Chapter 25: Acquired Conditions and Congenital Abnormalities in the Newborn

The nurse observes a newborn experiencing coughing, choking, and unexplained cyanosis during feeding. These are classic signs of what condition?

esophageal atresia

A gravid woman in her second trimester has shared that she still enjoys a glass of wine about once a week with dinner. What response by the nurse is most appropriate?

"There is no amount of alcohol consumption in pregnancy that is considered safe for the fetus."

While caring for a newborn with cleft lip, the nurse would assess which activity that may be compromised due to the cleft lip?

sucking ability

The priority for the nurse caring of a newborn with esophageal atresia is to observe for which finding?

Aspiration

A pregnant woman asks the nurse, "I'm a big coffee drinker. Will the caffeine in my coffee hurt my baby?" Which response by the nurse would be most appropriate?

"If you keep your intake to less than 300 mg/day, you should be okay."

A woman's baby is HIV positive at birth. She asks the nurse if this means the baby will develop AIDS. Which statement would be the nurse's best answer?

"The antibodies may be those transferred across the placenta; the baby may not develop AIDS."

The pregnant woman with diabetes asks the nurse why her last baby weighed 11 pounds. What is the best response by the nurse?

"The fetus increases insulin production in response to elevated glucose levels of the mother, which acts as a fetal growth hormone."

A newborn with high serum bilirubin is receiving phototherapy. Which is the most appropriate nursing intervention for this client?

Application of eye dressings to the infant

A pregnant woman in her 39th week of pregnancy presents to the clinic with a vaginal infection. She tests positive for chlamydia. What would this disease make her infant at risk for?

Blindness

Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?

Cocaine

A preterm newborn has developed necrotizing enterocolitis (NEC). Which of the following gastrointestinal (GI) characteristics would the nurse explain as predisposing a preterm newborn to NEC?

Diminished gastric enzymes

A baby is born with spina bifida with meningocele. The parents are visibly upset. The father states, "What did we do wrong? How will I ever love this child?" What is the priority action by the nurse?

Encourage the parents to express their feelings and emotions openly.

A nursing student is learning about newborn congenital defects. The defect with symptoms that include a shiny scalp, dilated scalp veins, a bulging anterior fontanelle, and eyes pushed downward with the sclerae visible above the irises is which defect?

Hydrocephalus

A nurse is caring for a preterm newborn born at 29 weeks' gestation. Which nursing diagnosis would have the highest priority?

Ineffective thermoregulation related to decreased amount of subcutaneous fat

Newborns receive an antibiotic in their eyes within the first hour after birth to prevent neonatorum ophthalmia. Which type of bacteria is most likely to cause this condition?

Neisseria gonorrhoeae

Assessment of a pregnant client reveals that she has tested positive for a sexually transmitted infection (STI). The nurse understands that the client's newborn is at risk for which of the following?

Neurologic damage

A nurse is caring for a newborn client who is diagnosed with myelomeningocele. Which nursing intervention would protect the newborn from injury?

Place the newborn in a prone or lateral position.

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

Report the finding to the pediatrician.

A nurse observes in a preterm newborn a respiratory rate of 60, nasal flaring, and retractions. What do these clinical manifestations indicate to the nurse?

Respiratory distress syndrome

The nurse is conducting a class for pregnant women on problems associated with infections seen in women during gestation. One mother tells the nurse that she has never had chickenpox (varicella) and is worried she will contract it before she delivers. What would the nurse explain to this mother to ease her anxiety?

She can receive her varicella vaccine immediately after delivery, followed by a second dose at her 6-week postpartum visit.

A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection?

Toxoplasmosis

The nurse is caring for a small-for-gestational-age infant born to a drug-dependent patient. For which manifestations should the nurse assess as evidence of withdrawal symptoms in the newborn?

Tremors Convulsions High-pitched cry Constant movement

A 36-week neonate born weighing 1,800 g has microcephaly and microophthalmia. Based on these findings, which risk factor might be expected in the maternal history?

Use of alcohol

The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis?

bloody stools

A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world?

cytomegalovirus

A 32 weeks' gestation newborn in the neonatal intensive care is being assessed for hyperbilirubinemia. Which diagnostic tests would the nurse expect to be done?

direct Coombs blood type hemoglobin bilirubin levels

A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority?

preventing infection

A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy?

reduction in viral loads in the blood

When caring for a neonate receiving phototherapy, the nurse should remember to:

reposition the neonate frequently.

The nurse is assessing a newborn of a woman who is suspected of abusing alcohol. Which newborn finding would provide additional evidence to support this suspicion?

thin upper lip