Hesi preparation _Maternity
NEC is marked by prolonged gastric emptying; an increase in abdominal girth of more than 1 cm in 4 hours is significant and requires immediate intervention.
Administering oxygen before the gastric feeding will have no therapeutic value for an infant with NEC.
Prolonged oxygen administration at a relatively high concentration in a preterm infant whose retinas are incompletely differentiated or vascularized may result in retinopathy of prematurity "ROP, retrolental fibroplasia"
Capillary overgrowth in the retinas and vitreous bodies may result, causing capillary hemorrhage, fibrosis, and retinal detachment.
The neonate's age is a critical assessment because the development of jaundice before 24 to 48 hours have elapsed since birth may indicate
a blood dyscrasia "pathologic jaundice, hyperbilirubinemia" requiring immediate investigation.
Diminished breath sounds are consistent with RDS because of atelectasis and underinflation of alveoli resulting from decreased surfactant in immature lungs. Neonates with respiratory distress syndrome (RDS) have expiratory, not inspiratory, stridor
. Neonates with RDS are more likely to have tachycardia. A pH of 7.35 to 7.45 is within the expected range for healthy newborns; neonates with RDS tend to have a decreased pH, which is indicative of respiratory or mixed acidosis.
Thirty degrees represents limited hip abduction and is indicative of developmental dysplasia of the hip. The Babinski reflex is an expected newborn finding.
A head circumference of 33 cm is an expected measurement for a newborn at term. An umbilical cord with three vessels is an expected finding.
The first step is to connect the tubing to a syringe; the formula should not be poured directly into the tubing. The tube must be crimped before the formula is poured into the syringe so the flow rate may be controlled while the formula is being released from the syringe.
After the tube is crimped, the formula should be poured into the syringe to ensure that the infant will receive the specified amount. Once the formula is in the syringe, the crimp is released and the rate of flow controlled. A rate of 1 mL/min is best tolerated. After the feeding has been completed, the infant should be turned on the right side to prevent aspiration.
typical behaviors helps parents understand the unique features of their newborn and promotes interaction and appropriate care.
Although important, this can best be fostered if parents know what behaviors to expect from their infant.
Only after the cord has fallen off should an infant be tub bathed; tub bathing before then increases the risk of infection by way of the moist umbilical stub. Although infants should be attended at all times during a bath, immersion in water at this age is inappropriate.
Although the prevention of chilling is important, immersion in water at this time is inappropriate. It is not necessary to wait to tub bathe an infant until the infant is able to sit alone.
First, the age of the neonate must be ascertained to determine whether this is physiologic or pathologic jaundice; next the nurse should obtain a sample of heel blood to determine the serum bilirubin level.
Bilirubin studies should be performed first to determine whether the serum level warrants phototherapy.
Epicanthal eye folds sign of
Down syndrome
NEC is marked by prolonged gastric emptying; an increase in abdominal girth of more than 1 cm in 4 hours is significant and requires immediate intervention.
During periods of active or irregular sleep, healthy newborns have some twitching movements and irregular respirations; the heart rate, respirations, and blood glucose level are within expected limits.
In the neonate, early signs of infection are often subtle and can be indicators of other conditions. There may be temperature instability, respiratory problems, and changes in feeding habits or behavior.
Early signs of sepsis in the neonate include full anterior fontanels (not flat) and prolonged capillary refill time (not brisk). Increased temperature or hyperthermia is a rare early sign of sepsis in the neonate.
Prolonged gastric emptying occurs with NEC; an increase in abdominal girth of greater than 1 cm in 4 hours is significant and requires immediate intervention.
Formula feedings are stopped and the infant is given parenteral therapy. Administering oxygen 10 minutes before each feeding will have no therapeutic value for an infant with NEC.
A nurse who is admitting a newborn to the nursery observes a fetal scalp monitor site on the scalp. For what complication should the nurse monitor this newborn?
Infection
A nurse assessing a newborn elicits a positive response on the Ortolani test and as a result suspects that the newborn has developmental dysplasia of the hips (DDH). Which clinical finding supports this suspicion?
Limited ability to abduct either hip
magnet reflex
Maintaining the supine position and applying pressure to the soles of the newborn's feet in which the legs extend in response to the pressure on the soles of the feet.
A nurse is caring for a newborn with a cephalohematoma. What is the priority nursing action?
Parents need support and reassurance that their newborn is not permanently damaged. Cephalohematomas do not cause impaired neurologic function. No special protection of the head is required; routine safety measures are adequate.
A newborn is circumcised before discharge from the hospital. What should immediate postoperative care include? Encouraging the mother to cuddle her baby to provide emotional support
Removal of dry gauze will cause bleeding; sterile petrolatum gauze is used and replaced with each diaper change.
The fetus is at 38 weeks' gestation. Add the total neuromuscular score of 16 to the total physical maturity score of 20 for a total of 36. Look under the score total score column and you will find that the closest number to the total score of 36 is 35.
Staying on the same row, move right, to the Gestational Age column, where you will find the gestational age of 38 weeks.
In 36 to 48 hours the newborn will have ingested an ample amount of the amino acid phenylalanine, which, if not metabolized because of a lack of a specific liver enzyme, can result in excessive levels of phenylalanine in the bloodstream and brain, resulting in cognitive impairment; early detection is essential to prevent this.
The infant will have a vitamin K injection soon after birth to prevent bleeding problems. Blood is withdrawn from the heel soon after birth to test for hypoglycemia. Necrotizing enterocolitis is a disorder that can affect preterm infants. It is not identified with the use of a test.
What should the nurse do when an apnea monitor sounds an alarm 10 seconds after cessation of respirations?
The nurse applies tactile stimulation after confirming that respirations are absent; this action may be sufficient to reestablish respirations in the high-risk neonate with frequent episodes of apnea.
Protection of newborns from unnecessary exposure to microorganisms is the priority. Giving the infant to the mother should not be done until the mother and newborn's identification bands have been verified.
Verifying the infant's and the mother's identification bands should be done after the visitor leaves the room.
cardiac sphincter, pyloric sphincter
cardiac sphincter is on the top of stomach, pyloric is at the bottom of stomach
Erb's palsy is
caused by forces that alter the alignment of the arm, shoulder, and neck; stretching or pulling away of the shoulder from the head during birth damages the brachial plexus.
A nurse suspects that a newborn's mother had rubella during the first trimester of pregnancy. Which newborn problems support this assumption? Select all that apply.
deafness, cardiac anomalies
drying infants: Preventing
heat loss conserves the newborn's oxygen and glycogen reserves; this is a priority. Warming the infant will reduce cyanosis if no respiratory obstruction is present.
Vaginal discharge on the diaper is related to the influence of
maternal hormones; it is temporary and is unrelated to problems with bleeding, infection, or urinary elimination.
congenital heart defect. Which clinical manifestations support this suspicion?
nasal flaring, sternal retractions, grunting respitations.
Discussing behaviors during the baby's waking times that will promote
positive interaction helps parents understand the unique features of their newborn and promotes interaction and care during periods of wakefulness.
Facial palsy (paralysis) is caused by pressure on the facial nerve during birth. This is the result of a
prolonged second stage of labor or a forceps birth
A fractured clavicle may occur if
pulling on the shoulders during the birth is required.
precipitate birth means
rapid birth
Assessment of a newborn reveals congenital cataracts, microcephaly, deafness, and cardiac anomalies. Which infection does the nurse suspect that the newborn's mother contracted during her pregnancy?
rubella
A nurse is assessing the newborn of a known opioid user for signs of withdrawal. What clinical manifestations does the nurse expect to identify? Select all that apply.
sneezing, hyperactivity, high pitched cry, reduced moro reflex, exaggerated deep tendon reflexe
Jaundice occurring with 48 to 72 hours of birth "physiologic jaundice" is a consequence of
the expected breakdown of fetal red blood cells and immaturity of the liver.
Congenital rubella (German measles) syndrome results in abnormalities that vary, depending on the gestational age of the fetus when the maternal infection was contracted;
the most severe results occur if the mother was infected during the first trimester, when organogenesis is taking place.
Untreated ophthalmia neonatorum becomes apparent on the
third or fourth postnatal day and provides evidence that the mother may have had gonorrhea or a chlamydial infection.
acrocyanotic
which is manifested by bluish hands and feet.
nevus vasculosus?
뉴본 아이의 얼굴이나 몸에 빨간 넓은 점. Spreading and then regressing is the usual pattern
Maculopapular lesions of the soles
시피러스 환자의 신생아 발바닥에 lesion이 생기는 현상, 3달후에 나타남
