Maternal-Newborn Ch 25 Acquired Conditions and Congenital Abnormalities in the Newborn
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? "They will be placing a tube in the stomach during surgery." "The baby will have tubes in the chest to drain chest fluids." "Intravenous fluids are going to be needed so that the baby won't get dehydrated." "After this surgery is done tomorrow, my baby will be able to eat and drink."
"After this surgery is done tomorrow, my baby will be able to eat and drink."
After teaching the parents of a newborn with retinopathy of prematurity (ROP) about the disorder and treatment, which statement by the parents indicates that the teaching was successful? "Can we schedule follow-up vision screenings with the pediatric ophthalmologist now?" "We can fix the problem with surgery." "We'll make sure to administer eye drops each day for the next few weeks." "I'm sure the baby will grow out of it."
"Can we schedule follow-up vision screenings with the pediatric ophthalmologist now?"
An infant born 10 minutes prior was brought into the nursery for its exam. The nurse notices the infant's lip and palate are malformed. The father comes up to door and asks if the baby seems okay. What is the appropriate response by the nurse? "Oh yeah, the baby seems fine, you can see him soon." "Come on over and I will explain your infant's exam and findings." "Wait outside and we will call you later." "The baby is okay, just wait until your doctor speaks to you."
"Come on over and I will explain your infant's exam and findings."
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." "It's important to add iron and vitamin B supplements to your diet." "It would be good to stop smoking before getting pregnant." "It's important to keep insulin levels controlled during pregnancy."
"It's a good idea to stop drinking alcohol 3 months before trying to get pregnant."
A gravid woman in her second trimester has shared that she still enjoys a glass of wine about once a week with dinner. What response by the nurse is most appropriate? "Now that you have reached the second trimester you are at a reduced risk for causing complications to your fetus." "There is no amount of alcohol consumption in pregnancy that is considered safe for the fetus." "As long as you do not increase the amount of alcohol you are drinking there is little risk." "The best thing for you to do is to reduce the amount of alcohol you are drinking." "The best thing for you to do is to reduce the amount of alcohol you are drinking."
"There is no amount of alcohol consumption in pregnancy that is considered safe for the fetus."
The nurse is caring for a newborn client newly diagnosed with developmental dysplasia of the hip. Which response by the nurse educates the parents on the correct plan of treatment for this diagnosis? "Treatment will start once your child can bear weight." "Treatment will begin immediately." "Treatment will consist of surgery when your child weighs about 10 pounds." "Treatment will include bilateral casts at 1 month of age."
"Treatment will begin immediately."
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? "He'll need antibiotics for a bit after the surgery to prevent infection." "We can probably start feeding him with the bottle about a day after the surgery." "The head of his bed will be elevated to prevent him from aspirating." "We can give him a pacifier to help satisfy his need to suck."
"We can probably start feeding him with the bottle about a day after the surgery."
A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? Select all that apply. "Your newborn can be infected during birth." "Your newborn may have eye infections from this infection." "Your membranes may rupture earlier than normal." "Your newborn is protected from this infection." "It will not have any affect on your pregnancy."
"Your newborn can be infected during birth." "Your newborn may have eye infections from this infection." "Your membranes may rupture earlier than normal."
The nurse is preparing a presentation for a health fair presenting the risks which can lead to sudden infant death syndrome (SIDS). Which factors would the nurse include as increasing the risk for SIDS? A low birth weight baby girl, March birth, middle-class, 25-year-old G2P2 nonsmoker An average weight baby boy, January birth, a poor, 16-year-old G1P1 nonsmoker A low birth weight baby boy, November birth, wealthy, educated, 19-year-old G1P1 smoker An average weight baby boy, April birth, poor, 27 year old G2P2 nonsmoker
A low birth weight baby boy, November birth, wealthy, educated, 19-year-old G1P1 smoker
A nurse is caring for a full-term neonate who's receiving phototherapy for hyperbilirubinemia. Which finding should the nurse report immediately? Maculopapular rash Absent Moro reflex Greenish stool Bronze-colored skin
Absent Moro reflex
A newborn with high serum bilirubin is receiving phototherapy. Which is the most appropriate nursing intervention for this client? Application of eye dressings to the infant Placing light 6 inches above the newborn's bassinet Delay of feeding until bilirubin levels are normal Gentle shaking of the baby
Application of eye dressings to the infant
The priority for the nurse caring of a newborn with esophageal atresia is to observe for which finding? Aspiration Bleeding Constipation Vomiting
Aspiration
Which condition would place a neonate at the least risk for developing respiratory distress syndrome (RDS)? Second born of twins Neonate born at 34 weeks Neonate of a diabetic mother Chronic maternal hypertension
Chronic maternal hypertension
A newborn develops jaundice, and the primary health care provider prescribes phototherapy. Which of the following would the nurse include in the newborn's plan of care? Select all that apply. Covering the newborn's eyes from the light Removing the newborn from the lights for feeding Dressing the newborn in a T-shirt and diaper while under the lights Monitoring the newborn's temperature frequently Providing frequent feedings to lessen the risk of dehydration
Covering the newborn's eyes from the light Removing the newborn from the lights for feeding Monitoring the newborn's temperature frequently Providing frequent feedings to lessen the risk of dehydration
Which assessment findings are most prominent in the infant with Tetralogy of Fallot and significant pulmonary stenosis? Irregular heart rate, fatigue, pink tinged skin Dry mucous membranes, poor urine output Poor weight gain, nausea, decreased muscle tone Dyspnea on limited exertion, fatigue, cyanosis
Dyspnea on limited exertion, fatigue, cyanosis
Which of the following would lead you to suspect that a newborn has developmental hip dysplasia? Inability of the right hip to abduct Crying on straightening of the right leg Continual drawing of his legs under him while prone Inward rotation of his right foot
Inability of the right hip to abduct
The nurse is assessing a newborn diagnosed with meconium aspiration. Which of the following would the nurse expect to assess? Select all that apply. Intercostal and substernal retractions Increased anteroposterior chest diameter Pink skin Respirations of 45 Tachycardia
Intercostal and substernal retractions Increased anteroposterior chest diameter
A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response? "It is not transmitted to your newborn as it is protected in the uterus." "The risk of your newborn being infected with HIV infection is about 1%." "It is only transmitted through the birth canal so a cesarean birth will be scheduled." It is recommended to formula-feed your newborn as it is transmitted through your breast milk."
It is recommended to formula-feed your newborn as it is transmitted through your breast milk."
A newborn is suspected to have fetal alcohol syndrome as a result of maternal use of alcohol during pregnancy. Which of the following would the nurse expect to assess. Thick upper lip Large bulging eyes Low nasal bridge Long nose
Low nasal bridge
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 if the infant Managing the pain level of the infant Promoting coping skills in the family caregivers Reducing family anxiety related to the treatment
Maintaining the nutritional needs if the infant
A nurse is caring for a newborn with a flat, thin upper lip, small eyes, short palpebral fissures, and a flattened midface with a short nose. Which of the following should the nurse consider as a possible cause for these features? Premature delivery Gestational diabetes Maternal alcohol abuse Hydrocephaly
Maternal alcohol abuse
Newborns receive an antibiotic in their eyes within the first hour after birth to prevent neonatorum ophthalmia. Which type of bacteria is most likely to cause this condition? Neisseria gonorrhoeae Escherichia coli Trichomonas vaginalis Group B streptococci
Neisseria gonorrhoeae
Assessment of a pregnant client reveals that she has tested positive for a sexually transmitted infection (STI). The nurse understands that the client's newborn is at risk for which of the following? Diabetes Hypertension Neurologic damage Low birth weight
Neurologic damage
A nurse is providing postoperative care to an infant who had a ventriculoatrial shunt placed. Approximately 8 hours after surgery, the nurse notes on assessment shrill crying and projective vomiting. Which response should the nurse prioritize at this time? Assess surgical site for signs of infection. Increase the flow of IV fluids and maintain NPO status. Assess and administer pain medication. Notify the primary care provider immediately.
Notify the primary care provider immediately
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. Delay the parents from holding the newborn. Place petroleum jelly gauze on the spinal sac to keep it moist. Place a urine collection bag on newborn for the continuous leakage.
Place the newborn in a prone or lateral position.
A preterm newborn is admitted to the neonatal intensive care with the diagnosis of an omphalocele. What nursing actions would the nurse perform? Select all that apply. The abdominal contents are protected. Fluid loss of the neonate will be minimized. Perfusion to the exposed abdominal contents will be maintained. Neonatal weight loss will be prevented. Assessment of hyperbilirubinemia will be monitored.
The abdominal contents are protected. Fluid loss of the neonate will be minimized. Perfusion to the exposed abdominal contents will be maintained.
A nurse is preparing a presentation for a group of neonatal nurses on congenital clubfoot. The nurse determines that the presentation was successful when the group makes which statement? Clubfoot is a common genetic disorder. The condition affects girls more often than boys. The exact cause of clubfoot is not known. The intrinsic form can be manually reduced.
The exact cause of clubfoot is not known.
A nurse is assigned to care for a newborn with hyperbilirubinemia. The newborn is relatively large in size and shows signs of listlessness. What most likely occurred? The infant's mother must have had a long labor. The infant's mother probably had diabetes. The infant may have experienced birth trauma. The infant may have been exposed to alcohol during pregnancy.
The infant's mother probably had diabetes.
The nurse is teaching new parents about their 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 hyperextended due to increased load of work. The infant has inherited allergies from the mother. The lungs are immature and deficient in surfactant. The mother has a history of asthma which interfered in lung development.
The lungs are immature and deficient in surfactant.
The nurse has administered erythromycin ointment to a newborn. What outcome indicates this nursing intervention has been effective? The newborn's active eye infection resolves. The newborn does not contract opthalmia neonatorum. The newborn's sclerae do not appear yellow. The newborn is about to produce sufficient tears.
The newborn does not contract opthalmia neonatorum.
Which respiratory disorder in a neonate is usually mild and runs a self-limited course? Pneumonia Meconium aspiration syndrome Transient tachypnea Persistent pulmonary hypertension
Transient tachypnea
The nurse is performing a cardiac assessment on a newborn and hears a loud, harsh murmur associated with a systolic thrill. What congenital heart defect does the nurse suspect? Atrial septal defect Patent ductus arteriosus Ventricular septal defect Coarctation of the aorta
Ventricular septal defect
A pregnant woman in her 39th week of pregnancy presents to the clinic with a vaginal infection. She tests positive for chlamydia. What would this disease make her infant at risk for? deafness blindness neonatal laryngeal papillomas chicken pox
blindness
The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis? bloody stools poor suck reflex high-pitched cry meconium stools
bloody stools
A nurse is conducting a presentation for a group of pregnant women about measures to prevent toxoplasmosis. The nurse determines that additional teaching is needed when the group identifies which measure as preventive? washing raw fruits and vegetables before eating them cooking all meat to an internal temperature of 125° F (52° C) wearing gardening gloves when working in the soil avoiding contact with a cat's litter box
cooking all meat to an internal temperature of 125° F (52° C)
A nurse is preparing a presentation for a group of young adult pregnant women about common infections and their effect on pregnancy. When describing the infections, which infection would the nurse include as the most common congenital and perinatal viral infection in the world? rubella hepatitis B cytomegalovirus parvovirus B19
cytomegalovirus
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? cleft palate esophageal atresia cleft lip coarctation of the aorta
esophageal atresia
The nurse observes a newborn experiencing coughing, choking, and unexplained cyanosis during feeding. These are classic signs of what condition? esophageal atresia intestinal obstruction cystic fibrosis ankyloglossia
esophageal atresia
The nurse is assessing a newborn suspected of having meconium aspiration syndrome. What sign or symptom would be most suggestive of this condition? high-pitched, shrill cry bile-stained emesis intermittent tachypnea expiratory grunting
expiratory grunting
A nurse is conducting a presentation about prenatal care and preexisting maternal conditions. When discussing the various risks to the mother and infant, the nurse would include information about which condition as the leading cause of intellectual disability in the United States? fetal alcohol spectrum disorder genetic anomalies maternal drug addiction pregnancy category X medications
fetal alcohol spectrum disorder
The newborn nursery nurse suspects a newborn of having neonatal abstinence syndrome. What assessment findings would most correlate with the diagnosis? frequent yawning and sneezing vigorous rooting and feeding positive Babinski and Moro reflexes cyanotic discoloration of the hands and feet
frequent yawning and sneezing
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection? syphilis Candida albicans gonorrhea human immunodeficiency virus
gonorrhea
The neonatal nurse is admitting a 37 weeks' gestation infant of a mother with poorly controlled gestational diabetes. Which laboratory test results would the nurse expect to find? Select all that apply. hypocalcemia hypermagnesemia polycythemia hypobilirubinemia hypoglycemia
hypocalcemia polycythemia hypoglycemia
A nurse assisting in a birth notices that the amniotic fluid is stained greenish black as the baby is being born. Which intervention should the nurse implement as a result of this finding? intubation and suctioning of the trachea administration of oxygen via a bag and mask gently shaking the infant flicking the sole of the infant's foot
intubation and suctioning of the trachea
Which symptom would most accurately indicate that a newborn has experienced meconium aspiration during the birth process? bluish skin discoloration listlessness or lethargy stained umbilical cord and skin meconium stained fluids followed by tachypnea
meconium stained fluids followed by tachypnea
A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: amniotic fluid. placenta. birth canal. breast milk.
placenta.
A nurse is providing preoperative care to a female newborn client with the congenital abnormality myelomeningocele. Which intervention is the priority? preventing infection promoting newborn nutrition preserving newborn GI function maximizing newborn motor function
preventing infection
Which assessment finding would best validate a problem in a small-for-gestational age newborn secondary to meconium in the amniotic fluid? total bilirubin level of 15 respiratory rate of 60 to 70 bpm heart rate of 162 bpm hematocrit of 44%
respiratory rate of 60 to 70 bpm
A nurse is conducting a presentation at a community health center about congenital malformations. The nurse describes that some common congenital malformations can occur and are recognized to be caused by multiple genetic and environmental factors. Which example would the nurse most likely cite? spina bifida cystic fibrosis color blindness hemophilia
spina bifida
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 the child of a teenage client who used marijuana through her pregnancy to cope with stress the newborn of a client addicted to heroin and in the methadone maintenance program the newborn of a client who used cocaine occasionally during her pregnancy
the child of a client who admits to drinking a liter of alcohol daily during the pregnancy
A nurse is caring for a pregnant client who is human immunodeficiency virus (HIV) positive. What is a priority issue that the nurse should discuss with the client? the client's relationship with the spouse the amount of physical contact that should occur with the infant the client's plan for future pregnancies the need for the client to avoid breastfeeding
the need for the client to avoid breastfeeding
A pregnant woman in her second trimester comes to the prenatal clinic for a routine visit. She reports that she has a new kitten. The nurse would have the woman evaluated for which infection? cytomegalovirus parvovirus B19 toxoplasmosis herpes simplex virus
toxoplasmosis
A nurse is teaching the mother of a newborn experiencing cocaine withdrawal about caring for the neonate at home. The mother stopped using cocaine near the end of her pregnancy. The nurse determines that additional teaching is needed when the mother identifies which action as appropriate for her newborn? wrapping the newborn snugly in a blanket waking the newborn every hour checking the newborn's fontanels offering a pacifier
waking the newborn every hour
A nurse is teaching the mother of a newborn experiencing cocaine withdrawal about caring for the neonate at home. The mother stopped using cocaine near the end of her pregnancy. The nurse determines that additional teaching is needed when the mother identifies which action as appropriate for her newborn? wrapping the newborn snugly in a blanket waking the newborn every hour checking the newborn's fontanels offering a pacifier
waking the newborn every hour
A pregnant client has tested positive for hepatitis B virus. When discussing the situation with the client, the nurse explains that her infant should be vaccinated with an initial HBV vaccine dose at which time? within 12 hours of birth within 24 hours of birth within 36 hours of birth within 48 hours of birth
within 12 hours of birth
