Chapter 24

A nurse is caring for a child with complex esophageal atresia who will be undergoing surgery for repair. What comment by the parents indicates further teaching is required?

"After this surgery is done tomorrow, my baby will be able to eat and drink."

A nursing instructor is teaching about newborn congenital disorders and realizes that the student needs further instruction after making which statement?

"All congenital disorders can be diagnosed at birth."

The nurse is assessing a toddler at a well-child visit and notes the following: small in stature, appears mildly developmentally delayed; short eyelid folds; and the nose is flat. Which advice should the nurse prioritize to the mother in response to her questions about having another baby?

"It's a good idea to stop drinking alcohol 3 months before trying to get pregnant."

A nurse is explaining to the parents the preoperative care for their infant born with bladder exstrophy. The parents ask, "What will happen to the bladder while waiting for the surgery?" What is the nurse's best response?

"The bladder will covered in a sterile plastic bag to keep it moist."

A newborn boy is diagnosed with esophageal atresia and tracheoesophageal fistula. After the nurse provides preoperative teaching, which statement indicates that the parents need additional teaching?

"We can probably start feeding him with the bottle about a day after the surgery."

The nurse is caring for a client who is at her due date. The client asks. "How long is the health care provider going to let me go?" The nurse is correct to state that typical a mother should not pass how many weeks gestation?

42 weeks

Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn?

Barlow sign and Ortolani click

A 3-day-old neonate needs phototherapy for hyperbilirubinemia. Nursery care of a neonate receiving phototherapy includes which treatment?

Eye patches to prevent retinal damage

In completing the newborn assessment checklist, the nurse documents a meconium stool. This documentation rules out which condition?

Imperforate anus

The nurse caring for a newborn notes a distended abdomen approximately 24 hours after birth. Which action should the nurse prioritize after review of the medical record reveals an apparent healthy newborn at birth but no documentation of a bowel movement?

Inform the RN and/or primary care provider immediately

Which nursing measure is most effective in reducing newborn infections?

Maintain medical asepsis while providing care.

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

Mobiles and rattles

Which nursing interventions are essential when caring for a newborn with macrosomia born to a diabetic mother? Select all that apply.

Obtain IV glucose for potential infusion. Obtain blood glucose reading. Anticipate supplemental oxygen. Assess for respiratory distress.

A ventilated 33 weeks' gestation newborn in the neonatal intensive care unit (NICU) receives surfactant therapy. Which would the nurse expect to assess as a positive response to this therapy?

Oxygen saturation levels are at 98%

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.

A nurse is assigned to care for a newborn with esophageal atresia. What preoperative nursing care is the priority for this newborn?

Prevent aspiration by elevating the head of the bed, and insert an NG tube to low suction.

An infant is suspected of having persistent pulmonary hypertension of the newborn (PPHN). What intervention implemented by the nurse would be most beneficial in treating this client?

Provide oxygen by oxygen hood or ventilator.

When attempting to interact with a neonate experiencing drug withdrawal, which behavior would indicate that the neonate is willing to interact?

Quiet, alert state

During the newborn examination, the nurse notes that an infant who is appropriate for gestational age by birth weight has a head circumference below the 10th percentile and the fontanelles are not palpable. What action would the nurse take?

Report the findings to the pediatric provider.

In the preterm newborn, the most critical complications are related to which system?

Respiratory

Which nursing action is required when caring for the post-term infant?

Serial blood glucose levels

Which nursing actions limit overstimulation of the preterm infant? Select all that apply.

Speak softly to the infant. Coordinate nursing care. Keep lights low in the nursery.

From the assessment, the nurse notes that there is paralysis of the lower extremities. For which condition does the nurse anticpate performing care?

Spina bifida with myelomeningocele

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

Which respiratory disorder in a neonate is usually mild and runs a self-limited course?

Transient tachypnea

A meconium plug is an extremely hard portion of meconium that has completely blocked the intestinal lumen, causing bowel obstruction.

True

When providing care to a newborn with necrotizing enterocolitis (NEC), the nurse would need to report which finding immediately?

abdomen appearing red and shiny

The nurse assesses an infant. Which finding may indicate heart failure?

diminished peripheral pulses

When providing postpartum teaching to a couple, the nurse correctly identifies what time as when pathologic jaundice may be found in the newborn?

during the first 24 hours of life

A nurse in the newborn nursery has noticed that an infant is frothing and appears to have excessive drooling. Further assessment reveals that the baby has episodes of respiratory distress with choking and cyanosis. What disorder should the nurse suspect based on these findings?

esophageal atresia

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

A newborn is found to have hemolytic disease. Which combination would be found related to the blood types of this newborn and the parents of the newborn?

newborn who is type A, mother who is type O

The nurse notes a diminished level of consciousness in an infant with hydrocephalus. What is a priority action at this time?

palpating the anterior fontanel

Which newborn would the nurse suspect to be most at risk for intellectual disability due to the mother's actions during pregnancy?

the child of a client who admits to drinking a liter of alcohol daily during the pregnancy

A nurse working in the newborn observational unit is assigned four newborns closely being monitored. Which newborn is at greatest risk of developing respiratory distress syndrome?

the male preterm infant born by cesarean birth with cold stress