PrepU OB assignment 6
While reviewing a newborn's hospital record, which of the following would be most important for you to locate?
If he breathed spontaneously at birth
Which statement made by a new nurse indicates additional teaching is needed on the topic of hyperbilirubinemia (physiologic jaundice) in newborns?
"Breastfed babies need supplements of glucose water to help lower bilirubin levels."
A new mother asks the nurse why her newborn must get a vitamin K injection. Which response made by the nurse is best?
"Newborns need vitamin K to prevent hemorrhage. They cannot produce it themselves right after birth because of the lack of normal flora in their intestines."
When instructing a new mom on providing skin care to her newborn, which statement should not be included in the teaching?
"Use talc powders to prevent diaper rash."
A nurse is teaching a newborn's parents how to change a diaper correctly. Which statement by the parents best demonstrates understanding of what they have been taught?
"We will fold down the front of her diaper under the cord until it falls off."
A nurse is preparing to administer eye prophylaxis to a 30-minute-old newborn. Which ophthalmic medication would the nurse place in the newborn's eyes?
0.5% erythromycin eye ointment
When caring for a newborn several hours after birth, what would the nurse assess as a normal newborn's respiratory rate?
30 to 60 breaths/min
Which statement regarding newborn circumcision is accurate?
An advantage of circumcision is a decreased risk of penile cancer.
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.
The nurse is visiting a new mother who has been home with a new infant for 4 days. Which observation indicates that the mother's home environment was inadequately assessed prior to being discharged from the hospital?
Baby sleeps with the mother in bed.
The nurse is caring for a newborn immediately following birth. Which body system is priority for the nurse to monitor during the transition phase?
Cardiopulmonary
The parents of a newborn are upset that their newborn needs treatment for ophthalmia neonatorum. The nurse should explain this is related to which maternal infection? Select all that apply.
Chlamydia Gonorrhea
On inspecting a newborn's abdomen, which finding would you note as abnormal?
Clear drainage at the base of the umbilical cord
A new mother calls her pediatrician's office concerned about her 2-week-old infant "crying all the time." When the nurse explores further, the mother reports that the infant cries at least 2 hours each day, usually in the afternoons. What recommendations would the nurse not make to this mother?
Feeding the infant more formula whenever she begins to fuss
The nurse documents that a newborn has a normal head-to-body proportion. What did the nurse document in the baby's medical record?
Head one fourth of total length
Which assessment finding indicates to the nurse that a newborn has hip subluxation?
Inability of the right hip to abduct
The nurse is preparing a newborn male for circumcision. During the assessment, the nurse notes the newborn has a hypospadias. Which action made by the nurse is best?
Inform the practitioner and cancel the procedure.
The nurse is preparing to administer the vitamin K injection to a newborn. Which action would be correct for this client?
Injecting the medication into the vastus lateralis
A local hospital has a home visitation program for new families after discharge from the hospital. What benefit would this program have for parents?
It allows the parents an opportunity to demonstrate competency in caring for their infant and ask any questions.
A new mother is distraught because the baby has a white discharge coming from the breasts. What should the nurse explain to the mother about this discharge?
It is caused by the mother's hormones.
What instructions should the nurse include when teaching a mother to care for her newborn's umbilical cord?
Keep it dry.
A 36-hour-old newborn is ready for discharge from the hospital and the nurse notices that his skin looks yellow. What action should the nurse take?
Notify the physician of the finding and get a serum bilirubin ordered.
A laboring mother requests that she be allowed to participate in kangaroo care following delivery. The nurse understands that this involves what action?
Placing the diapered newborn skin-to-skin with the mother and cover them both with a blanket.
The nurse is caring for a newborn that weighed 7 lb 3 oz (3220 g) at birth. What action should the nurse take first based on this weight?
Plot the weight on a gestational age graph.
The nurse is inspecting a male newborn's genitalia. Which action should the nurse avoid when conducting this assessment?
Retracting the foreskin over the glans to assess for secretions
Just after birth, a newborn's axillary temperature is 94°F (34.4°C). What action would be most appropriate?
Rewarm the newborn gradually.
The nurse has administered an opthlalmic agent for eye prophylaxis, as prescribed. What outcome indicates that this intervention has been effective?
The infant remains free of opthalmia neonatorum
The nurse is explaining the care the newborn will be receiving right after birth to the parents. The nurse should point out the infant will receive an ophthalmic antibiotic ointment by approximately which time?
Within one hour
When assessing a newborn 1 hour after birth, the nurse measures an axillary temperature of 95.8° F (35.4° C), an apical pulse of 114 beats per minute, and a respiratory rate of 60 breaths per minute. The nurse would identify which area as the priority?
hypothermia
While examining a 2-day old newborn, a nurse notices that the skin and sclera of the eyes appear yellow. The nurse recognizes this condition as:
jaundice.
The primipara tells the nurse, "My baby jumps every time I pick her up. Is she afraid that I will drop her?" Which response by the nurse would be best?
"No, it is the Moro reflex. This reflex simulates the action of warding off an attacker."
The nurse records a newborn's Apgar score at birth. A normal 1-minute Apgar score is:
7 to 10.
How can new parents aid their newborn to develop trust so the infant can become more organized in the responses to his or her environment?
Be attentive to the basic needs of the infant and be consistent.
The newborn has been placed in skin-to-skin contact with his mother. A blanket covers all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the most likely type of heat loss this baby may experience?
Evaporative
The nurse administers vitamin K intramuscularly to the newborn based on which rationale?
Promote blood clotting.
A mother asks the nurse about having her son circumcised. The nurse understands that circumcision is contraindicated under which circumstances? Select all that apply.
There is a family history of hemophilia. The infant is at 33 weeks' gestation.
The nurse measures a newborn's temperature immediately after birth and finds it to be 99°F (37.2°C). An hour later, it has dropped several degrees. The nurse understands that this heat loss can be explained in part by which factor in the newborn?
lack of subcutaneous fat