NURSING CARE OF THE NEWBORN (ELSEVIER)
A newborn with a myelomineingocele (spina bifida) is being transferred immediately from the birthing room to the NICU, what is the initial nursing intervention?
Apply a sterile saline dressing
A new mother who is learning about infant feedings asks the nurse how anyone who is breast-feeding gets anything done with the baby feeding on demand. What is the best response by the nurse?
"babies on demand feedings eventually set a schedule, so there should be a time for you to do other things"
While inspecting her newborn a mother asks the nurse whether her baby has flat feet. How should the nurse respond?
"infants feet appear flat because the arch is covered with a fat pad"
A new mother exclaims to the nurse, "My baby looks like a conehead!" How should the nurse respond?
"this often happens as the baby's head moves down the birth canal- the bones move for easier passage"
During the initial assessment of a dark skinned neonate the nurse observes several dark round areas on the neonates buttocks. How should this be documented?
Mongolian spots
The nurse is planning to use a newborns foot to obtain blood for the required newborn metabolic testing. Which part of the foot is the best site for the puncture?
Outer heel (well perfused and heals quickly)
What is teh most important parameter for the nurse to monitor during the first 24 hours after the birth of an infant at 36 weeks gestation?
respiratory distress
A mother is inspecting her newborn girl for the first time. The infant's breasts are edematous, and she has a pink vaginal discharge. How should the nurse respond when the mother asks what is wrong?
"the swelling and discharge are expected. They're a response to your hormones"
In specific situations gloves are used to handle newborns whether or not they are positive for HIV. When is it necessary for the nurse to wear gloves while caring for the newborn?
-changing the diaper -giving an admission bath -suctioning the nasopharynx
A newborn weighing 9lb 14oz is delivering by cesarean due to cephalopelvic disproportion. The Apgar scores are 7 at 1 minute and 9 at 5 minutes. Which nursing action should be taken after the initial physical assessment?
Determine the blood glucose level
A nurse teaches a new mother about neonatal weight loss in the first three days of life. How does the nurse explain the cause of this weight loss?
Excretion of accumulated excess fluids. (not body mass)
Fetal HR tracing abnormalities are observed on a fetal monitor when a client in active labor turns to a supine position. Which nursing action is most beneficial at this time?
Helping the client change her position
The parent of a preterm infant asks the nurse in the neonatal intensive care unit why the baby is in a bed with a radiant warmer. How does the nurse explain the increased risk for hypothermia in preterm infants?
Lack of subcutaneous fat that usually provides insulation.
The nurse is performing the nursery intake assessment of a 1 hour newborn. The assessment reveals that the hands and feet are cyanotic and there is circumoral pallor when the infant cries or feeds. What action should the nurse perform bases on these findings?
Notify the practitioner, because circumoral pallor may indicate cardiac problems
While assessing a newborn the nurse notes the following findings: -arms and legs slightly flexed -smooth, transparent skin -abundant lanugo on back -slow recoil of pinnae -few sole creases what complication does the nurse anticipate in light of these findings?
Respiratory distress syndrome
What is an appropriate NIC or a neonate with respiratory distress syndrome (RDS)?
position the infant to promote respiratory efforts
What is the most common complication for which a nurse must monitor for preterm infants?
respiratory distress
The most appropriate method for a nurse to evaluate the effects of the maternal blood glucose level in the infant of a diabetic mother is by performing a heel stick blood test on the newborn. What specifically does this test determine?
serum glucose levels
At 10 hours of age a newborn has a large amount of mucus in the nasopharynx and becomes cyanotic. What is the initial action of the nurse?
suction the mouth
Photo-therapy is prescribed for a preterm neonate with hyperbilirubinemia. Which nursing intervention is appropriate to reduce the potentially harmful effects of photo therapy?
using shields on the eyes to protect them from the light
