An infant is considered premature prior to what gestational age?

At what gestational age is an infant considered viable?

24 weeksAt what gestational age is an infant considered viable?

Anemia of prematurity is not usually treated unless the infant is symptomatic. What symptoms might you see in anemic infant that is symptomatic?

3-12 weeks of age; associated symptoms inlcude, tachycardia, poor weight gain, increased requirement of supplemental oxygen, or increased episodes of apnea or bradycardia.

How many wet diapers should a newborn infant have in a 24 hour periods?

6-8

Respiratory evaluation to monitor for respiratory distress

A 42-week-gestation baby has been admitted to the neonatal intensive care unit. At delivery, thick green amniotic fluid was noted. Which of the following neonatal care actions by the nurse is critical at this time? 1. Bath to remove meconium-contaminated fluid from the skin. 2. Ophthalmic assessment to check for conjunctival irritation. 3. Rectal temperature to assess for septic hyperthermia. 4. Respiratory evaluation to monitor for respiratory distress

4. Wrinkled skin.

A baby has been admitted to the neonatal intensive care unit with a diagnosis of postmaturity. The nurse expects to find which of the following during the initial newborn assessment? 1. Abundant lanugo. 2. Flat breast tissue. 3. Prominent clitoris. 4. Wrinkled skin.

B. "I will assess the​ baby's ability to suck and swallow​ first."

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."

1. Crying and sad.

A client with a fetal demise is admitted to labor and delivery in the latent phase of labor. Which of the following behaviors would the nurse expect this client to exhibit? 1. Crying and sad. 2. Talkative and excited. 3. Quietly doing rapid breathing. 4. Loudly chanting songs.

1. Fetal distress.

A client, 42 weeks' gestation, is admitted to the labor and delivery suite with a diagnosis of acute oligohydramnios. The nurse must carefully observe this client for signs of which of the following? 1. Fetal distress. 2. Dehydration. 3. Oliguria. 4. Jaundice.

4.Impaired gas exchange.

A neonate is admitted to the neonatal intensive care unit for observation with a diagnosis of probable meconium aspiration syndrome (MAS). The neonate weighs 10 lb, 4 oz (4,650 g) and is at 41 weeks' gestation. Which of the following would be the priority problem? 1.Impaired skin integrity. 2.Hyperglycemia. 3.Risk for impaired parent-infant-child attachment. 4.Impaired gas exchange.

Monitor urine output

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."

Measuring abdominal girth frequently

A nurse is caring for a preterm infant with necrotizing enterocolitis (NEC). Which nursing intervention is most important for this infant? 1 Measuring abdominal girth frequently 2 Diluting the formula mixture as prescribed 3 Administering oxygen before the gastric feeding 4 Using half-strength formula for gavage feeding

Magnesium Sulfate

A pregnant woman is administered medication to treat preterm labor that requires a prescription for calcium gluconate to counter the effects of the drug. Which drug was administered? 1 Nifedipine 2 Indomethacin 3 Betamethasone 4 Magnesium sulfate

Urine output

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

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

C. 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. Late fetal heart decelerations.

A woman, G3 P2002, 42 weeks' gestation, is admitted to the labor suite for induction. A biophysical profile (BPP) report on the client's chart states BPP score of 6 of 10. The nurse should monitor this client carefully for which of the following? 1. Maternal hypertension. 2. Maternal hyperglycemia. 3. Increased fetal heart variability. 4. Late fetal heart decelerations.

1.) age of baby from the day of birth 2.) age of baby based on due date 3.) the first day of the woman's last menstrual cycle to the current date (or time of delivery)

Definition of: 1.) Chronological age 2.) Adjusted age 3.) Gestational age

What are some common causes of cerebral palsy in premature babies?

Intraventricular hemorrhage and/or hypoxia (before, during, or after birth).

What dangerous neurological condition can result from a high level of bilirubin accumulating in the brain?

Kernicterus

-Previous preterm birth -Pregnant with multiple -Uterine or cervical abnormalities -smoking -cervical and placenta problem

Name 3 INDIVIDUAL risk factors for premature birth

1.) Late/No prenatal care2.) Drug/Alcohol use3.) Domestic violence (emotional/sexual/physical)4.) Stress & Lack of social support

Name 3 LIFESTYLE / ENVIRONMENTAL risk factors for premature birth

1.) Diabetes 2.) High Blood Pressure 3.) IVF (in vitro fertilization) 4.) Clotting Disorders

Name 3 MEDICAL COMPLICATIONS that are risk factors for premature birth

Why do premature babies often have PDA's? HEART DEFECTS

PDA usually closes 12-72 hrs. after birth and loud strong cries help PDA to close, but premature infants are too small to make loud cries.

intercostal retractions

Respiratory distress syndrome (RDS) develops 6 hours after birth in a neonate born at 33 weeks' gestation. What would the nurse's assessment of the newborn at this time reveal? 1 High-pitched cry 2 Intercostal retractions 3 Heart rate of 140 beats/min 4 Respirations of 30 breaths/min

What causes apnea a prematurity?

Secondary to immature nervous system. Apnea can last 15-20 seconds.

Why are premature babies more susceptible to hypoglycemia?

Secondary to increased energy demands to keep temperature stable, increased respiratory effort, and working harder to feed.

-gestational age -prematurity

Small for ___ is worse than for ____

Verifying oxygen saturation frequently to adjust flow on the basis of need

Supplemental oxygen is ordered for a preterm neonate with respiratory distress syndrome (RDS). What action does the nurse take to reduce the possibility of retinopathy to prematurity? 1 Humidifying oxygen flow to prevent dehydration 2 Uncovering the entire body to increase exposure to the oxygen 3 Applying eye patches to both eyes to protect them from the oxygen 4 Verifying oxygen saturation frequently to adjust flow on the basis of need

Respiratory distress syndrome in premature babies is often due to lack of ____?

Surfactant

"Babies are nose breathers, so the feeding tube should be placed through the mouth."

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 nose breathers, 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."

1.B/P. 4. Color. 5. Heart rate.

The neonate in the nurse's care has a pneumothorax. The nurse knows the signs of early decompensation and to carefully assess which of the following? Select all that apply. 1.B/P. 2.Temperature. 3.Urinary output. 4.Color. 5.Heart rate.

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

3. Cervical dilation. 4. Fetal station. 5. Cervical position.

The nurse is assessing the Bishop score on a postdates client. Which of the following measurements will the nurse assess? Select all that apply. 1. Gestational age. 2. Rupture of membranes. 3. Cervical dilation. 4. Fetal station. 5. Cervical position.

D. ​"Hold the baby in a​ semi-seated position."

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 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

A. ​"Your baby is doing well for a preterm​ infant."

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."

skin integrity

The nurse is caring for a client with a diagnosis of necrotizing fasciitis. Which is the priority concern of the nurse when caring for this client? 1 Fluid volume 2 Skin integrity 3 Physical mobility 4 Urinary elimination

Prevents conductive heat loss

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

Jerky movements

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

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

Necrotizing enterocolitis

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

Support the neonate's oxygen saturation while providing minimal FiO2

The nurse is caring for a preterm infant who is receiving oxygen therapy. What should the nurse do to prevent retinopathy of prematurity (ROP)? 1 Cover the neonate's eyes with a shield 2 Place the neonate in an elevated side-lying position 3 Assess the neonate every hour with a pulse oximeter 4 Support the neonate's oxygen saturation while providing minimal FiO2

Metabolic acidosis

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

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. 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.

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."

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 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 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

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

Swaddling to keep the hands away from the face

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

Ear cartilage remains folded over, lanugo present over much of the body, some flexion of arms and legs at rest

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

Protein

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 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."

body posture

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

C. Infection control practice

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

Stopping the feeding

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

The baby losing 17% of body weight since discharge

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 on 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 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 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 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."

Why is intraventricular hemorrhage (IVH) more common in premature infants?

Vessels in head are fragile and rupture easily.

Prolonged rupture of membranes (amniotic fluids) and group b strep.

What are some causes of sepsis in premature infants?

Abd distention, decreased bowel signs, vomiting, signs of sepsis, railroad track patterns in bowel on radiograph, apneic episodes, residuals after two feedings

What are some signs of Necrotizing Enterocolitis (NEC)?

Keeping the infant warm to maintain body temperature

What is the focus of nursing care for a newborn with respiratory distress syndrome (RDS)? 1 Tapping the toes to stimulate respirations 2 Turning the infant frequently to prevent apnea 3 Maintaining oxygen concentration at 40% to support respiration 4 Keeping the infant warm to maintain body temperature

Has type 1 diabetes

What maternal condition would cause the nurse to expect signs of respiratory distress syndrome (RDS) in a neonate? 1 Has type 1 diabetes 2 Has been hypertensive during pregnancy 3 Was preeclamptic during the labor and birth

What medication might be given to help a PDA to close?

What medication might be given to help a PDA to close?Indomethacin

Keeping the infant in a warm environment

Which component of nursing care is most important for a newborn with respiratory distress syndrome (RDS)? 1 Keeping the infant in a warm environment 2 Turning the infant frequently to prevent apnea 3 Tapping the infant's toes to stimulate deep breathing 4 Maintaining the infant's oxygen administration level at the same rate

Nifedipine (Procardia)

Which drug is used to prevent preterm labor? 1 Oxytocin 2 Nifedipine 3 Raloxifene 4 Clomiphen

3. Lanugo.

Which of the following developmental features would the nurse expect to be absent in a 41-week gestation fetus? 1. Fingernails. 2. Eyelashes. 3. Lanugo. 4. Milia.

2. The treatment for preterm labor includes bed rest and hydration. 3. Preterm labor before the 20th week is indicative of a nonviable fetus.

Which statements relate to preterm labor? Select all that apply. 1 A premature baby has good cognitive development. 2 The treatment for preterm labor includes bed rest and hydration. 3 Preterm labor before the 20th week is indicative of a nonviable fetus. 4 It is not desirable to stop the delivery in the case of preterm labor. 5 Preterm labor refers to uterine contractions progressing to delivery before the 27th week of pregnancy.

Indomethacin

Which tocolytic agent inhibits prostaglandin activity and is given along with sucralfate to help manage preterm labor? 1 Nifedipine 2 Indomethacin 3 Calcium gluconate 4 Magnesium sulfate

Immunizations are given based on chronological age, not gestational age. What is the only vaccine that should be delayed until the infants reaches 2000 grams?

hepB