26-27

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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 newborn was resuscitated at birth due to poor respiratory effort. Which assessment data would concern the nurse the most at 6 hours after birth?

Body temperature of 98.0°F

In the delivery of an infant with meconium-stained fluid, the nurse should anticipate which measure being taken first?

Bulb syringe used to suction mouth and nose before delivery of shoulders

The nurse notices that an infant's left foot does not straighten to midline after moderate pressure. The best information that can be given to the parents/caregivers is

Effective intervention begins in the newborn period with a series of casts or braces.

If the nurse manages a newborn with low blood sugar, which intervention would be appropriate to prevent hypoglycemia?

Feed the neonate.

The nurse is doing an examination on an infant with a diagnosis of developmental dysplasia of the hip (DDH). Which finding would be an indication of this diagnosis?

Gluteal fold higher on one side than the other

Because Maia's baby was born with developmental dysplasia of the hip, he has a Pavlik harness prescribed. What information would the nurse want Maia to know about his care?

Her baby should wear the harness at all times except while bathing.

Which types of play are most appropriate for the 3-month-old who is in an orthopedic cast?

Mobiles and rattles

A client with diabetes gives birth to a full-term neonate who weights 10 lb, 1 oz (4,600 g). While caring for this large-for-gestational-age (LGA) neonate, the nurse palpates the clavicles for which reason?

One of the neonate's clavicles may have been broken during birth.

Parents are taught to place their infants on their backs to sleep to prevent sudden infant death syndrome (SIDS). Which disorder would require the infant to be placed on the side to sleep to avoid airway obstruction?

Pierre Robin syndrome

A nurse is caring for a newborn with a repaired cleft lip. What intervention can the nurse provide to facilitate drainage of mucus and secretions to prevent aspiration?

Position the child on the side.

The nurse is working in the special care nursery caring for a newborn withdrawing from alcohol. Which nursing intervention promotes client comfort?

Swaddle and decrease stimulation

Suppose Maia's baby develops a torticollis, and she is distraught by her baby's appearance. What care measure would best relieve the infant's physical anomaly and Maia's distress?

Teach Maia how to perform her baby's neck stretching exercises.

A 20-year-old client gave birth to a baby boy at 43 weeks' gestation. What might the nurse observe in the newborn during routine assessment?

The newborn may look wrinkled and old at birth.

Which assessment finding within the first 24 hours of birth requires immediate health care provider notification?

The skin is jaundiced.

While assessing a full-term neonate, which symptom would cause the nurse to suspect a neurologic impairment?

a weak sucking reflex

A nurse is caring for a newborn who was diagnosed with an imperforate anus. Assessment reveals drooling, copious bubbles of mucus in mouth, rattling respirations, and abdominal distention. During feeding, the newborn coughs and becomes cyanotic. Which action by the nurse would be appropriate?

clear the airway

The nurse is caring for a large-for-gestational-age newborn (also known as macrosomia). What maternal condition is the usual cause of this condition?

diabetes

When caring for a newborn, the nurse observes that a newborn has difficulty feeding. Which of the following anomalies can lead to feeding difficulties?

esophageal atresia

A woman gives birth to a newborn at 39 weeks' gestation. The nurse classifies this newborn as:

full term.

A newborn that has a surfactant deficiency will have which assessment noted on a physical exam?

grunting

A client has given birth to a small-for-gestation-age (SGA) newborn. Which finding would the nurse expect to assess?

head larger than body

The nurse is checking a newborn for the presence of Ortolani maneuver and Barlow sign. For which health problem are these assessments used?

hip dysplasia

A woman with diabetes has just given birth. While caring for this neonate, the nurse is aware that the child is at risk for which complication?

hypoglycemia

A newborn has not passed any stools in the first 24 hours after birth, and his abdomen is becoming distended. The nurse recognizes that which condition could explain such findings?

imperforate anus

In the infant born with a cleft lip and a cleft palate, the highest priority of the nurse is related to which intervention?

maintaining the nutritional needs of the infant

It would be best to place an infant with a myelomeningocele in which position prior to surgery?

on the stomach (prone)

A mother is inspecting her newborn and notices the baby has a sixth finger. The nurse would explain that this condition is called:

polydactyly.

What would be appropriate for the nurse to document in a child suffering from meconium aspiration syndrome?

respirations as increased and high

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


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