Passpoint Neonate

A newborn baby has developed physiologic jaundice. The parents are concerned about the appearance of the newborn and ask the nurse about their concerns. Which of the following would be the most appropriate response by the nurse?

"I can tell you are worried about your baby. Let's talk about this change in your baby's skin color."

During a home visit to a primiparous client 1 week postpartum who is bottle-feeding her neonate, the client tells the nurse that her mother has suggested that she feed the neonate cereal so he will sleep through the night. What would be the nurse's best response?

"It's better to continue feeding only formula until about 4 to 6 months of age."

The triage nurse in the pediatrician's office returns a call to a birth parent who is breastfeeding their 4-day-old infant. The parent is concerned about the yellow seedy stool that has developed since discharge home. What is the best reply by the nurse?

"Soft, seedy, unformed stools with each feeding are normal for this age infant and will continue through breastfeeding."

After a long labor process, a primigravid client gives birth to a healthy newborn with a moderate amount of skull molding. What information would the nurse include when explaining to the client about this condition?

It usually lasts a day or two before resolving.

Which assessment finding would lead a nurse to suspect dehydration in a preterm neonate?

Urine output below 1 ml/hour

A parent is visiting their neonate in the neonatal intensive care unit. The baby is fussy and the parent wants to know what to do. To quiet a sick neonate, what can the nurse teach the parent to do?

Use a constant, gentle touch.

Which finding would the nurse most expect to find in a neonate born at 28 weeks' gestation who is diagnosed with intraventricular hemorrhage (IVH)?

bulging fontanelles

Which action is the best precaution against transmission of infection?

eye prophylaxis with antibiotics for a neonate whose mother has gonorrhea infection

Commercial formulas contain 20 calories per 30 mL. A 1-day-old infant was fed 45 mL at 0200, 0530, 0800, 1100, 1400, 1630, 2000, and 2230. What is the total amount of calories the infant received today? Record your answer using one decimal place.

240

A certified nurse-midwife places a neonate under the radiant heat unit for the nurse's initial assessment. The initial assessment includes a heart rate of 110 beats/minute and an irregular respiratory effort. The neonate is moving all extremities and the body is pink. The neonate responds to gentle stimulation by withdrawing. The nurse notes copious amounts of clear mucus present both orally and nasally. Based on these assessment findings, what should the nurse do next?

Assign an Apgar score of 9, place the neonate in modified Trendelenburg position, and suction the neonate's nose and oropharynx.

The nurse plans the discharge of a newborn diagnosed with torticollis (wry neck). Which action should the nurse take?

Coordinate outpatient physical therapy.

When performing an initial assessment of a postterm male neonate weighing 4,000 g (8 lb, 13 oz) who was admitted to the observation nursery after a vaginal birth with low forceps, the nurse detects Ortolani's sign. Which action should the nurse take next?

Notify the health care provider (HCP) immediately.

A multiparous client gives birth to twins at 37 weeks' gestation. The twin neonates require additional hospitalization after the client is discharged. What is the most appropriate goal to include in the plan of care for the parents while the twins are hospitalized?

Participate in the care of the twins as much as possible.

A nurse is providing care to a neonate. Place the following steps in the order that the nurse would implement them to properly perform ophthalmia neonatorum prophylaxis. All options must be used.

Wash hands and put on gloves. Shield the neonate's eyes from direct light, and tilt the head slightly to the side that will receive the treatment. Gently raise the neonate's upper eyelid with the index finger and gently pull the lower eyelid down with the thumb. Instill the ointment in the lower conjunctival sac. Close and manipulate the eyelids to spread the medication over the eye. Repeat the procedure for the other eye.

While assessing a term neonate on a home visit to a primiparous client 2 weeks after a vaginal birth, the nurse observes that the neonate is slightly jaundiced and the stool is a pale, light color. The nurse notifies the health care provider because these findings indicate which problem?

biliary atresia

Assessment of a term neonate at 2 hours after birth reveals a heart rate of less than 100 bpm, periods of apnea approximately 25 to 30 seconds in length, and mild cyanosis around the mouth. The nurse notifies the health care provider (HCP) based on the interpretation that these findings may lead to which condition?

respiratory arrest

Which observation is expected when the nurse is assessing the gestational age of a neonate born at term?

sole creases covering the entire foot

A new parent feels left out of the new family relationship because they are not bonding with the infant in the same way as the breastfeeding birth mother. What is the most appropriate response by the nurse?

"Holding, talking to, and playing with the infant will facilitate bonding."

The nurse is providing teaching to the parent of a newborn with early jaundice about the condition's progression. The nurse knows that the teaching regarding hyperbilirubinemia was successful when the parent makes which response?

"Kernicterus is a consequence of elevated bilirubin levels and has possible lifelong effects."

A 15-year-old primipara who gave birth to a term neonate vaginally tells the nurse, "My parent started feeding me rice cereal when I was only 2 weeks old." What would be the most appropriate response to the client?

"Wait until the infant is at least 4 months of age before using cereal."

A nurse is caring for a full-term neonate who is 24 hours old. Assessment findings include axillary temperature of 96.8° F (36° C), apical heart rate of 188 beats/minute, and respiratory rate of 48 breaths/minute. The mother reports that the neonate is lethargic when she tries to breast-feed and looks "like a rag doll." The mother also has a low-grade fever. Pulse oximetry reveals saturation of 89% on room air, and the neonate has dusky mucous membranes. What are the most appropriate nursing i

-Observe the neonate carefully, contact the physician, and explain her suspicions of early neonatal sepsis. -Provide blow-by oxygen and monitor the neonate's respiratory status. -Inform the parents that she wants to monitor the neonate closely.

An infant 5 hours old and weighing 3180 g (7 lb) has a prescription for gentamicin sulfate 13 mg every 36 hours. The pharmacy sends gentamicin 20 mg/2 mL. How many milliliters should the nurse administer? Record your answer using one decimal place.

1.3

The nurse is notified that a neonate who was discharged several days ago has a phenylketonuria (PKU) metabolic screening test result of 7 mg/dL. What action should the nurse take?

Notify the healthcare provider because the test result is critically elevated.

Which action by the nurse would be most appropriate after assessing a neonate's cry as infrequent, weak, and very high pitched?

Request that the health care provider evaluate the neonate's neurologic status.

When preparing for the discharge of a newborn after surgery to correct tracheoesophageal fistula (TEF), the nurse teaches the parents about the need for long-term health care because their child has a high probability of developing which complication?

esophageal stricture

A full-term neonate is suspected of having hydrocephalus. The nurse collects what assessment finding to best assist in confirming the diagnosis?

increasing occipital frontal circumference

The nurse assesses the neurologic system of a newborn. Which behavior would the nurse interpret as a normal reflex response?

makes a walking movement when held upright with one foot touching the table

The nurse assesses a postterm neonate. Which finding is considered normal for a postterm infant?

wrinkled, peeling skin

The nurse should be especially alert for what problem when caring for a term neonate, who weighed 10 lb (4500 g) at birth, 1 hour after a vaginal birth?

hypoglycemia

While preparing to provide neonatal care instructions to a primiparous client who gave birth to a term neonate 24 hours ago, what should the nurse include in the client's teaching plan?

Milia are white papules from plugged sebaceous ducts that disappear by age 2 to 4 weeks.

A mother with a history of gestational hypertension gives birth to a neonate at 26 weeks' gestation. After the neonate receives surfactant through an endotracheal tube in the delivery room, a nurse takes the neonate to the neonatal intensive care unit (NICU), places the neonate on an overbed warmer, and provides mechanical ventilation. When the mother arrives in the NICU for the first time, the nurse's priority should be to

enhance bonding by pointing out the neonate's features.

Which finding is considered normal in the neonate during the first few days after birth?

weight loss then return to birth weight

The health care provider prescribes ampicillin 100 mg/kg per dose for a newly admitted neonate. The neonate weighs 1350 g (2.97 lb). How many milligrams should the nurse administer? Record your answer using one decimal place.

135

A neonate weighing 1870 g (4.1 lb) with a respiratory rate of 46 breaths/minute, a pulse rate of 175 bpm, and a serum pH of 7.11 (reference range 7.35 to 7.45) has received sodium bicarbonate intravenously. The drug has been effective if the neonate exhibits which finding?

resolves the metabolic acidosis