-pitched manner and cannot be consoled by the mother. Which action should the nurse prioritize if jitteriness is also noted and the infant is unable to breastfeed?

Check blood glucose. Explanation: One of the primary signs/symptoms of hypoglycemia in newborn infants is jitteriness and irritability. Anytime an infant is suspected of having hypoglycemia, the nurse needs to check the blood glucose level. Cold stress and pain are potential considerations to rule out if hypoglycemia is not the cause; however, jitteriness is not a recognized sign of these.

The nurse is caring for a newborn whose mother tested positive for hepatitis B surface antigen (HBsAg). Which intervention(s) will the nurse perform? Select all that apply.

Give Hepatitis B immune globulin. Obtain consent from the mother. Administer Hepatitis B vaccination. Bathe the newborn thoroughly. Explanation: When a mother has a positive test for hepatitis B surface antigen (HBsAg), the newborn is given the hepatitis B vaccine and hepatitis B immune globulin. Consent must be obtained before administering vaccinations. The newborn should be bathed to remove traces of blood and attempt to limit transmission. Standard precaution should be followed.

The nursing instructor is teaching a class on the physiologic properities involved with the birthing process. The instructor determines the session is successful when the students correctly match surfactant with which function?

It keeps alveoli from collapsing with breaths.

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 infant on back to prevent SIDS

The nursery nurse notes that one of the newborn infants has white patches on his tongue that look like milk curds. What action would be appropriate for the nurse to take?

Report the finding to the pediatrician. Explanation: Although the finding looks like a milk curd, if the white patch remains after feeding, the pediatrician needs to be notified. The likely cause of the white patch on the tongue is a fungal infection called Candida albicans, which the newborn probably contracted while passing through the birth canal. The nurse should not try to remove the patches.

The nurse notes a newborn has a temperature of 97.4oF (36.3oC) on assessment. The nurse takes action to prevent which complication first?

Respiratory distress Explanation: It takes oxygen to produce heat and an infant who has an episode of cold stress is at risk for respiratory distress. The infant needs to be warmed. The temperature should be in the range of 97.7°F to 98.6°F (36.5°C to 37°C). After respiratory distress sets in, it can be followed by seizures, cardiovascular distress or hypoglycemia.

The nurse is assessing a 2-hour-old newborn and notes that the infant has irregular patterns of breathing rate, depth, and rhythm. Which is the best action made by the nurse?

Taking no action because these are normal findings in a newborn Explanation: The rate, rhythm, and depth of breathing in a newborn are often irregular. Because these are normal findings, no further action is required by the nurse.