Newborn and postpartum prep u

The nurse is conducting a prenatal class on breastfeeding. The nurse determines the class is successful when the young parents correctly choose which time frame is recommended for breastfeeding the infant? 4 months 6 months One year Two years

One year

nurse is caring for a female client in the postpartum phase. The client reports "afterpains." Which intervention should the nurse complete first? Administer pain medications. Assess client vital signs. Assist the client in emptying her bladder. Encourage the client to stop breastfeeding until the pains stop.

Administer pain medications.

A nursing instructor is teaching new mothers about nutrition and the actual calories infants need for maintenance and growth. Which of the following statements by one of the mothers indicates a need for further instruction? "Growth in the neonatal period is very rapid." "All infants require the same amount of calories." "After 2 months, the amount needed in calories declines." "An adult requires fewer calories per kg than an infant."

"All infants require the same amount of calories."

A newborn's parents ask the nurse how to prevent the newborn from becoming ill. What is the best response by the nurse? "Be sure to keep the newborn's umbilical cord stump clean and dry." "Keep your newborn at home and do not allow visitors for the first month." "Be sure to keep all scheduled doctor appointments for vaccinations." "Always wash your hands before you pick up or provide care to your newborn."

"Always wash your hands before you pick up or provide care to your newborn."

x A postpartum woman tells the home care nurse, "My hemorrhoids are really uncomfortable. Is there anything I can do?" Which suggestion(s) by the nurse would be appropriate? Select all that apply. "Applying ice to the area can help." "You should pour cold water over the area with your peribottle." "Witch hazel pads can have a cooling effect." "I will show you how to use a sitz bath." "You might think anesthetic sprays help but they do not."

"Applying ice to the area can help." "Witch hazel pads can have a cooling effect." "I will show you how to use a sitz bath."

Parents ask the nurse why they are not supposed to throw a bottle of milk into the microwave to warm it. Which response is mostaccurate? "The milk gets so warm that bacteria can start to grow immediately." "The microwave causes the milk in the center of the bottle to become hotter than near the sides." "The microwave will heat the milk so high that the components will break down and the milk will have little nutritional value." "It's always best to put a pan on the stove and warm the milk in a warm water bath."

"The microwave causes the milk in the center of the bottle to become hotter than near the sides."

The nurse is assessing a male neonate in the presence of the parents and notes that the neonate has hypospadias. How should the nurse respond when questioned by the parents as to what this means? "He has normal male genitalia." "His testicles have not descended into the scrotal sac." "The opening of his urethra in located on the under surface of the tip of the penis." "He has fluid in the scrotal sac."

"The opening of his urethra in located on the under surface of the tip of the penis."

x A single mother with financial constraints asks the nurse if she can keep unused milk from one feeding for the next feeding. Which response is most accurate? "Absolutely, you can use it as long as it's within 24 hours of being prepared." "You can save and reuse milk if your infant is feeding frequently, like every 2 to 3 hours." "Since the milk components break down during heating, it will not supply proper nutrition when reheated." "With any type of bottle, the contents remaining after a feeding should be discarded, not reused."

"With any type of bottle, the contents remaining after a feeding should be discarded, not reused."

The nurse is teaching a breastfeeding class. Which statement made by a mother indicates comprehension of the composition of breast milk. "I will completely empty one breast before starting on the other because my baby needs the: "water in the foremilk." "fat in the hindmilk." "prolactin in the let-down." "protein in the colostrum."

"fat in the hindmilk."

apnea in newborn

- 10 seconds of apnea is normal; if 11 seconds need stimulate or rub their back

In premature they get high levels of oxygen which can cause

- blindness called retinopathy prematurity

Methrogyne :

- elevated BP can make BP go up

Full bladder:

- get up as soon as possible as long as its safe to do so

Gestational diabetes are greater risk3

- macrosomia, LGA, and hypoglycemia(sugar source is discontinue)

Immediately after delivery, the fundus

- midline and palpable halfway between the symphysis pubis and the umbilicus.

Withdrawal babies:

- need quiet room, wont eat that well, failure to thrive

See cerebral palsy in injury of delivery

- of brain cord wrap around neck, or deprive of oxygen

Failure to thrive:4

- small, skinny and lean, lose muscle and fat, do not have drive to eat , and don't have bond with anyone, just want to sleep

Most common is cp

- spastic muscles of contracted tense, increase tone

A newborn is receiving ampicillin and gentamicin every 12 hours. When would this client have his hearing screen performed? 1 day after birth After the newborn has completed the antibiotic therapy Before discharge from the hospital 1 month after discharge

After the newborn has completed the antibiotic therapy

A nurse is conducting the initial assessment for a 3-hour-old neonate and notes the following: RR 30 breaths/min, BP 60/40 mm Hg, HR 155 beats/min, axillary temperature 98.2°F (36.8°C), and the neonate is in a state of quiet alert. What action should the nurse take? Inform the charge nurse. Call the primary care provider. Document the data. Stimulate the neonate.

Document the data.

After the birth of a newborn, which action would the nurse do firstto assist in thermoregulation? Dry the newborn thoroughly. Put a hat on the newborn's head. Check the newborn's temperature. Wrap the newborn in a blanket.

Dry the newborn thoroughly.

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. Place the newborn in isolation precaution. Bathe the newborn thoroughly.

Give hepatitis B immune globulin. Obtain consent from the mother. Administer hepatitis B vaccination. Bathe the newborn thoroughly.

A new mother calls the lactation consultant at the hospital because she is concerned that her 1-week-old baby is not getting enough to eat when he is breast-feeding. What reported behavior by the baby would the nurse be concerned about? He is feeding 6 times per day. Mother is changing seven to eight wet diapers per day. His nursing time has increased from when he was born. His stools are loose and yellow in color.

He is feeding 6 times per day.

A new mother exhibits signs of feeling abandoned shortly before being released from the hospital. The mother gave birth to a healthy newborn 2 days ago. Which nursing intervention would be most appropriate in this case? Mention to the mother how it is common to feel "left out" when all of the attention shifts from the pregnant mother to the newborn. Comment on the child's good points. Explain how hormonal changes can contribute to feelings of overwhelming sadness. Refer her to a psychologist.

Mention to the mother how it is common to feel "left out" when all of the attention shifts from the pregnant mother to the newborn.

The nurse is assisting with the admission of a newborn to the nursery. The nurse notes what appears to be bruising on the left upper outer thigh of this dark-skinned newborn. Which documentation should the nurse provide? Mongolian spot noted on left upper outer thigh. Harlequin sign noted on left upper outer thigh. Mottling noted on left upper outer thigh. Birth trauma noted on left upper outer thigh.

Mongolian spot noted on left upper outer thigh.

Choose the correct statement regarding breast milk production. Oxytocin is responsible for the let-down reflex, and prolactin stimulates milk production. Prolactin is responsible for the let-down reflex, and oxytocin stimulates milk production. Progesterone is responsible for the let-down reflex, and prolactin stimulates milk production. Prolactin is responsible for the let-down reflex, and progesterone stimulates milk production.

Oxytocin is responsible for the let-down reflex, and prolactin stimulates milk production.

When counseling a mother about the benefits of breastfeeding, all of the following should be stated except: Reduces the incidence of colic in a newborn Promotes better tooth and jaw development Provides protection against food allergies Prevents the transmission of group beta streptococcus skin infections

Prevents the transmission of group beta streptococcus skin infections

A nurse is explaining to a group of new parents about the changes that occur in the neonate to sustain extrauterine life, describing the cardiac and respiratory systems as undergoing the most changes. Which information would the nurse integrate into the explanation to support this description? The cardiac murmur heard at birth disappears by 48 hours of age. Pulmonary vascular resistance (PVR) is decreased as lungs begin to function. Heart rate remains elevated after the first few moments of birth. Breath sounds will have rhonchi for at least the first day of life as fluid is absorbed.

Pulmonary vascular resistance (PVR) is decreased as lungs begin to function.

The nurse is caring for a newborn who is lethargic, apneic, and not eating well, and has an axillary temperature of 36.2ºC. Which might the nurse have a concern about? Jaundice Sepsis Respiratory distress Hypoglycemia

Sepsis

The nurse is checking the lochia of a new mother at her 2-week checkup. The mother reports that the lochia is a small amount, pale yellow with occasional tinges of brown. She also reports that it has fleshy odor to it. How would the nurse evaluate these findings? The lochia's odor indicates that an infection may be present and the doctor needs to be notified. The color and amount of the lochia is normal and there are no concerns. The brownish tinges indicate that the mother is regressing on the expected pattern of lochia and this is problematic. Lochia should have stopped by now, so this is definitely concerning for the nurse and should be reported.

The color and amount of the lochia is normal and there are no concerns.

The nurse is looking at the latest lab work for her postpartum client. The client's predelivery hemoglobin and hematocrit (H & H) was 12.8 and 39, respectively. This morning, the client's values are 8.9 and 30. How would the nurse interpret these lab values? The client will need a transfusion, so the RN needs to be notified. The client will be tired, so encourage her to sleep whenever the baby sleeps. The health care provider needs to be notified of the latest lab values. These values are expected for a 1-day postpartum mother.

The health care provider needs to be notified of the latest lab values.

The nurse is looking over a newborn's plan of care regarding expected outcomes. Which outcome would not be appropriate according to a newborn's nursing care? The newborn's body temperature will stabilize between 97.8ºF and 99.5ºF (36.6ºC and 37.5ºC). The newborn's blood glucose will remain above 50 mg/dl The newborn will experience no bleeding episodes lasting more than 5 minutes. The newborn will be correctly identified prior to separation from the parents.

The newborn will experience no bleeding episodes lasting more than 5 minutes.

Which factors affect a woman's decision to breastfeed? Select all that apply. socioeconomic culture past experience family work status

socioeconomic culture past experience family work status

- Get rid of breast milk: 4

tight bra, avoid warm water, ice packs, and cabbage

After teaching a group of pregnant women about the skin changes that will occur after the birth of their newborn, the nurse understands there is a need for additional teaching when one of the women makes which statement? "I can't wait for these stretch marks to disappear after I give birth." "I might lose some hair, but it will grow back." "This line on my belly will go away over time." "My nipples won't be so dark after I give birth."

"I can't wait for these stretch marks to disappear after I give birth."

The nurse provides discharge instructions to a postpartum client. Which client statement indicates that teaching has been effective? "I should limit stair climbing to four times a day." "I can have coitus at any time after returning home." "I should plan to return to my full-time job after 6 weeks." "I should notify the physician if my discharge decreases in amount."

"I should plan to return to my full-time job after 6 weeks." -good rule of thumb is the woman should not lift anything heavier than the baby for the first 6 weeks after delivery.

The nurse would provide additional teaching if which statement was made by a new mother? "I drank fluoridated water during pregnancy." "While lactating, I should drink fluoridated water." "I should prepare the baby's formula with fluoridated water." "I will have to buy bottled, 'natural' water for mixing formula."

"I will have to buy bottled, 'natural' water for mixing formula."

A mother shares with the nurse that she is lactose intolerant and does not want her newborn to be given formula. What response is most accurate to give this woman? "We will put your baby directly on a soy-based formula." "Will you consider breastfeeding this newborn?" "Lactose intolerance is rare in newborns, so let's give regular formula a try." "Lactose intolerance is usually passed down from the father's genetics."

"Lactose intolerance is rare in newborns, so let's give regular formula a try."

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? "This is likely just coincidence." "Neonates born by cesarean do not benefit from the squeezing of the contractions, which helps to clear the lungs." "Normally, neonates born by cesarean do better after delivery since it is a much gentler birth." "You are older now and that can impact how your neonate adapts to the birth process." "Neonates born by cesarean tend to need oxygen supplementation due to the rapid change in fetal circulation when the uterus was cut during the birth."

"Neonates born by cesarean do not benefit from the squeezing of the contractions, which helps to clear the lungs."

A new mother who is about to be discharged expresses concern about how to know her baby is getting enough breast milk. Which response should the nurse prioritize? "Observe if your baby is eating 8-12 times a day." "Supplementing with one bottle of formula is okay." "Make sure the baby stays on the breast for at least 5 minutes each time on each side." "If you have nipple pain, that is a sign of inadequate supply."

"Observe if your baby is eating 8-12 times a day."

A nurse teaches new parents how to soothe a crying newborn. Which statement by the parents indicates to the nurse the teaching was effective? "We will vigorously rub our baby's back as we play some music." "We will place our baby on the belly on a blanket on the floor." "We will turn the mobile on that's hanging on our baby's crib." "We will hold feedings until our baby stops crying."

"We will turn the mobile on that's hanging on our baby's crib."

1. Deep sleep: 2. Light sleep: 3. Drowsy: 4. Quiet alert: 5. Active alert: 6. Crying:

-quiet, nonrestless sleep state; newborn is hard to awaken. -eyes are closed, but more activity is noted; newborn moves actively and may show sucking behavior. -eyes open and close, and the eyelids look heavy; body activity is present with intermittent periods of fussiness. -quiet state with little body movement, but the newborn's eyes are open, and he or she is attentive to people and things that are in close proximity; this is a good time for the parents to interact with their newborn. -eyes are open and active body movements are present; newborn responds to stimuli with activity. -eyes may be tightly closed, thrashing movements are made in conjunction with active crying.

The nurse is checking on a newborn who was circumcised 2 hours ago using a Plastibell. Which intervention would be inappropriatefor this client? Apply petroleum gauze to the penis with each diaper change. Monitor the amount of bleeding and chart it. Position the infant on his side for comfort. Administer analgesics for pain on a scheduled basis.

Apply petroleum gauze to the penis with each diaper change.

The nurse is explaining to the parents about the various laboratory tests which will be conducted on their newborn. The nurse should point out that testing for phenylketonuria will be conducted in which time frame? within 1 hour after birth. within 24 hours after birth. 24 to 72 hours after birth. 4 weeks after solid food is first eaten.

24 to 72 hours after birth.

One minute after birth, the neonate's heart rate is 98 beats per minute (bpm), respirations are slow and irregular, arms are flexed, hips are extended, the neonate has no grimace, and the hands/feet are acrocyanotic. What Apgar score should the nurse assign to the neonate? 4 5 6 7

4

A nurse is assessing a newborn five minutes after birth and notes: HR 110 bpm; a good, strong cry; well flexed extremities; grimacing when slapped on the sole of the foot; and normal pigment in most of the body, with blue hands and feet. What Apgar score will the nurse document for this infant? 8 9 7 6

8

A student nurse is reviewing newborn physical measurements and asks the charge nurse if her client's weight of 2800 g and length of 51 cm falls within normal parameters. The charge nurse would respond to the student nurse in which manner? A birth weight between 2200 and 3000 g is considered small for gestational age. A length between 48 and 50 cm plots out at the 95th percentile for length. A birth weight of 2800 g falls within the normal weight parameters for a full-term newborn. Normal birth length is usually 52 cm or above for a full-term newborn.

A birth weight of 2800 g falls within the normal weight parameters for a full-term newborn.

One assessment parameter that the LPN/LVN is responsible for is fluid volume loss. It would be important to assess the umbilical cord for any sign of bleeding. What would be important to assess for if the infant has an unusually large cord? Disintegrating vessels A large amount of Wharton's jelly A loose clamp A dry cord

A loose clamp

A 36-hour-old newborn is ready for discharge from the hospital and the nurse notices that the skin looks yellow. What action will the nurse take? Proceed with the discharge. Notify the health care provider. Assess the bilirubin level. Assist the mother to feed the newborn.

Assess the bilirubin level.

The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parents' findings which action should the nurse prioritize? Notify the health care provider immediately. Assess the newborn for signs of respiratory distress. Reassure the parents that this is an expected pattern. Tell the parents not to worry since his color is fine.

Assess the newborn for signs of respiratory distress.

When performing an assessment on a neonate, which assessment finding is suggestive of hypothermia? Bradycardia Hyperglycemia Metabolic alkalosis Shivering

Bradycardia

The nurse is assessing a newborn who appears healthy and at term. Which assessment finding of the feet does the nurse predict to observe to confirm the status of at-term birth? Creases covering one fourth of the foot Longitudinal but no horizontal creases Creases on two-thirds of the foot Heel but no anterior creases

Creases on two-thirds of the foot

A postpartum client tells the nurse that she feels like crying for no apparent reason and is unable to sleep well. What should the nurse point out to the client that this may be related to? Increased thyroid hormone levels Increased estrogen levels Decreased hemoglobin levels Decreased progesterone levels

Decreased progesterone levels

A nurse is teaching a new mother the benefits and protective effects of breastfeeding. The nurse should point out breastfeeding is known to provide protection against which disorder? Typhoid Edema Cholera Diarrhea

Diarrhea

A client is exhibiting signs of engorgement, but her milk is still flowing easily. Which suggestion should the nurse prioritize? Restrict fluid intake to 2 L each day. Ensure the baby empties the breasts at each feeding Apply ice packs before a feeding. Wear a tight fitting bra at all times.

Ensure the baby empties the breasts at each feeding

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 recommendation would the nurse not make to this mother? Rocking and talking to the infant Swaddling the infant before returning to the crib Feeding the infant more formula whenever she begins to fuss Gently patting or stroking the infant's back

Feeding the infant more formula whenever she begins to fuss

The nurse takes a newborn into the mother's room for feeding following a cesarean delivery. The nurse notes that the mother has large breasts when assisting her to feed the newborn. Which position would the nurse recommend to this mother? Football hold Side-lying position Cradle hold Abdominal hold

Football hold

An Rh-negative mother delivered an Rh-positive infant. What information would the nurse need to gather prior to administering Rho (D) immune globulin injection? Select all that apply. Has the mother ever been sensitized to Rh-positive blood? What was the birth weight of the infant? Has the mother had any previous pregnancies? Has she delivered by cesarean section or vaginally? Has the mother experienced any spontaneous abortions (miscarriages) or abortions (elective terminations of pregnancy)?

Has the mother ever been sensitized to Rh-positive blood? Has the mother had any previous pregnancies? Has the mother experienced any spontaneous abortions (miscarriages) or abortions (elective terminations of pregnancy)?

New parents report to the nurse that their newborn has "crying jags" in the afternoon each day. They are worried that if they hold the newborn every time she cries, she will become spoiled. What advice would the nurse give these parents? Rocking the newborn may soothe her but the time needs to be limited to 30 minutes per session. Crying indicates that the newborn has a need, so changing the diaper and feeding the infant should help. Holding and comforting the newborn will not cause the infant to become spoiled. Try walking with the newborn around the house then place her back in the crib to let her cry for a while.

Holding and comforting the newborn will not cause the infant to become spoiled.

A new mother is concerned about how she will know whether her newborn is receiving enough breast milk. The nurse should explain that which factor is the least accurate measure of how much nutrition the baby is receiving? How long the baby nurses Change in the baby's body weight Whether the baby is voiding Whether the baby is alert

How long the baby nurses

The nurse assesses the postpartum client's fundal height and tone in the first 24 hours. Which action should the nurse prioritize to prevent inversion of the uterus while completing this assessment? Place index and middle fingers across the muscle Palpate the abdomen while feeling the uterine fundus Massage the fundus carefully to expel any blood clots Place a gloved hand just above the symphysis pubis

Place a gloved hand just above the symphysis pubis

The nursing director of a busy postpartum unit has arranged for the lactating consultant to provide some education about ways to create an atmosphere conducive to breastfeeding success. Which topics should be emphasized? Select all that apply. Talk with all mothers, even those who have chosen to bottle-feed, about the benefits of breastfeeding. If feasible, help women initiate breastfeeding within 30 minutes of birth. Assist all mothers who are separated from their infant in the NICU to breastfeed and maintain lactation. Use of pacifiers will help the infant develop a stronger sucking ability. In between feedings, mothers should start giving juice to the baby as early as 2 months of age.

If feasible, help women initiate breastfeeding within 30 minutes of birth. Assist all mothers who are separated from their infant in the NICU to breastfeed and maintain lactation.

The lactation nurse is working with a woman who is experiencing some difficulties getting her newborn to "latch on" to her breast. They are trying various positions to see which is best for this infant. The nurse will document which nursing problem related to this teaching session? Risk for ineffective breastfeeding resulting in switching to a bottle Imbalanced nutrition, less than body requirements related to poor latch Risk for impaired parenting due to mother's stress of possible breastfeeding failure Anxiety related to not being able to communicate with infant about how best to position during feedings

Imbalanced nutrition, less than body requirements related to poor latch

Which is true regarding mineral requirements in the newborn? Infants who are breastfed need supplemental iron. Tetany from inadequate calcium intake is likely to occur in a breastfed infant, not in a formula-fed infant. Mothers who are breastfeeding should drink spring water only. Infants who are formula-fed should drink an iron-enriched formula for at least 12 months.

Infants who are formula-fed should drink an iron-enriched formula for at least 12 months.

What measures can a nurse take to reduce the risk of hypoglycemia in a newborn? Select all that apply. Initiate early and frequent breastfeeding. Dry the newborn off immediately after birth to prevent chilling. Feed the newborn formula every 4 hours, starting 8 hours after birth. Feed only glucose water for the first 24 hours following birth. Begin skin-to-skin (kangaroo) care for the newborn.

Initiate early and frequent breastfeeding. Dry the newborn off immediately after birth to prevent chilling. Begin skin-to-skin (kangaroo) care for the newborn.

The nurse is inspecting a new mother's perineum. What actions would the nurse take for this client? Select all that apply. Inspect the episiotomy for sutures and to ensure that the edges are approximated. Palpate the episiotomy for pain. Note any hemorrhoids. Place the patient in Trendelenburg position for inspection. Gently palpate for any hematomas.

Inspect the episiotomy for sutures and to ensure that the edges are approximated. Note any hemorrhoids. Gently palpate for any hematomas.

A nurse does an initial assessment on a newborn and notes a pulsation over the anterior fontanel (fontanelle) that corresponds with the newborn's heart rate. How would the nurse interpret this finding? This is an abnormal finding and needs to be reported immediately. If the fontanel (fontanelle) feels full, then this is normal. This finding is normal if the pulsation can also be palpated in the posterior fontanel (fontanelle). It is normal to feel pulsations that correlate with the newborn's heart rate over the anterior fontanel (fontanelle).

It is normal to feel pulsations that correlate with the newborn's heart rate over the anterior fontanel (fontanelle).

A nurse is conducting a parenting class on infant skin care. What information should the nurse include when preparing materials on the characteristics of the skin of infants? Select all that apply. It is thinner and more fragile than an adult's Substances are easily absorbed. Skin is less susceptible to the sun. The epidermis is thicker than in adults. Sweat glands are fully functioning at birth.

It is thinner and more fragile than an adult's Substances are easily absorbed.

While assessing a new mother breastfeeding, the nurse notices that she is dimpling her breast. Which nursing teaching should the nurse prioritize? It puts pressure on the milk ducts and decreases the flow of milk. It can lead to sore nipples. It creates a risk factor for mastitis It can put pressure on the infant's lips, slowing the flow of milk

It puts pressure on the milk ducts and decreases the flow of milk.

According to Brazelton's Neonatal Behavioral Assessment Scale, a newborn would be in what state if the eyes are open and looking at people nearby, and the newborn has minimal activity or body movement? Drowsy Quiet alert Active alert Active attentive

Quiet alert

A nurse is assessing a postpartum woman. Which behavior would the nurse interpret as an indication that the woman is entering the taking-hold phase of the postpartum period? She sits and rocks her infant for long intervals. She is eager to talk about her birth experience. She has not asked for anything for pain all day. She did her perineal care independently.

She did her perineal care independently.

A postpartum client is reluctant to begin taking warm sitz baths. What should the nurse emphasize when teaching the client about this treatment approach? Sitz baths may lead to increased postpartal infection. Sitz baths increase the blood supply to the perineal area. Sitz baths cause perineal vasoconstriction and decreased bleeding. The longer a sitz bath is continued, the more therapeutic it becomes.

Sitz baths increase the blood supply to the perineal area.

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? Calling the provider immediately and report the findings. Reassess the newborn in 2 hours. Take no action because these are normal findings in a newborn. Begin supplemental oxygen with a nasal cannula immediately.

Take no action because these are normal findings in a newborn.

A 1-day-old newborn is being examined by the nurse practitioner, who makes the following notation: face and sclera appear mildly jaundiced. What causes this finding? The breakdown of RBCs release bilirubin, which the liver cannot excrete. The GI tract is immature, so the bilirubin remains in the intestines. The newborn's Vitamin K levels are low. Feedings are not adequate to eliminate the build-up of bilirubin.

The breakdown of RBCs release bilirubin, which the liver cannot excrete.

The nurse is evaluating the effectiveness of teaching on perineal care provided to a postpartum client. Which outcome indicates that teaching has been effective? The client performs perineal care independently with every morning shower. The client explains the purpose of performing perineal care at least once a day. The client flushes the commode before standing when performing perineal care. The client washes the perineum from back to front when performing perineal care.

The client performs perineal care independently with every morning shower.

Which statement is true regarding fetal and newborn senses? A newborn cannot experience pain. A newborn cannot see until several hours after birth. A newborn does not have the ability to discriminate between tastes. The rooting reflex is an example that the newborn has a sense of touch. A fetus is unable to hear in utero.

The rooting reflex is an example that the newborn has a sense of touch.

The nurse is assessing an infant's reflexes. While eliciting a rooting reflex, the infant strongly sucks on the nurse's finger. How does the nurse interpret this finding? The rooting reflex shows a strong sucking response. The infant does not have a normal rooting reflex. The infant displays a normal rooting reflex. The rooting reflex was tested incorrectly.

The rooting reflex was tested incorrectly.

A mother asks the nurse about having her son circumcised. The nurse understands that circumcision is contraindicated under which circumstances? Select all that apply. The penis is small. There is a family history of hemophilia. The newborn was febrile at birth but temperature is now normal. The father is uncircumcised. The infant is at 33 weeks' gestation.

There is a family history of hemophilia. The infant is at 33 weeks' gestation.

What should the nurse expect for a full-term newborn's weight during the first few days of life? There is an increase in 3% to 5% of birth weight by day 3 in formula-fed babies. A formula-fed newborn should gain 3% to 5% of the initial birth weight in the first 48 hours, but a breastfed newborn may lose up to 3%. There is a loss of 5% to 10% of the birth weight in the first few days in breastfed infants only. There is a loss of 5% to 10% of birth weight in formula-fed and breastfed newborns.

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

A new mother asks the nurse what she is allowed to do when she goes home from the hospital. Which statement by the nurse would be correct? You should be able to resume normal activities after 2 weeks. You should not lift anything heavier than your infant in its carrier. Only clean half of the house per day to allow yourself more rest. You need to hire a maid for the first month after delivery to help out around the house.

You should not lift anything heavier than your infant in its carrier.

A nurse is working with four new mothers and assessing their ability to breastfeed. For which mother would breastfeeding be appropriate and safe? a mother who smokes cigarettes a mother who is receiving chemotherapy a mother with an infant with galactosemia a mother with herpes lesions on her nipples

a mother who smokes cigarettes

Which postpartum client will the nurse recommend to formula-feed her infant? Select all that apply. a new mother who is receiving radioactive iodine to treat a cancer nodule on her thyroid a mother who admits to drinking alcohol about once a week with friends a new mother who tested positive for herpes and has lesions on her nipples a mother with a history of bipolar disease being treated with lithium and who has some documented compliance issues a mother who has tested positive for HIV who is receiving several medications to control the disease

a new mother who is receiving radioactive iodine to treat a cancer nodule on her thyroid a new mother who tested positive for herpes and has lesions on her nipples a mother with a history of bipolar disease being treated with lithium and who has some documented compliance issues a mother who has tested positive for HIV who is receiving several medications to control the disease

The nurse is teaching a breastfeeding class for nursing students. Teaching has been effective when the student can cite which maternal conditions in which breastfeeding is contraindicated? Select all that apply. active untreated tuberculosis chlamydia chemotherapy illegal drug use HIV

active untreated tuberculosis chemotherapy illegal drug use HIV

A postpartum mother is experiencing sore nipples. The woman asks the nurse what she is doing wrong that is causing this problem. The nurse identifies which breastfeeding technique or condition may result in sore nipples? Select all that apply. positioning the newborn so that the head is level or in the sniffing position placing a finger in the newborn's cheeks to break seal prior to removing the newborn from the breast allowing the newborn to stay latched on to the breast for a prolonged period after feeding not assessing that the newborn has a highly arched palate that interferes with proper latching setting the breast pump on a higher pressure setting to empty milk faster

allowing the newborn to stay latched on to the breast for a prolonged period after feeding not assessing that the newborn has a highly arched palate that interferes with proper latching setting the breast pump on a higher pressure setting to empty milk faster

The nurse institutes measures to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they: have a smaller body surface compared to body mass. lose more body heat when they sweat than adults. have an abundant amount of subcutaneous fat all over. are unable to shiver effectively to increase heat production.

are unable to shiver effectively to increase heat production.

The nursing instructor is conducting a class explaining the various causes of jaundice in a newborn infant. The instructor determines additional education is warranted after the class chooses which factor as being responsible for newborn jaundice? bilirubin overproduction decreased bilirubin conversion impaired bilirubin excretion bilirubin hyperexcretion

bilirubin hyperexcretion

When the nurse is assessing a postpartum client approximately 6 hours after birth, which finding would warrant further investigation? deep red, fleshy-smelling lochia voiding of 350 cc blood pressure 90/50 mm Hg profuse sweating

blood pressure 90/50 mm Hg

A postpartum client is concerned about loose tissue around the abdominal area. Which exercise should the nurse recommend that the patient begin on postpartum day 2 to strengthen and tighten these muscles? sit-ups chin-to-chest pelvic rocking Kegel exercises

chin-to-chest

Newborn temp below 97.0 or 98,0

cold infant need to go to rewarm them on the heater slowly if 98.0 snuggle them with mom (97.5-99.3)

Which type of breast milk is highest in antibodies? colostrum hind milk foremilk transitional milk

colostrum

The nurse is assessing a client at a postpartum visit who reports constipation. The nurse should point out this is likely related to which factor? discomfort due to hemorrhoids distention of abdominal muscles separation of rectus muscles relaxation of abdominal muscles

discomfort due to hemorrhoids

When describing the hormonal changes that occur after birth of a newborn, the nurse would identify a decrease in which hormone as being associated with breast engorgement? estrogen progesterone prolactin human chorionic gonadotropin (hCG)

estrogen

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? drop in pressure in the neonate's chest higher oxygen content of the circulating blood higher oxygen levels at the respiratory centers of the brain precipitous drop in blood pressure

higher oxygen content of the circulating blood

A nurse is teaching a postpartum client how to do muscle-clenching exercises for the perineum. The client asks the nurse, "Why do I need to do these exercises?" Which reason would the nurse mostlikely incorporate into the response? reduces lochia promotes uterine involution improves pelvic floor tone alleviates perineal pain

improves pelvic floor tone

When working with a new mom sharing information as to when the newborn is getting hungry, the nurse should include which manifestations? Select all that apply. increase in restlessness kicking legs mouth movements drooling fussiness leading to crying

increase in restlessness mouth movements fussiness leading to crying

The nurse is preparing a teaching plan for new parents about why newborns experience heat loss. Which information about newborns would the nurse include? thick skin with deep lying blood vessels enhanced shivering ability expanded stores of glucose and glycogen limited voluntary muscle activity

limited voluntary muscle activity

On inspection, the nurse notes that a newborn has a normal newborn head/body proportion. This proportion for the head is: one-half his total length. one-fourth his total length. one-sixth his total length. one-eighth his total length.

one-fourth his total length.

Nurses know that which factor most influences whether women decide to initiate breastfeeding? economic savings with breastfeeding ease of learning to breastfeed convenience with breastfeeding prenatal education

prenatal education

The nurse notices that a new mother who is beginning postpartum day 2 handles the newborn tentatively and does not kiss the child when holding him. What should the nurse suspect as the probable reason for this behavior? disappointment with the child's sex difficulty accepting the role changes reacting normally to accepting a new child cultural customs do not include kissing children

reacting normally to accepting a new child

A nurse is making a postpartum home visit to a woman who gave birth vaginally about 12 days ago. The woman's partner is present during the visit. When assessing the woman and the family, which finding related to the partner would lead the nurse to suspect that the partner may be experiencing postpartum depression? Select all that apply. reports of feeling highly stressed use of encouraging statements about the infant reports of frequent headaches statements that the woman is getting all the attention feelings of being unprepared for the role

reports of feeling highly stressed reports of frequent headaches statements that the woman is getting all the attention

When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the mostrapid changes? gastrointestinal and hepatic urinary and hematologic respiratory and cardiovascular neurological and integumentary

respiratory and cardiovascular

x Which feeding position should the nurse suggest as most beneficial for the mother who had a cesarean birth? supine in bed with the newborn lying across the mother's chest and abdomen side-lying position with newborn near the mother's armpit so the mother can rest while the newborn feeds newborn in a sling draped over the mother's shoulder so the breast is near the newborn's face sitting in a chair using a football hold with the newborn on a pillow on the mother's lap

sitting in a chair using a football hold with the newborn on a pillow on the mother's lap

When assessing the newborn's umbilical cord, what should the nurse expect to find? two smaller arteries and one larger vein two smaller veins and one larger artery one smaller vein and two larger arteries one smaller artery and two larger veins

two smaller arteries and one larger vein

A postpartum woman is experiencing subinvolution. When reviewing the client's history for factors that might contribute to this condition, which factors would the nurse identify? Select all that apply. uterine infection prolonged labor hydramnios breastfeeding early ambulation empty bladder

uterine infection prolonged labor hydramnios

When teaching new parents about the sensory capabilities of their newborn, which sense would the nurse identify as being the least mature? hearing touch taste vision

vision

The nurse is preparing discharge training for a G2P2 client who will breastfeed her infant. The client mentions she wants more children but wants to wait a couple of years and asks about birth control. Which time frame for using a birth control method should the nurse point out will best help the client achieve her goals? when she stops breastfeeding within 18 months within 6 weeks when she resumes sexual activity

when she resumes sexual activity