OB Exam 8 Unit 8 - Pearce
The mother of a preterm infant tells her nurse that she would like to visit her newborn in the neonatal intensive care unit (NICU). Which response by the nurse would be most appropriate?
"Certainly. You will need to wash your hands and gown before you can hold him, however."
The nurse is caring for a newborn that is small-for-gestational age (SGA). The parents ask the nurse what may have caused their newborn to be SGA. Which response by the nurse is appropriate?
"SGA is may be related to maternal, placental, or fetal factors."
The nurse weighs the new infant and calculates the child's measurements. The new mom asks, "Did my baby grow well? The doctor said he was LGA. What does that mean?"What is the nurse's best response?
"That means your baby is over the 90th percentile for weight."
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 be covered in a sterile plastic bag to keep it moist."
The nurse is teaching the parents of a newborn diagnosed with a right midclavicular fracture about care of the newborn at home. The nurse determines that the teaching was successful based on which statement by the parents?
"We will pin the right sleeve of the shirt to the front of the shirt to keep it secure."
A newborn has been diagnosed with retinopathy of prematurity. The nurse is teaching the parents about this condition. Which statement would the nurse most likely include in the teaching?
"You'll need to schedule follow-up eye examinations with the pediatric ophthalmologist."
The nurse is screening an expectant mother for the extent of current substance use. Which statement made by the mother is most concerning?
"since i have learned that I am pregnant, i have only binged a few times"
A set of newborn twins has been admitted to the neonatal intensive care unit with the diagnosis of fetal growth restriction (FGR). Which maternal factors would predispose the newborn to this diagnosis?
A1C levels of 8% (0.08) heroin use disorder blood pressure baseline of 170/90 mm Hg age 39 years multiple gestation
A preterm newborn in the neonatal intensive care unit (NICU) has been diagnosed with periventricular-intraventricular hemorrhage (PVH-IVH). Which nursing action would be a priority in the plan of care for this newborn?
Avoiding lifting the lower extremities above the midline.
In the child diagnosed with hydrocephalus, an obstruction occurs that blocks the normal process of:
CSF
What is the correct sequence of events in a neonatal resuscitation?
Dry the infant, establish an airway, expand the lungs, and initiate ventilation.
A baby is born with spina bifida with meningocele. The parents are visibly upset. The father states, "What did we do wrong? How will I ever love this child?" What is the priority action by the nurse?
Encourage the parents to express their feelings and emotions openly.
A small-for-gestational-age neonate is admitted to the observational nursery for blood work. Which result would require further assessment?
Hct 80% (0.80)
An 18-year-old client has given birth to a very-low-birth-weight preterm infant. Which intervention should the nurse consider to prevent the newborn from losing body temperature?
Provide isolette or radiant warmer care to the newborn.
A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the neonate is being born. Which intervention should the nurse implement as a result of this finding?
Provide supplemental oxygen and monitor respiratory status
An infant has just been born with a cleft lip and palate. The birthing room suddenly becomes very quiet, and the birth team seems somber. The health care provider is busy examining the newborn, but the mother is obviously aware that something is not right. What should the nurse do?
Say to the parents, "Your son has been born with a cleft lip and palate. This condition is highly treatable by surgery, however, and he is otherwise in excellent health."
A newborn is suspected of having gastroschisis at birth. How does the nurse differentiate this condition from other congenital conditions?
The exposed intestines appear reddened and swollen and have no sac around them.
An infant is born with an omphalocele. Which explanation by the nurse is the best description of the feeding plan for the infant?
The infant will be fed by TPN to supply nutrients and keep the bowel from filling with air or stool.
A nursing instructor is preparing a discussion which will illustrate the different forms of spina bifida. The instructor determines the session is successful after the students correctly choose which form as being spina bifida with myelomeningocele?
The spinal cord, meninges, and nerve roots protrude out the lower back.
When providing care to a newborn with necrotizing enterocolitis (NEC), the nurse would need to report which finding immediately?
abdomen appearing red adn shiny
A nurse is reviewing the maternal history and medical record of an SGA newborn. Which finding would the nurse identify as a placental factor contributing to the newborn's current state?
abnormal cord insertion
The nurse is assessing a large-for-gestational-age newborn who had shoulder dystocia at birth. Which assessment findings would indicate a possible fracture?
absent Moro, bicep, and radial reflexes
A nurse is reading a journal article about neural tube defects and preventive measures. Which defect would the nurse most likely find identified as the most severe?
anencephaly
Bronchopulmonary dysplasia (BPD) is the result of lung injury in the preterm newborn. What can be done to reduce the incidence of BPD in the preterm newborn?
antepartal administration of steroids to the mother
The priority for the nurse caring for a newborn with esophageal atresia is to observe for which finding?
aspiration
A nurse is administering prescribed enteral feedings to assist in preparing the gut of a preterm newborn. Which type of solution would the nurse most likely administer for the feeding?
breast milk
A newborn does not breathe spontaneously at birth. The nurse administers oxygen by bag and mask. If oxygen is entering the lungs, the nurse should notice that the:
chest rises with each bag compression
Periventricular-intraventricular hemorrhage is suspected in a newborn of 30 weeks' gestation. The nurse would anticipate preparing the newborn for which diagnostic tool to confirm the diagnosis?
cranial ultrasound
What assessment should the nurse perform daily on an infant suspected of having hydrocephalus?
daily head circumference
The nurse prepares to assess a newborn who is considered to be large-for-gestational-age (LGA). Which characteristic would the nurse correlate with this gestational age variation?
difficulty in arousing to a quiet alert state
A newborn is suspected of developing persistent pulmonary hypertension. The nurse would expect to prepare the newborn for which procedure to confirm the suspicion?
echocardiogram
The parents of a newborn with a cleft palate ask the nurse what is the best method to feed their infant. The mother desires to breastfeed but is afraid due to the defect. What would be the nurse's best response?
encourage the mother to breastfeed the infant
The nurse is feeding a 2-day-old in the nursery when the infant begins choking and becomes cyanotic. Frothy sputum is observed coming from the mouth. What congenital malformation does the nurse understand these symptoms indicate?
esophageal atresia
A preterm newborn is receiving enteral feedings. Which finding would alert the nurse to suspect that the newborn is developing necrotizing enterocolitis (NEC)?
feeding intolerance
A nursing student has read that cleft lip is diagnosed at birth based on inspection of physical appearance and that cleft palate is diagnosed by which method?
feeling the palate with a gloved finger or using a tongue blade
A newborn that has a surfactant deficiency will have which assessment noted on a physical exam?
grunting
A premature infant in the neonatal intensive care unit exhibits worsening respiratory distress and is noted to have abdominal distention, absent bowel sounds, and frequent diarrhea stools that are hemoccult positive. Which diagnosis will the nurse anticipate to be given to this neonate??
herpes simplex virus
The nurse is reviewing the medical record of a newborn born 2 hours ago. The nurse notes that the newborn was born at 35 weeks' gestation. How would the nurse classify this newborn?
late preterm
Which nursing measure is most effective in reducing newborn infections?
maintain medical asepsis while providing care
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
Which action would be most important to do for an infant following surgery for meningomyelocele?
measure a daily head circumference
A nurse is caring for a newborn whose chest X-ray reveals marked hyperaeration mixed with areas of atelectasis. The infant's arterial blood gas analysis indicates metabolic acidosis. For which dangerous condition should the nurse prepare when providing care to this newborn?
meconium aspiration syndrome
The nurse is admitting a term, large-for-gestational-age neonate weighing 4,610 g (10 lb, 2 oz), born vaginally with a mid-forceps assist, to a 15-year-old primipara. What would the nurse anticipate as a result of the birth?
midclavicular fracture
Which medication would be included in the plan of care for a newborn with acute neonatal abstinence syndrome who is not responding to conservative nursing approaches?
morphine sulfate
A newborn has been diagnosed with a group B streptococcus infection shortly after birth. The nurse understands that the newborn most likely acquired this infection from which cause?
mother's birth canal
A couple has just given birth to a baby who has low Apgar scores due to asphyxia from prolonged cord compression. The neonatologist has given a poor prognosis to the newborn, who is not expected to live. Which interventions are appropriate at this time?
offer to pray with family if appropriate, initiate spiritual comfort by calling the hospital clergy, if appropriate, respect variations in the family's spiritual needs and readiness
A 32 weeks' gestation newborn is admitted to the neonatal intensive care unit. The assessment reveals a pale dyspneic newborn with marked tremors, a bulging anterior fontanel (fontanelle), and a high-pitched cry. What diagnosis best correlates with the assessment findings?
periventricular-intraventricular hemorrhage
A woman who has a history of cocaine use disorder gives birth to a newborn. Which findings would the nurse expect to assess in the newborn?
piercing cry, poor sucking, inconsolability
When preparing to resuscitate a preterm newborn, the nurse would perform which action first?
place the newborn's head in a neutral position
The small-for-gestational-age neonate is at increased risk for which complication during the transitional period?
polycythemia, probably d/t chronic fetal hypoxia
A term newborn is diagnosed with esophageal atresia. When reviewing the mother's prenatal records, which maternal complication would correlate with the diagnosis?
polyhydramnios
Which condition of delivery would predispose a neonate to respiratory distress syndrome (RDS)?
premature birth
A 30 weeks' gestation neonate born with low Apgar scores is in the neonatal intensive care unit with respiratory distress syndrome and underwent an exchange transfusion for anemia. Which factors place the neonate at risk for necrotizing enterocolitis?
preterm birth, resp distress syndrome, low Apgar, exchange transfusion
A nurse is assessing a preterm newborn for possible sepsis. The nurse suspects an early-onset infection based on which risk factor(s)?
preterm labor, prolonged ROM, birth parent's fever during pregnancy
Which intervention would be most appropriate for the nurse to do when assisting parents who have experienced the loss of their preterm newborn?
provide opportunities for them to hold the newborn
What would be appropriate for the nurse to document in a child suffering from meconium aspiration syndrome?
respirations as increased and high
A thin newborn has a respiratory rate of 80 breaths/min, nasal flaring with sternal retractions, a heart rate of 120 beats/min, temperature of 36° C (96.8° F) and persisting oxygen saturation of <87%. The nurse interprets these findings as:
respiratory distress
A preterm newborn receives oxygen therapy to treat respiratory distress syndrome (RDS). Which complication should the nurse consider a result of oxygen administration at a high concentration?
retinopathy of prematurity
During the first feeding, the nurse observes the infant becoming cyanotic, coughing, and having difficulty breathing. Which nursing diagnosis would the nurse identify as a priority for this infant?
risk of injury related to increased potential for aspiration
The parents of an infant with congenital club foot question the nurse about what the treatment will be to address this problem. What initial treatment plan would the nurse explain to the parents?
serial casting
A nursing student is caring for a newborn with a defect in the neural arch where the posterior laminae of the vertebrae have failed to close. The nurse knows that this infant is suffering from which disorder?
spina bifida
After completing an assessment of a preterm newborn, the nurse is suspicious the infant has a congenital diaphragmatic hernia. Which symptoms are indications of this defect?
tachycardia, grunting, concave-shaped abdomen
A nurse is providing care to a newborn. The nurse suspects that the newborn is developing sepsis based on which assessment finding?
temperature instability
The nurse is teaching new parents about their premature newborn who was born with respiratory distress syndrome (RDS). The nurse determines the teaching session is successful when the parents correctly choose which explanation as being the cause of their newborn's condition?
the lungs are immature and deficient in surfactant
A neonate born at 40 weeks' gestation, weighing 2300 grams (5 lb, 1 oz) is admitted to the newborn nursery for observation only. What is the nurse's first observation about the infant?
the neonate is small for its gestational age
The nursing instructor is leading a discussion with a group of nursing students who are analyzing the preterm infant's physiologic immaturity and the associated difficulties the newborn and family must deal with. The instructor determines the session is successful when the students correctly choose which body system that presents with the most critical concerns related to this immaturity?
the respiratory system
A preterm infant is transferred to a distant hospital for care. When her parents visit her, which action would be most important for the nurse to urge them to do?
touch and, if possible, hold her
A nurse is assessing a newborn. The nurse suspects that the newborn was exposed to drugs while in utero based on which findings?
tremors, frequent yawning, nasal flaring
After completing an assessment of a newborn, the nurse determines that the newborn is small-for-gestational-age based on which weight assessment?
weight of 2400 g
A neonatal intensive care nurse is caring for a preterm newborn diagnosed with transient tachypnea who is NPO and receiving intravenous fluid therapy. When would the nurse expect the newborn to begin oral feedings?
when the respiratory rate is 44 bpm
