prepU ch 24 Nursing Management of the Newborn at Risk: Acquired and Congenital Newborn Conditions
The nurse is teaching the caregivers of an infant diagnosed with hypospadias how to properly care for the infant. The nurse determines the session is successful when the caregivers make which statement?
"Being able to most likely correct this in one stage rather than several is reassuring."
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 requires resuscitation secondary to asphyxia. The resuscitation team frequently assesses the newborn's response and continues resuscitation efforts based on which assessment finding?
Heart rate of 70 beats/min
The nurse is admitting to the nursery a newborn of a mother who continued to drink alcohol during her pregnancy. Which finding does the nurse predict to encounter on the newborn's assessment?
Hyperactive and irritable
A neonate undergoing phototherapy treatment must be monitored for which adverse effect?
Increased insensible water loss
At birth, a neonate is diagnosed with brachial plexus palsy. The parent asks how the nurse knows the neonate's positioning of the arm is a result of the palsy and not just a preferred position. The nurse would show the parent that the neonate has asymmetry of which neonatal reflex?
Moro
The nurse should carefully monitor which neonate for hyperbilirubinemia?
Neonate with ABO incompatibility
Which intervention is helpful for the neonate experiencing drug withdrawal?
Place the Isolette in a quiet area of the nursery.
The nurse is preparing a nursing care plan for an infant who was born with spina bifida with myelomeningocele. Which nursing goal should the nurse prioritize for this child?
Preventing infection
Which nursing action is required when caring for the post-term infant?
Serial blood glucose levels
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
The nurse is caring for a neonate with an exstrophy of the bladder. When the nurse is planning care, which client goal is the priority?
The client will be free from infection.
Which congenital condition is an immediate emergency requiring notification of the health care provider?
Tracheoesophageal fistula
The prenatal health nurse is conducting an educational session focusing on alcohol use during pregnancy. The nurse feels the session was a success when a participant makes which statement?
"Alcohol use could cause my baby to be intellectually disabled."
Immediately after birth, the nurse is caring for a newborn with a myelomeningocele. What intervention should the nurse provide to prevent drying out of the sac to avoid damage?
Apply a sterile dressing moistened in a warm, sterile saline solution.
The nurse assesses preterm infants as they come for routine well-baby checkups. The nurse will carefully assess the infant's vision to assess for which potential complication related to their birth?
Retinopathy
The nurse assesses an infant. Which finding may indicate heart failure?
diminished peripheral pulses
While caring for a neonate born of a mother with diabetes, the nurse should monitor the neonate for which complication?
macrosomia
The use of breast milk for premature neonates helps prevent which condition?
necrotizing enterocolitis
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
It would be best to place an infant with a meningomyelocele in which position prior to surgery?
on the stomach (prone)
When caring for a neonate receiving phototherapy, the nurse should remember to:
reposition the neonate frequently.
The nurse is caring for a newborn receiving vasopressors to treat meconium aspiration syndrome. The nurse monitors the blood pressure frequently during administration. What action will the nurse implement when administering these drugs?
titrate the dosage to meet blood pressure parameters prescribed
A 36-week neonate born weighing 1,800 g has microcephaly and microphthalmia. Based on these findings, which risk factor might be expected in the maternal history?
use of alcohol
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
Four weeks before the birth of a client's already large child, the health care provider has told the client that if the baby gets bigger and the baby's lungs are ready, a cesarean birth is preferred. The woman asks the nurse what the downside is to having a cesarean rather than a vaginal birth. What is an appropriate response by the nurse?
"As the baby passes through the birth canal some of the excess fluid is expelled from the lungs; if that doesn't happen there's a higher risk of respiratory distress."
The nursing instructor is teaching a session on techniques that the nursing students can use to properly address concerns of parents with children who are born with a cleft lip and palate. The instructor determines the session is successful when the students correctly choose which nursing intervention as being the most effective in these situations?
Use reflective listening with nonjudgmental support.
In the infant diagnosed with spina bifida with myelomeningocele, the infant will likely have:
a partial to complete paralysis in the lower extremities.
A pregnant woman gives birth to a small-for-gestational-age neonate who is admitted to the neonatal intensive care unit with seizure activity. The neonate appears to have abnormally small eyes and a thin upper lip. The infant is noted to be microcephalic. Based on these findings, which substance would the nurse suspect the women of using during pregnancy?
alcohol
Assessment reveals that a young mother has several risk factors for giving birth to an infant with a neural tube defect. Which laboratory test would the nurse expect to be used to monitor the fetus for this birth defect?
alpha-fetoprotein levels
The priority for the nurse caring for a newborn with esophageal atresia is to observe for which finding?
aspiration
The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis?
bloody stools
What is the term for a small collection of blood that forms underneath the skull as a result of birth trauma?
cephalohematoma
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 teaching the parents of a newborn who was born with a high type of imperforate anus the care the newborn will need at home after surgery. The parents need to be aware that the newborn will require which measure temporarily?
colostomy
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
The nurse is assessing a newborn suspected of having meconium aspiration syndrome. What sign or symptom would be most suggestive of this condition?
expiratory grunting
