3 Maternity

Infants born between 34 0/7 and 36 6/7 weeks of gestation are called late-preterm infants because they have many needs like those of preterm infants. Because they are more stable than early preterm infants, they may receive care that is much like that of a full-term baby. The mother-baby or nursery nurse knows that these babies are at increased risk for: (Select all that apply.) a. problems with thermoregulation. b. cardiac distress. c. hyperbilirubinemia. d. sepsis. e. hyperglycemia.

A, c and d

34-week infant pain treatment a. keep the baby unwrap b. Physical distraction by holding the hand or rub the back of the baby c. Provide Oral sucrose and pacifier d. Provide pyretic e. Rub nice and tight and give them containment

C and e

Hearing murmur Normal finding for the first 24 hrs Crput hematoma Extracorporeal membrane oxygenation

Normal finding for the first 24 hrs

An infant with severe meconium aspiration syndrome (MAS) is not responding to conventional treatment. Which highly technical method of treatment may be necessary for an infant who does not respond to conventional treatment? a. Extracorporeal membrane oxygenation b. Respiratory support with a ventilator c. Insertion of a laryngoscope and suctioning of the trachea d. d. Insertion of an endotracheal tube

a. Extracorporeal membrane oxygenation

Which is of the following is true statement regarding fetal circulation a. Placenta caries oxygen and nutrients from mom to fetus b. Fetal blood circulation bypasses the lung c. Normal baby has one artery and one vein d. Fetal circulation mixes throughout the pregnancy e. Fetal oxygen saturation is b/n 90 and 100%

a. Placenta caries oxygen and nutrients from mom to fetus

where we need to put the led to check Ductal dependent a. Pre ducal always right-hand post ductal feet b. Ithastobewithin5% c. It is ok to use left hand d. you have to test the first 12 hr before ductus arteriosus to close

a. Pre ducal always right-hand post ductal feet

Which of the following is Not true regarding Intimate Partner Violence'? a. Screen only those we suspect victims of Intimate Partner Violence b. this can happen to anyone c. victims of Intimate Partner Violence likely to be uncomfortable for screening d. there is often a desire the victim try to protect the perpetrator

a. Screen only those we suspect victims of Intimate Partner Violence

The nurse should immediately alert the physician when: a. the infant is dusky and turns cyanotic when crying. b. acrocyanosis is present at age 1 hour. c. the infant's blood glucose level is 45 mg/dL. d. the infant goes into a deep sleep at age 1 hour.

a. the infant is dusky and turns cyanotic when crying.

When responding to the question "Will I produce enough milk for my baby as she grows and needs more milk at each feeding?" the nurse should explain that: a. the breast milk will gradually become richer to supply additional calories. b. as the infant requires more milk, feedings can be supplemented with cow's milk. c. early addition of baby food will meet the infant's needs. d. the mother's milk supply will increase as the infant demands more at each feeding.

d. the mother's milk supply will increase as the infant demands more at each feeding.

To keep preterm thermoregulating what the nurses needs to do? a. Set the control panel b/n 35 and 38 degree Celsius b. Put the temperature pro beneath the both the cord c. Asses rectal temperature every 1 hr. d. undress the infant before placing infant under warmer

d. undress the infant before placing infant under warmer

When caring for a preterm infant born at 30 was gestation, the nurse should recognize which of the following as the newborns primary dx? A. Risk for infection related to decreased immune response B. Ineffective breathing pattern related to surfactant deficiency and weak respiratory muscle effort C. Ineffective their orejuela tino related to immature therm orejuela tino center D. Imbalanced nutrition: less than body requirements related to ineffective suck, swallow, and breath pattern

B. Ineffective breathing pattern related to surfactant deficiency and weak respiratory muscle effort

Which neonatal behavior is most commonly associated with fetal alcohol syndrome FAS? A. Hypoactivity B. High birth wt C. Poor wake and sleep patterns D. High threshold of stimulation

C. Poor wake and sleep patterns

Baby Isaac's parents were just informed that he has non-mosaic trisomy 13, a diagnosis that is incompatible with life. In speaking with the parents, the nurse understands that they will need to provide support to the grieving parents by stating: A. You can always have another baby B. It is probably best that you stay in the hospital. Parents who take their baby home to die often experience more trauma from the death C. Dying can be painful. Would you like me to give your baby some morphine? D. Your feelings around Isaac's diagnosis are valid. We are all here to support you through this difficult time with whatever you need.

D. Your feelings around Isaac's diagnosis are valid. We are all here to support you through this difficult time with whatever you need.

Nursing care which of true statement about infant neurological behaviors a. If they hold against their body and the tremors stop it is seizure b. Babinski reflex is abnormal c. The nurses trying wake the baby during deep sleep d. The is the answer

d. The is the answer

What is the main reason the under 20-week infant brain is vulnerable to hemorrhage? a. underdevelopment of the germinal matrix b. full function of the immune defense system at birth. c. maintenance of a stable temperature. d. initiation and maintenance of respirations.

a. underdevelopment of the germinal matrix

16 order 1g available 250mg/tablet

= 4 tabs

Order 3mcg/kg/min wt 740g available 10ml syringe with 2mg/5ml

=0.33ml/hr

order 500mg available 2ml vail 250mg/ml

=2mL

3183g how many lbs

=7lbs

Which Sign and symptoms of infant fetal respiratory distress a. Cyanotic b. Tachypnea c. Hypotension d. Retraction e. Grunting f. Presence of Barrel chest

A, b, d, e

The single most effective measure to reduce health-care associated in high risk neonates is: A. Warning a mask B. Washing your hands C. Broad spectrum antibiotics D. Maintain infant in incubator as long as possible

B. Washing your hands

Which one of is cross suture line that has bugginess the back of the head a. Crput hematoma b. Cephalohematoma c. Subgaleal hemmorhage:

a. Crput hematoma

how do we treat Gastroschisis? a. Place bowel contents in sterile dressing for transport to NICU b. have one person to transport the baby to NICU c. primary closure of the abdomen occurs during the first 72 hours d. the baby will be able to eat 12 to 24 hr. after the repair

a. Place bowel contents in sterile dressing for transport to NICU

Baby is admitted in the NICU what the most important thing is you do a. Put them on monitors b. recusation bag to the oxygen outlet c. Start IV d. Warm them

b. recusation bag to the oxygen outlet

The nurse is helping teach parents to care for their 26 wk gestation infant for the first time. An appropriate statement to encourage parent involvement is: A. Please do not touch your child. The only time they grow is when they are sleeping. B. The germs on your body are harmful, so we recommend holding your baby swaddled until they are discharged home. C. What information would you like to know about your baby? D. Let me show you how to change a diaper so you can do it next time, and then you can provide gentle containment while your baby rests.

D. Let me show you how to change a diaper so you can do it next time, and then you can provide gentle containment while your baby rests.

An infant born at 28 was gestation is at greater risk of sepsis than a baby born at 39 was gestation because premature infants: A. Are more likely to have meconium aspiration B. Have immature body organs C. Have too mush surfactant present in the lungs D. Are more listless and lethargic than term babies

B. Have immature body organs

Four babies are in the neonatal ICU. The nurse pages the neonatologist to see the baby who exhibits which of the following: A. A 29 wk gestation infant with a tight shiny abdomen B. A newly admitted baby exhibiting abdominal breathing at a rate of 37breathes per minute C. A 34 wk gestation infant with yellow tinged skin down to just above the diaper line D. A 27 was gestation infant with a heart rat of 165bpm.

A. A 29 wk gestation infant with a tight shiny abdomen

A 34 wk gestation baby, born to a GBS positive mom with a fever, is admitted to the NICU shortly after birth. The neonatologist orders antibiotics for the baby based solely on the results of the online neonatal early-onset sepsis calculator. The nurse understands that antibiotics: A. Are given for at least 48 hrs to prevent early onset sepsis in babies who are calculated to be at high risk given the results of the early-onset sepsis calculator, even if the baby appears well. B. Are given to all babies entering the NICU since their immune systems are immature C. Should not be given to a baby in the first 48hrs of life unless they are exhibiting obvious signs and symptoms of illness; the calculator is used at 48hrs of life. D. Should only be given after the neonatologist looks at the baby, regardless of what the calculator states.

A. Are given for at least 48 hrs to prevent early onset sepsis in babies who are calculated to be at high risk given the results of the early-onset sepsis calculator, even if the baby appears well.

A premature infant is born at 24th so gestation. The baby is admitted to their NICU. The admitting nurse knows the goal of care is to mimic intrauterine life. This can be done by: A. Cluster care, cover the incubator, and minimize touch B. Quiet voices, provide black and white pictures, and cluster care C. Cluster care, "pancake flip" the baby, and provide boundaries D. Provide boundaries, provide regular stimulation, and silence alarms quickly.

A. Cluster care, cover the incubator, and minimize touch

What is the need of giving vitamin K for the ne born baby? A. It prevents fetal bleeding B. Cold stress prevention C. Crput hematoma

A. It prevents fetal bleeding

An infant born at 39 was gestation is admitted to the NICU. The apagar score at 10 mins of life was 4, the infant had a arterial pH of 6.97, intermittent seizures are noted, and the infant is otherwise hypotonic. Orders are given to start therapeutic hypothermia. The nurse knows starting therapeutic hypothermia: A. Will likely stop the secondary inflammatory cascade that occurs 6-72hrs after the initial trauma. B. Is not warranted in this case, as the infant is too close to term C. Will prevent the initial trauma of O2 deprivation from causing brain damage D. Will stop the seizures, so must be done prior to any other intervention

A. Will likely stop the secondary inflammatory cascade that occurs 6-72hrs after the initial trauma.

What of the following is true about discharge education for P.U.R.P.L.E. Crying select all that apply? a. A lot of Pain is the reason the baby is crying b. start around two weeks of life, peaks around 6-8 weeks, and finishes off around 3-4 months c. If I am overwhelmed, I can put the baby in safe place and take a break d. If he doesn't take a pacifier, it is not likely stop crying e. There is no known reason

B, c and e

Necrotizing enterocolitis (NEC) is an inflammatory disease of the gastrointestinal mucosa. The signs of NEC are nonspecific. Some generalized signs include: A. Hypertonic, tachycardia, and metabolic alkalosis B. Abdominal distensión, temperature instability, and grossly bloody stools. C. HTN, absence of apnea and ruddy skin color D. Scaphoid abdomen, no residual with feedings, and increased urinary output.

B. Abdominal distensión, temperature instability, and grossly bloody stools.

On assessment of a preterm baby in the NICU, the nurse notes signs of respiratory distress syndrome. The doctor is notified and writes an order for surfactant replacement therapy. The nurse would prepare for administration of surfactant by: A. Oral route of admin B. Intravenous injection C. Instillation through the endotracheal tube directly into the lungs D. Intramuscular injection

C. Instillation through the endotracheal tube directly into the lungs

A term neonate is admitted to a hospitals NICU for elevated bilirubin. The neonate's vital signs are: temp=96.5 degree F, HR=120bpm, and RR=40/min. The infant appears pink with slight jaundice and acrocyanosis. The priority nursing diagnosis for the neonate is: A. Ineffective thermoregulation related to fluctuating environmental temperatures. B. Potential for infection related to lack of immunity. C. Altered nutrition, less than body requirements related to diminished sucking reflex. D. Altered elimination pattern related to lack of nourishment.

D. Altered elimination pattern related to lack of nourishment.

A macrosomia infant is born after a difficult forceps-assisted delivery. After stabilization the infant is weighed, and the birth weight is 4550 g (9 lbs, 6 ounces). The nurse's most appropriate action is to: a. leave the infant in the room with the mother. b. take the infant immediately to the nursery. c. perform a gestational age assessment to determine whether the infant is large for gestational age. d. monitor blood glucose levels frequently and observe closely for signs of hypoglycemia

d. monitor blood glucose levels frequently and observe closely for signs of hypoglycemia

what medication we use to prevent apnea in premature baby? a. Tylenol b. Caffeine c. Acedemorphine

b. Caffeine

In caring for the preterm infant, what complication is thought to be a result of high arterial blood oxygen level? a. Necrotizing enterocolitis (NEC) b. Retinopathy of prematurity (ROP) c. Bronchopulmonary dysplasia (BPD) d. Intraventricular hemorrhage (IVH)

b. Retinopathy of prematurity (ROP)

A newborn is placed under a radiant heat warmer, and the nurse evaluates the infant's body temperature every hour. Maintaining the newborn's body temperature is important for preventing: a. respiratory depression. b. cold stress. c. tachycardia. d. vasoconstriction.

b. cold stress.

A newborn was admitted to the neonatal intensive care unit after being delivered at 29 weeks of gestation to a 28-year-old multiparous, married, Caucasian woman whose pregnancy was uncomplicated until premature rupture of membranes and preterm birth. The newborn's parents arrive for their first visit after the birth. The parents walk toward the bedside but remain approximately 5 feet away from the bed. The nurse's most appropriate action would be to: a. wait quietly at the newborn's bedside until the parents come closer. b. go to the parents, introduce himself or herself, and gently encourage the parents to come meet their infant; explain the equipment first, and then focus on the newborn. c. leave the parents at the bedside while they are visiting so they can have some privacy. d. tell the parents only about the newborn's physical condition and caution them to avoid touching their baby.

b. go to the parents, introduce himself or herself, and gently encourage the parents to come meet their infant; explain the equipment first, and then focus on the newborn.

An infant boy was born just a few minutes ago. The nurse is conducting the initial assessment. Part of the assessment includes the Apgar score. The Apgar assessment is performed: a. only if the newborn is in obvious distress. b. once by the obstetrician, just after the birth. c. at least twice, 1 minute and 5 minutes after birth. d. every 15 minutes during the newborn's first hour after birth.

c. at least twice, 1 minute and 5 minutes after birth.

The nurse practicing in the perinatal setting should promote skin to skin care regardless of an infant's gestational age. a. is adopted from classical British nursing traditions. b. helps infants with motor and central nervous system impairment. c. helps infants to interact directly with their parents and enhances infant body function e. gets infants ready for breastfeeding.

c. helps infants to interact directly with their parents and enhances infant body function

Depressed pregnant women during prenatal baby aske to stop the medication because it will affect my baby a. Good idea the baby will go through withdraw if you don't stop b. Understanded your fear about taking medication that is harmful to your baby c. Anti-depressant's cause no extra side effects on your baby d. It is important to keep taking your medication Let's talk about the risk of about keeping is and stop it e. Let's take you off from the medication and take talk therapy

d. It is important to keep taking your medication Let's talk about the risk of about keeping is and stop it

After a neonate death what we need to do a. Great to keep air lock safe for all parents regardless of their culture b. After death baby stay in the hospital morgue for 24 before going to funeral c. You shouldn't show grief in front of the family this is not your baby d. It is important to make Baby bucket even if they say they don't want one

d. It is important to make Baby bucket even if they say they don't want one

While evaluating the reflexes of a newborn, the nurse notes that with a loud noise the newborn symmetrically abducts and extends his arms, his fingers fan out and form a "C" with the thumb and forefinger, and he has a slight tremor. The nurse would document this finding as a positive: a. tonic neck reflex. b. glabellar (Myerson) reflex. c. Babinski reflex. d. Moro reflex.

d. Moro reflex.

The best way to deal heat lost for the newborn baby a. You don't Swaddle them and put them to the warmer b. Passing them from person to person c. Dry and dress and swaddle nicely with blanket d. Put skin to skin

d. Put skin to skin

Premature infants who exhibit 5 to 10 seconds of respiratory pauses followed by 10 to 15 seconds of compensatory rapid respiration are: a. suffering from sleep or wakeful apnea. b. experiencing severe swings in blood pressure. c. trying to maintain a neutral thermal environment. d. breathing in a respiratory pattern common to premature infants.

d. breathing in a respiratory pattern common to premature infants.

The nurse assessing a newborn knows that the most critical physiologic change required of the newborn is: a. closure of fetal shunts in the circulatory system. b. full function of the immune defense system at birth. c. maintenance of a stable temperature. d. initiation and maintenance of respirations.

d. initiation and maintenance of respirations.