Ch 18: Nursing Management of the Newborn
A woman who is about to be discharged after a vaginal birth notices a flea-like rash on her newborn's chest. The rash has tiny red lesions all across the nipple line. What does this rash indicate? A) It is a sign of a group beta streptococcus skin infection. B) It is a normal skin finding in a newborn. C) It is a self-limiting virus that does not require treatment. D) It is an indication that the woman has mistreated her newborn.
B) It is a normal skin finding in a newborn. This rash is most likely is erythema toxicum, also known as newborn rash.
New parents are upset their newborn has lost weight since birth. The nurse explains that newborns typically lose how much of their birth weight by 3 to 4 days of age? A) 10% B) 12% C) 14% D) 16%
A) 10% Newborns typically lose approximately 10% of their initial birth weight by 3 to 4 days of age secondary to the loss of meconium, extracellular fluid, and limited food intake. This weight loss is usually regained by the 10th day of life.
The newborn has been placed in skin-to-skin contact with his mother. A blanket covers all of his body except his head. His hair is still wet with amniotic fluid, etc. What is the most likely type of heat loss this baby may experience? A) evaporative B) convective C) conductive D) radiating
A) evaporative Evaporative heat loss occurs with the evaporation of fluid from the infant.
The primapara tells the nurse, "My baby jumps every time I pick her up. Is she afraid that I will drop her?" Which response by the nurse would be best? A) "No, it is the blink reflex. It is meant to protect the eyes." B) "No, it is the tonic neck reflex. It signifies handedness." C) "No, it is the Moro reflex. This reflex stimulates the action of warding off an attacker." D) "Yes, she is afraid you will drop her."
C) "No, it is the Moro reflex. This reflex stimulates the action of warding off an attacker." The Moro reflex is known as the startle reflex. A startled newborn will extend the arms and legs away from the body and to the side. Then the arms come back toward each other with the fingers spread in a "C" shape. The arms look as if the newborn is trying to embrace something. The Moro reflex should be symmetrical.
The nurse records a newborn's Apgar score at birth. A normal 1-minute Apgar score is: A) 1 to 2. B) 12 to 15. C) 7 to 10. D) 5 to 9.
C) 7 to 10. An Apgar score of 7 to 10 implies the infant is breathing well and cardiovascular adaptation is occurring.
Which measurements were most likely obtained from a normal newborn born at 38 weeks to a healthy mother with no maternal complications? A) weight = 2000 g, length = 17 inches (43 cm), head circumference = 32 cm, and chest circumference = 30 cm B) weight = 2500 g, length = 18 inches (46 cm), head circumference = 32 cm, and chest circumference = 30 cm C) weight = 3500 g, length = 20 inches (51 cm), head circumference = 34 cm, and chest circumference = 32 cm D) weight = 4500 g, length = 22 inches (56 cm), head circumference = 36 cm, and chest circumference = 34 cm
C) weight = 3500 g, length = 20 inches (51 cm), head circumference = 34 cm, and chest circumference = 32 cm For a term infant, expected weight is 2500 to 4000 g; length is 19 to 21 inches (48 to 53 cm); head circumference is 33 to 35 cm; and chest circumference is 30.5 to 33 cm.
The nurse caring for a newborn has to perform assessment at various intervals. When should the nurse complete the second assessment for the newborn? A) within 30 minutes after birth, in the birthing area B) prior to the newborn being discharged C) within the first 2 to 4 hours, when the newborn reaches the nursery D) 24 hours after the newborn's birth
C) within the first 2 to 4 hours, when the newborn reaches the nursery The nurse should complete the second assessment for the newborn within the first 2 to 4 hours, when the newborn is in the nursery. The nurse should complete the initial newborn assessment in the birthing area and the third assessment before the newborn is discharged, whenever that may be.
When instructing a new mom on providing skin care to her newborn, which statement should not be included in the teaching? A) "Change diapers frequently." B) "Daily tub baths are not necessary." C) "Give the newborn sponge baths until the umbilical cord falls off." D) "Use talc powders to prevent diaper rash."
D) "Use talc powders to prevent diaper rash." Talc powders can be a respiratory hazard and should not be used with a newborn.
A woman has just given birth vaginally to a newborn. Which action would the nurse do first? A) Administer vitamin K. B) Obtain footprints. C) Apply identification bracelet. D) Suction the mouth and nose.
D) Suction the mouth and nose. The first priority is to ensure a patent airway by suctioning the newborn's mouth and nose. Before leaving the birthing area, newborn identification procedures are completed, including applying the identification bracelet and possibly footprinting, depending on the agency's policy. Vitamin K is administered soon after birth, but it does not take priority over ensuring a patent airway.
Discharge teaching is an important part of the labor and birth room nurse's position. New parents need to know the basics of baby care, like how to monitor fluid volume and when to call the primary care provider. What are the parameters for calling the care provider in regards to an infant's temperature? A) less than 96.7º F (35.9º C) or greater than 99.5º F (37.4º C) B) less than 96º F (35.6º C) or greater than 101º F (38.3º C) C) less than 97º F (36.1º C) or greater than 100.5º F (38.1º C) D) less than 97.7º F (36.5º C) or greater than 100º F (37.8º C)
D) less than 97.7º F (36.5º C) or greater than 100º F (37.8º C) Temperatures of less than 97.7 ° F (36.5° C) or greater than 100 ° F (37.8° C) should be reported to the primary care provider.
