newborn questions

A new mother is bottle-feeding her newborn for the first time. The mother expresses concern to the nurse that the newborn is only drinking ½ ounce. The nurse can best answer the mother's concerns by stating: "Don't worry; the baby will drink more when he gets hungry." "Yes, he should be drinking more; let me try to feed him." "His stomach just holds about ½ ounce right now. By the end of the week it will have expanded and he will be drinking more." "Babies don't drink much at the first feeding, they are tired."

"His stomach just holds about ½ ounce right now. By the end of the week it will have expanded and he will be drinking more." - At birth the stomach capacity of a newborn is about 6 mL but will expand to about 90 mL within the first week.

A new mother expresses concern that her 18-hour-old son has only voided once since birth. The nurse's best response is: "We are aware of that and have notified the pediatrician." "How is he eating?" "Newborns don't void frequently for the first 2 days, but by the fourth day it will be about six times a day." "This may be a concern, so we will continue to monitor his voidings for the next 12 hours."

"Newborns don't void frequently for the first 2 days, but by the fourth day it will be about six times a day." - It is appropriate to teach the mother about newborn characteristics. Newborns may not void at all for the first 24 hours; however, most will void once in the first 12 hours. Only one or two voidings may occur during the first 2 days of life. The infant voids four to six times a day by the fourth day.

A preterm infant is on intake and output. During the past 8 hours, the infant had used three diapers that weighed 5 g before putting them on and 6, 9, and 12 g on removal. In addition, the lab had drawn 3 mL of blood for testing. There was no emesis or stools. The output should be recorded as 15 mL. 12 mL. 3 mL. unable to determine with information given.

15 mL. - Output from regurgitation, drainage tubes, stools, urine, and blood taken for laboratory tests should be included in a preterm infant's output record. The urine is measured by weighing the diaper before being used and after removal from the infant. A difference of 1 g is equivalent to 1 mL of urine (12 mL urine + 3 mL blood = 15 mL total).

A newborn weighed 7 lb, 8 oz at birth. What is the least this newborn can weigh and still be within the guidelines of weight loss during the first 7 to 10 days of life? 7 lb, 4 oz 7 lb 6 lb, 12 oz 6 lb, 8 oz

6 lb, 12 oz - A newborn can lose up to 10% of its birth weight during the first 7 to 10 days of life. The 7 lb, 8 oz newborn can lose 12 oz and still be within the guidelines. The lowest weight would be 6 lb, 12 oz.

On which infant would the nurse notice the greater amounts of lanugo? A postterm, light-skinned infant A preterm, light-skinned infant A post-term, dark-skinned infant A preterm, dark-skinned infant

A preterm, dark-skinned infant - Lanugo is fine hair that covers the fetus during intrauterine life. As the fetus nears term, the lanugo becomes thinner. Dark-skinned infants often have more lanugo than infants with lighter coloring and their darker hair is more visible.

Parents often have questions about pacifiers. Select all the following that is correct information to teach the parents. (Select all that apply.) All infants have an urge to suck. Pacifiers will cause malocclusion of the teeth only if they are used after the secondary teeth begin to erupt. Pacifiers should be replaced every 1 or 2 months. Pacifiers can be placed on a string around the infant's neck. If the infant uses thumb sucking instead of a pacifier, it will be easier to give up as the child grows.

All infants have an urge to suck. Pacifiers will cause malocclusion of the teeth only if they are used after the secondary teeth begin to erupt. Pacifiers should be replaced every 1 or 2 months. - All infants have a need to suck, although the amount of sucking needed varies among infants. The AAP recommends the use of pacifiers for sleep to help prevent SIDS. Use of pacifiers should be delayed until 1 month in breastfeeding infants. Use of a pacifier for part of the day, not using an upside down pacifier, and stopping sucking on a pacifier before the secondary teeth begin to erupt is unlikely to cause malocclusion. Pacifiers should be replaced every month or two and should never be placed on a string around the infant's neck. Pacifiers are easier to give up than thumb sucking because they are not as easily accessible as a thumb.

The nurse's initial action when caring for an infant with a slightly decreased temperature is to A. Notify the physician immediately. B. Wrap the infant in two warmed blankets and place a cap on his or her head. C. Tell the mother that the infant must be kept in the nursery and observed for the next 4 hours. D. Change the formula because this is a sign of formula intolerance.

B. Wrap the infant in two warmed blankets and place a cap on his or her head.

A newborn's pulse should be assessed using which pulse point? Brachial Radial Apical Femoral

Apical - The brachial, radial, and femoral pulses may be felt but are difficult to count. The apical pulse can be assessed, not only for the heart rate but also for the heart sounds. The nurse should assess for arrhythmias, murmurs, and other abnormal sounds.

If the nurse notices one artery and one vein in the cord during the initial assessment of a newborn, which one of the following actions should be carried out? Assess for other anomalies. Document this as a normal finding. The finding is not normal; however, it has no significance.

Assess for other anomalies. - A two-vessel cord is associated with chromosomal, renal, and gastrointestinal defects. Therefore the newborn should be assessed for other anomalies.

A newborn is 2 days old and scheduled for discharge. The hospital stay has been uneventful. The nurse is preparing to assess the newborn's temperature. Which method would be the best choice? Tympanic Rectal Axillary oral

Axillary - Axillary temperature is the most common method of taking a newborn's temperature because it is safer than taking a rectal temperature. Rectal temperatures have the risk of irritating or damaging the rectum. Tympanic thermometers are less accurate in newborns. Some agencies use temporal artery thermometers.

Plantar creases need to be evaluated within a few hours of birth because A. The newborn has to be footprinted. B. As the skin dries, the creases will become more prominent. C. Heel sticks may be required. D. Creases will be less prominent after 24 hours.

B. As the skin dries, the creases will become more prominent.

Based on the nurse's knowledge of the extrusion reflex, the nurse informs new parents to feed their baby solids when he or she A. Is about 2 weeks old and is still not sleeping through the night. B. No longer pushes their tongue against anything that touches it, usually at about 4 to 6 months of age. C. Is nursing or drinking too much breast milk or formula. D. Has regained weight loss after birth.

B. No longer pushes their tongue against anything that touches it, usually at about 4 to 6 months of age.

Which one(s) of the following tests assess for developmental hip dysplasia and instability? (Select all that apply.) Barlow's test Ortolani's test Bending the knees and comparing height Comparing gluteal creases Comparing leg lengths Ritgen's maneuver

Barlow's test Ortolani's test Bending the knees and comparing height Comparing gluteal creases Comparing leg lengths - In the Barlow test, adduct the hips, and apply gentle pressure down and back with the thumbs. In hip dysplasia the examiner can feel the femoral head move out of the acetabulum. In the Ortolani test, abduct the thighs, and apply gentle pressure forward over the greater trochanter. A "clunking" sensation indicates a dislocated femoral head moving into the acetabulum. The symmetry of gluteal and thigh creases are noted; the knees are bent and the height compared, and the equality of leg lengths are noted. The Ritgen maneuver is used during birth to extend the head and protect the perineum.

A newborn has been assessed as high risk for hypoglycemia. The nurse assesses the newborn's blood glucose and it is 38 mg/dL. What should be the nurse's next action? Notify the pediatrician. Feed the newborn approximately 1 ounce of glucose water. Keep the newborn in the nursery and reassess the glucose in 30 minutes. Breast-feed or bottle-feed formula to the newborn.

Breast-feed or bottle-feed formula to the newborn. - Glucose water alone is not recommended for newborns because the rapid rise in glucose results in increased insulin production, causing a further drop in blood glucose. Milk provides a longer lasting supply of glucose. Action should be taken prior to notifying the pediatrician or health care provider.

The nurse is assessing a newborn for gestational age. Which technique should be used when performing the scarf sign? A. Fold the lower leg against the abdomen, and straighten out the leg. Measure the angle at the popliteal space. B. Bring the arm across the body to the opposite side, and note the position of the elbow in relation to the midline. C. Pull the foot straight up alongside the body toward the ear. Note the position of the foot in relation to the head. D. Bend the hand at the wrist until the palm is as flat against the forearm as possible with gentle pressure. Measure the angle between the palm and forearm.

Bring the arm across the body to the opposite side, and note the position of the elbow in relation to the midline.

There are many complications that can occur with preterm infants. Select those listed that may be directly related to the use of high oxygen content during the acute phases of care. (Select all that apply.) Bronchopulmonary dysplasia Periventricular-intraventricular hemorrhage Retinopathy of prematurity Necrotizing enterocolitis

Bronchopulmonary dysplasia Retinopathy of prematurity - Common complications of preterm birth are respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity, necrotizing enterocolitis, and short bowel syndrome. Bronchopulmonary dysplasia (BPD) is a chronic condition in which damage to the infant's lungs requires prolonged dependence on supplemental oxygen. Intraventricular hemorrhage is associated with increased or decreased blood pressure, asphyxia or respiratory distress requiring mechanical ventilation, and increased or fluctuating cerebral blood flow. The exact cause of retinopathy of prematurity is unknown, but high levels of oxygen in the blood are a risk factor. Although the exact causes of necrotizing enterocolitis are unknown, immaturity of the intestines is a major factor in preterm infants. Previous hypoxia of the intestines may be a causative factor.

A first-time father is concerned that his 3-day-old daughter's skin looks "yellow." In the nurse's explanation of physiologic jaundice, which point should be included? A. Physiologic jaundice occurs during the first 24 hours of life. B. Physiologic jaundice is caused by blood incompatibilities between the mother and infant blood types. C. The bilirubin levels of physiologic jaundice peak at 5 to 7 mg/dL between the second and fourth days of life. D. This condition is also known as breast milk jaundice.

C. The bilirubin levels of physiologic jaundice peak at 5 to 7 mg/dL between the second and fourth days of life.

The new parents of their first child tell the nurse that the crib they will be using is the same crib that the father used as a baby. The nurse should teach them which of the following safety considerations to assess in this older crib? (Select all that apply.) Crib slats must be no more than 5 inches apart. Corner posts should not extend more than 1/16th inch above the end panel. The crib mattress should fit snugly, with less than two fingers able to fit into the space between the mattress and sides of the crib. Check that all nuts, screws, bolts, and hooks are tight.

Corner posts should not extend more than 1/16th inch above the end panel. The crib mattress should fit snugly, with less than two fingers able to fit into the space between the mattress and sides of the crib. Check that all nuts, screws, bolts, and hooks are tight. - The crib mattress should be firm and fit snugly, there should be no more than 2 3/8 inches between crib slats, no corner posts over 1/16th inch high so the baby's clothing cannot catch, no cutouts in the headboard or foot board, have no missing, loose, broken or improperly installed screws or brackets, and the paint should be lead free.

How can the nurse help the mother who is breastfeeding and has engorged breasts? A. Suggest that she switch to bottled formula just for today. B. Assist her to remove her bra, making her more comfortable. C. Apply heat to her breasts between feeding and cold to the breasts just before feedings. D. Instruct and assist the mother to massage her breasts.

D. Instruct and assist the mother to massage her breasts. - Massage of the breasts causes release of oxytocin and increases the speed of milk release

Select which one(s) of the following that assist the newborn to initiate respirations. (Select all that apply.) Decrease in oxygen Decrease in carbon dioxide Release of pressure on the chest at birth Rise in environmental temperature at birth

Decrease in oxygen Release of pressure on the chest at birth - Breathing is initiated by chemical, mechanical, thermal, and sensory factors that stimulate the respiratory center in the medulla and trigger respirations. A decrease in the partial pressure of oxygen (PO2) and pH and an increase in the partial pressure of carbon dioxide (PCO2) in the blood cause impulses from these receptors to stimulate the respiratory center in the medulla. When the pressure against the chest is released at birth, recoil of the chest draws a small amount of air into the lungs and helps remove some of the viscous fluid in the airways. The temperature change that occurs with birth from the warm intrauterine environment to the cooler room air stimulates the initiation of respirations. The stimulation of the light, sound, smell, and pain at delivery may also aid in initiating respirations.

When giving an initial bath to a newborn, which one(s) of the following techniques are appropriate? (Select all that apply.) Do not bathe the infant until the newborn's temperature is stable. Wash all the vernix and blood off of the skin and hair. Gloves should be worn. The bath should be performed quickly and the infant dried. After the bath, the infant may be wrapped in blankets and placed in an open crib.

Do not bathe the infant until the newborn's temperature is stable. Gloves should be worn. The bath should be performed quickly and the infant dried. - Gloves should be worn when handling a newborn until the initial bath has been given. A sponge bath is given with the infant under the radiant warmer to help maintain the infant's temperature. The bath should be performed quickly and the infant thoroughly dried to prevent heat loss by evaporation. While shampooing the hair, the nurse combs through it to remove dried blood. Vernix need not be removed. Combing the infant's hair hastens drying. The infant remains under the radiant warmer until the hair is dry and the temperature returns to the previous level. The infant is dressed and wrapped in two warm blankets, and a warm cap is placed on the infant's head before he or she is removed from the radiant warmer. The temperature should be rechecked within 1 hour to ensure that the infant is maintaining thermoregulation adequately.

Vitamin K is given to the newborn for which one of the following reasons? Reduce bilirubin levels. Increase the production or red blood cells. Enhance the ability of blood to clot. Stimulate the formation of surfactant.

Enhance the ability of blood to clot. - Newborns have a deficiency of vitamin K until intestinal bacteria that produce the vitamin are formed. Vitamin K is required for the production of certain clotting factors.

Which nutrients are added to formula to make it closer to the composition of breast milk? (Select all that apply.) Lactose Fatty acids Vitamin C Vitamin D Iron

Fatty acids Vitamin C Vitamin D Iron - Modified cow's milk is the source of most commercial formulas. Manufacturers specifically formulate it for infants by reducing protein content to decrease renal solute load. Saturated fat is removed and replaced with vegetable fats. Vitamins and other nutrients are added to simulate the contents of breast milk. Formula with added iron should be used for all infants receiving formula.

When inserting a nasogastric feeding tube into a preterm infant, which of the following procedures is correct? Determine the length of catheter to insert by measuring from the mouth to the ear to the xiphoid process. Give the infant a pacifier prior to insertion. Insert 10 mL of air through the tube after insertion while listening over the stomach with a stethoscope. Don sterile gloves.

Give the infant a pacifier prior to insertion. - Nonnutritive sucking helps the tube pass more easily. The length of the catheter for a nasogastric tube is measured from the tip of the nose to the base of the ear to halfway between the xiphoid process and the umbilicus. Determine the pH of the aspirate to confirm stomach contents. Gloves are important for this procedure because of the tendency of the infant to regurgitate. However, sterile gloves are not required.

Pain assessment is an important nursing intervention for the preterm infant. Select all of the appropriate assessment tools to determine pain in the preterm infant. (Select all that apply.) Heart rate "Cry face" Oxygen saturation Brow bulge Increased flexion of the arms and legs Eye squeeze Nasolabial furrow

Heart rate "Cry face" Oxygen saturation Brow bulge Eye squeeze Nasolabial furrow - Pain assessment is performed whenever vital signs are taken. Assessment tools are available to evaluate physiologic and behavioral responses to pain in term and preterm infants. Some such as the Premature Infant Pain Profile (PIPP) are designed for both term and preterm infants. This tool assesses gestational age and behavior states, heart rate, oxygen saturation, brow bulge, eye squeeze, and nasolabial furrow (lines from the edge of the nostrils to beyond the corners of the mouth) to assign a pain score.

When caring for a newborn the nurse must be alert for signs of cold stress, which would include which one of the following? Decreased activity level Increased respiratory rate Hyperglycemia Shivering

Increased respiratory rate - Additional signs of cold stress include increased activity level, crying, basal metabolic rate (BMR), and heat production. Hypoglycemia occurs as glucose stores are depleted. Newborns are unable to shiver as a means to increase heat production; they increase their activity level instead.

A nursing student is asked to administer vitamin K to a newborn. The student is aware that vitamin K must be administered within 1 hour of birth but is not sure about which route is appropriate. Vitamin K should be given by which route to this newborn? Oral Subcutaneous Intravascular Intramuscular

Intramuscular - Oral vitamin K has been used for newborn prophylaxis. It is not recommended at this time because it has not been shown to be as effective as parenteral vitamin K. The appropriate route is intramuscular. It is usually given within the first hour after birth but can be delayed until the infant has finished breastfeeding at birth.

Select which one(s) of the following situations that could accelerate fetal lung maturation. (Select all that apply.) Intrauterine growth restriction Maternal hypertension Prolonged rupture of membranes Maternal diabetes Maternal administration of steroids

Intrauterine growth restriction Maternal hypertension Prolonged rupture of membranes Maternal administration of steroids

Which one(s) of the following are true concerning colic in an infant? (Select all that apply.) It is characterized by irritable crying for no obvious reason for 3 hours/day or longer. It occurs only in formula-fed infants. Infants will draw their knees onto the abdomen. One cause may be an allergic reaction to the type of formula used.

It is characterized by irritable crying for no obvious reason for 3 hours/day or longer Infants will draw their knees onto the abdomen. One cause may be an allergic reaction to the type of formula used. - Colic is described as inconsolable paroxysmal crying periods that occur daily for several days a week. It can last several months. Both breast fed and formula fed infants can have colic. Infants with colic cry as though in pain and draw their knees onto the abdomen, rigidly extend the legs, and may pass flatus. The cause is unknown but allergies to cow's milk or substances in the breastfeeding mother's diet may be a factor.

A new mother wants to nurse her infant only 5 minutes at each breast to avoid sore nipples. Choose the appropriate teaching. Limiting time at the breast during the early days can lessen trauma to the nipples and allow them time to toughen. Limiting time at the breast can cause frequent infant hunger because the baby does not receive richer milk. Limiting time at the breast does not reduce sore nipples but does reduce engorgement. Limiting time at the breast delays the transition from colostrum to transitional and true milk.

Limiting time at the breast can cause frequent infant hunger because the baby does not receive richer milk - When feedings are too short, infants receive little or no colostrum or milk. It may take as long as 5 minutes for the milk-ejection reflex to occur during the early days after birth. The infant will receive mostly foremilk with these short feedings, which has a higher fluid content. The hindmilk has a higher fat content.

Which one(s) of the following factors lead to the production of excessive amounts of bilirubin during the first week of life? (Select all that apply.) Longer red blood cell life Liver immaturity Sterile intestines Trauma during birth

Liver immaturity Sterile intestines Trauma during birth - General Feedback: A number of factors lead to the production of excessive amounts of bilirubin or interfere with the normal process of conjugation: excess production of bilirubin; fetal RBCs break down more quickly than adult erythrocytes; neonate erythrocytes are more fragile and susceptible to injury than those in an adult; at birth the intestines of the newborn are sterile and conjugated bilirubin cannot be reduced to urobilinogen or stercobilin for excretion without the action of intestinal flora; the liver is immature. Delayed feeding and birth trauma are other factors.

A mother expresses concern to the nurse that her new baby has blue eyes. She states, "Everyone in my family and my husband's family has brown eyes." The nurse should base the response on which of the following? Blue eyes are recessive; therefore it is impossible for this baby to have two brown-eyed parents. Brown eyes are dominant, so the baby may have blue eyes. Most babies have gray-blue eyes at birth.

Most babies have gray-blue eyes at birth. - The iris of the eye is dark gray, blue, or brown at birth but may change color by 6 months of age.

Which method is correct for assessing the fontanels of a newborn? Newborn lying supine and at rest Newborn crying with head slightly elevated Newborn quiet and head slightly elevated Newborn lying supine and crying

Newborn quiet and head slightly elevated - When the anterior fontanel is palpated, the infant's head should be elevated for accurate assessment. The fontanel should be palpated when the newborn is quiet because vigorous crying may cause it to protrude.

The nurse should teach the different ways new mothers can assess if the newborn is receiving sufficient milk. Select all that are appropriate to assess. (Select all that apply.) Nutritive suckling Number of wet diapers Number of stools Length of time newborn is attached to the breast

Nutritive suckling Number of wet diapers Number of stools - Ways to determine if the infant is receiving enough milk include noting nutritive suckling (sucking) during which the infant sucks with smooth, continuous movements with occasional pauses to rest. The infant may swallow after each suck or may suck several times before swallowing. Counting the number of wet and soiled diapers helps determine whether the infant is receiving enough milk.

Which one(s) of the following newborns are at risk for hypoglycemia? (Select all that apply.) Premature Postmature Appropriate-for-gestational age Cold stressed Mother is a diabetic Mother was treated with terbutaline

Premature Postmature Cold stressed Mother is a diabetic Mother was treated with terbutaline - Risk factors for hypoglycemia include prematurity, postmaturity, late preterm infant, intrauterine growth restriction, large or small for gestational age, asphyxia, problems at birth, cold stress, maternal diabetes, and maternal intake of terbutaline.

Which one(s) of the newborns listed are at high risk for hypoglycemia? (Select all that apply.) Preterm Small-for-gestational age Postterm Large-for-gestational age Average-for-gestational age Infants with infections Infants with cold stress

Preterm Small-for-gestational age Postterm Large-for-gestational age Infants with infections Infants with cold stress - Newborns at increased risk for hypoglycemia include preterm infants, the small-for-gestational-age infant, postterm, large-for-gestational-age infants and those with diabetic mothers. Infants exposed to stressors such as asphyxia or infection and cold-stressed infants are at risk for hypoglycemia.

On discharge from the birthing center the nurse should assess the type of car seat the new parents are using. For a newborn, the seat should be No car seat is necessary for infants younger than 3 months of age; they can be placed in an adult's lap. Rear-facing in the back seat of the car. Front-facing. Sitting straight up.

Rear-facing in the back seat of the car. - Infants who are younger than 1 year old must ride in a rear-facing seat to protect them. Car restraints are required in all 50 states and Canada for all infants and young children. The seat should recline at approximately a 45-degree angle for an infant.

Reports and studies have shown that infants who are breast-fed for even short periods have a decreased incidence of infection. Select all the infections that may be prevented. (Select all that apply.) Respiratory Cord Gastrointestinal Ear Eye

Respiratory Gastrointestinal Ear - Infants who are not breastfed have an increased incidence of respiratory, GI, and urinary tract infections, otitis media, asthma, diabetes, some cancers, obesity, sudden infant death syndrome (SIDS), and necrotizing enterocolitis.

Which reflex normally present in full-term newborns is most helpful with the latching-on process? Moro Rooting Babinski Tonic neck

Rooting - By brushing the nipple of the breast around the infant's month, the infant will turn toward the stimulus and open the mouth. This is the rooting reflex. The Moro reflex occurs when the infant is startled and reacts. The Babinski reflex is the flaring of the toes with stimulation. The tonic neck reflex is the position of the arms, with the head turned to the side.

If a nurse desires to promote infant-parent attachment, the best time to have the parents spend time with the infant is when the infant is going through which stage? Period of sleep Second period of reactivity Quiet sleep state Active sleep state

Second period of reactivity - During the second period of reactivity, the infant is alert and interested in feeding. It is a good time for the parents to get to know the infant. During the period of sleep, the quiet sleep state, and active sleep state, the infant is asleep and will not interact with the parents.

Parent teaching is an important aspect of care of the newborn and family. Which one(s) of the following are appropriate teaching techniques during the first 2 days after birth? (Select all that apply.) Setting priorities Giving written material to the family to reinforce learning Using audiovisual materials to reinforce learning Modeling behavior for the new family Teaching as much as possible in one setting to allow more rest time Including the father Being sensitive to cultural differences

Setting priorities Giving written material to the family to reinforce learning Using audiovisual materials to reinforce learning Modeling behavior for the new family Including the father - To effectively teach parents, priorities should be set and a teaching plan developed. Use a variety of teaching methods to increase effectiveness, make the subject more interesting, and increase retention of the material. Use verbal and written methods, demonstrations, and return demonstrations. Parents often learn best by seeing skills performed correctly and then practicing them while the nurse gives suggestions. To increase the likelihood that parents will follow instructions, explain the rationale for each point made during teaching sessions. Use audiovisual materials, including pamphlets, magazines, television programs, and Internet sites. Highlight the most important areas in written material, discuss the programs with the new parents, and clarify information, as necessary, to reinforce learning.

Throughout the assessment, the nurse must be alert for signs of respiratory distress. Select all of the following that are signs of respiratory distress. (Select all that apply.) Respiratory rate of 55 breaths per minute Substernal retractions Nasal constriction Cyanosis of the hands and feet Grunting Seesaw respirations

Substernal retractions Grunting Seesaw respirations - Signs of respiratory distress include tachypnea, retractions, flaring, cyanosis, grunting, seesawing, apneic periods, and asymmetry of chest movements.

Select all the causes of decreased milk supply in a lactating mother. (Select all that apply.) Supplementation with formula Multivitamin use Feedings that are too short Chocolate Some oral contraceptives Certain foods

Supplementation with formula Feedings that are too short Some oral contraceptives - Common causes of decreased milk supply include ineffective suckling by the infant, feedings that are infrequent or too short, feeding formula, maternal fatigue, low maternal thyroid function, preterm or late preterm infants, and some medications including oral contraceptives containing estrogen.

Postterm infants should be assessed for anticipated complications. The complications that are associated with postterm infants are which of the following? (Select all that apply.) Hyperglycemia. Temperature instability. Hyperbilirubinemia. Polycythemia. Respiratory problems.

Temperature instability. Hyperbilirubinemia. Polycythemia. Respiratory problems. - Respiratory problems may necessitate continued assessment and care. Infants with any indications of postmaturity should be tested for hypoglycemia soon after birth and again an hour later or according to hospital policy. Temperature regulation may be poor because fat stores were used for nourishment in utero. Polycythemia, resulting from hypoxia before birth, increases the risk of hyperbilirubinemia.

Which of the following are appropriate goals for a newborn for the first 2 to 3 days of life? (Select all that apply.) The infant will maintain a patent airway as evidenced by a respiratory rate within the range of 30 to 60 breaths per minute. The infant will show no signs of respiratory distress. The infant will maintain an axillary temperature between 34.5 and 35.5°C. The infant will show no signs of hypoglycemia.

The infant will maintain a patent airway as evidenced by a respiratory rate within the range of 30 to 60 breaths per minute. The infant will show no signs of respiratory distress. The infant will show no signs of hypoglycemia. - Goals for a newborn are that the infant will maintain a patent airway, a respiratory rate of 30 to 60 breaths per minute with no respiratory distress, an axillary temperature between 36.5 and 37.5°C, will feed well and show no signs of hypoglycemia.

When suctioning a newborn, which technique is correct? Use of a suction catheter attached to low suction is appropriate for nasal suction. The bulb syringe should be used to suction the mouth only. The mouth should be suctioned first and then the nose, with the bulb syringe. The bulb syringe is placed inside the mouth and then depressed.

The mouth should be suctioned first and then the nose, with the bulb syringe. - The mouth should be suctioned first because the infant may gasp when the nose is suctioned, causing aspiration of mucus or fluid in the mouth. Then gently suction the nose only if necessary. A bulb syringe should be used for infant suctioning unless deeper suctioning is necessary. The bulb syringe should be depressed first and then put inside the mouth.

Techniques the nurse can use to prevent heat loss in a newborn include which one(s) of the following? (Select all that apply.) Turning on the radiant warmer before the infant's birth Drying the wet infant quickly Changing wet linens with warm dry linens Covering the infant's head with a cap after placing it under the radiant warmer

Turning on the radiant warmer before the infant's birth Drying the wet infant quickly Changing wet linens with warm dry linens - The radiant warmer should be turned on and be warm before placing a newborn in the warmer. Dry the wet infant quickly with warm towels to prevent heat loss by evaporation. Pay particular attention to drying the hair because the head has a large surface area and hair that remains damp increases heat loss. Remove towels or blankets as soon as they become wet and replace them with dry, warmed linens. Cover the head with a prewarmed cap when the infant is not under a radiant warmer. Do not use a hat when the infant is under the warmer because it interferes with transfer of heat to the infant's head.

A newborn's mother has tested positive for hepatitis B. When should the newborn receive the hepatitis B vaccine? By 2 months Within 12 hours Within 1 week By 6 months

Within 12 hours - For infants of hepatitis B-positive mothers, the vaccine is given within 12 hours of birth and then at 1 to 2 months and 6 months. Hepatitis B immune globulin is also given within 12 hours of birth.

The most important reason to protect the preterm infant from cold stress is that a. It could make respiratory distress syndrome worse. b. Shivering to produce heat may use up too many calories. c. A low temperature may make the infant less able to digest nutrients. d. Cold decreases circulation to the extremities.

a. It could make respiratory distress syndrome worse. - Cold stress may interfere with the production of surfactant, making respiratory distress syndrome worse.

Breast milk is produced in the ____________ of the breasts.

alveoli

A newborn of a diabetic mother has been classified as large-for-gestational age. The father is at the nursery window and expresses concern, stating, "The nurses are doing too much to my baby. I think they are just trying to increase the amount of money we will have to pay. There is nothing wrong with my baby; he is too chubby and pink. He looks healthy." The nurse's response to this father should be based on the knowledge that infants of diabetic mothers often have major renal complications that need assessing. are at risk for hypoglycemia and polycythemia. are at high risk for transient tachypnea of newborn. are assessed with the same procedures for all newborns.

are at risk for hypoglycemia and polycythemia. - Large-for-gestational age newborns are at high risk for hypoglycemia and need to be assessed frequently. Infants of diabetic mothers often have a plethoric coloration that is caused by polycythemia and needs assessing. In some cultures, an infant who is chubby and pink is considered healthy.

A woman is admitted to the antepartal unit with a diagnosis of a partial abruptio placentae. Part of the plan of care for this woman should be to assess the fetus for signs of infection. asphyxia. prematurity. postmaturity.

asphyxia. - Asphyxia is a lack of oxygen and an increase of carbon dioxide in the blood. It may occur in utero and can be caused by abruptio placentae when there is a decrease in fetal blood flow.

A newborn has just been circumcised. The nurse's first priority would be to assess the penis for bleeding. apply a lubricant such as Vaseline or KY jelly to the site at every diaper change. note time of first voiding after the procedure. take the newborn to his mother for comfort and feeding.

assess the penis for bleeding. - Although options B, C, and D are appropriate actions, observation for bleeding is the priority.

When seeing a new mother on her 6-week postpartum checkup, the nurse questions her about feeding techniques with the newborn. The mother confesses that because of lack of money she has been diluting the powdered formula with more water so it lasts longer. The nurse can best assist this mother by explaining that diluting the formula more is harmful to the newborn. allowing the mother to express her frustrations. assisting the mother to find financial assistance for purchasing formula. teaching the mother that she can start to breastfeed the newborn and that would save some money.

assisting the mother to find financial assistance for purchasing formula. - Improper dilution of the formula may cause undernutrition in the newborn. However, that is not the best help for the mother at this point; she is in need of services that will help her purchase the formula needed. She is not able to establish breastfeeding at this time.

A new mother wants to breastfeed but also wants to feed her infant formula occasionally. The nurse should teach her to avoid using any bottles the first month to establish her milk supply. make a clear choice to feed by one method or the other to avoid nipple confusion. limit formula feeding to once each day until her milk supply is well established. alternate formula and nursing to allow the infant to become accustomed to both.

avoid using any bottles the first month to establish her milk supply. - If the mother chooses combination feeding, it is best to delay giving formula until lactation has been well established at 3 to 4 weeks of age. Giving formula to breastfeeding infants leads to a decrease in breastfeeding frequency and milk production, making successful breastfeeding less likely.

The nurse should assess all newborns for jaundice every 8 to 12 hours. This is done by ordering the appropriate blood work. monitoring the color and consistency of the stools. monitoring intake and output. blanching the newborn's skin.

blanching the newborn's skin. - Assess for jaundice by blanching the infant's skin on the nose or sternum at least every 8 to 12 hours. Blood work is ordered if changes in color are seen.

A large-for-gestational age infant is born outside of the hospital. The infant is brought to the emergency department 5 hours after birth with tremors, diaphoresis, and respirations of 75 breaths per minute. The nurse's next action should be to assess the temperature. cardiac status. bilirubin level. blood glucose level.

blood glucose level. - Large-for-gestational age infants are at high risk for low blood glucose levels. The typical symptoms of hypoglycemia are tremors, diaphoresis, and rapid respirations.

An infant born at 35 weeks of gestation and weighs 4 lb, 3 oz would be classified as preterm, low birth weight. preterm, very low birth weight, with fetal growth restriction. preterm, extremely low birth weight. full term, low birth weight.

preterm, low birth weight. - A preterm infant is one born before the beginning of the 38th week of gestation. A low-birth-weight infant refers to infants weighing 2500 g (5 lb, 8 oz) or less at birth. A very low-birth-weight infant weighs 1500 g (3 lb, 5 oz) or less at birth. An extremely low-birth-weight infant weighs 1000 g (2 lb, 3 oz) or less at birth. Intrauterine growth restriction usually applies to a full-term infant who is smaller than normal.

A mother expresses concern about breastfeeding her newborn, who is receiving phototherapy for jaundice. The nurse should teach the mother that breastfeeding is discontinued during phototherapy, but she should pump her breasts. breastfeeding can continue after the newborn has been under the light for 12 hours. breastfeeding should continue and the newborn can be removed from the light to be fed. breastfeeding can continue after the bilirubin level decreases.

breastfeeding should continue and the newborn can be removed from the light to be fed. - Jaundice need not interfere with breastfeeding. Even when infants receive phototherapy, they usually can be removed from the lights for feeding or may be able to breastfeed with a bili blanket in place. Frequent breastfeeding during phototherapy will increase the number of stools, which aids in bilirubin excretion and provides adequate intake of protein and fluid.

The nurse notices a soft swollen area over the 1-day-old newborn's skull. It is approximately 3 × 2 cm and has clear edges that stop at the suture line. The nurse may document this finding as being caput succedaneum. cephalohematoma.

cephalohematoma. - Cephalohematoma does not cross the suture line; caput succedaneum will cross the suture line.

A mother who is breastfeeding puts ice packs on her breast 15 minutes before feeding to "relieve the pain." The nurse should teach the mother that this is an appropriate action. cold packs should not be used on the breasts of breastfeeding mothers. cold packs can be used after feeding to reduce pain. hot packs can be used before feeding to reduce pain.

cold packs can be used after feeding to reduce pain. - Cold packs can be used after feeding to reduce edema and pain. Heat can be applied just before feedings to increase vasodilation and milk flow; it will not decrease the pain.

The breast fluid secreted during pregnancy and the first week after childbirth is called ____________________.

colostrum

Before excretion of bilirubin can occur, it must be changed by the liver to a water-soluble form. This process is called ________________.

conjugation

A newborn who is 12 hours old is having body temperature instability and respiratory difficulties. A complete blood count was ordered and shows a decrease in total neutrophils and an increase in bands. A chest x-ray shows clear lungs. The nurse is aware that the next treatment for this newborn will probably be antibiotic therapy. cultures of blood and urine. respiratory therapy. phototherapy.

cultures of blood and urine. - Neonatal sepsis and respiratory distress syndrome have many of the same symptoms. To differentiate, lab tests are ordered. Sepsis will show a decreased total neutrophils and increased bands. X-rays will show clear lungs with sepsis. The next treatment will be cultures, and then antibiotic therapy will be started. Cultures should always be done before starting antibiotic therapy.

During a newborn's first assessment a few minutes after birth, the nurse notes moisture in the left lower lung field. The newborn is having no respiratory difficulty. The nurse's next action should be to suction the infant. administer oxygen. notify the pediatrician. document the findings and continue to monitor.

document the findings and continue to monitor. - Hearing sounds of moisture in the lungs during the first hour or two after birth is not unusual because fetal lung fluid has not been completely absorbed. If the abnormal sounds continue, they should be reported.

While observing a 3-hour-old newborn, the nurse counted respirations of 45 breaths per minute, irregular, with one episode of periodic breathing lasting 10 seconds. The newborn had no cyanosis during this time, no retractions, and no grunting. The nurse's next action is to notify the pediatrician. document the normal findings. administer oxygen. stimulate the newborn to cry.

document the normal findings. - The normal respiratory rate of a newborn is 30 to 60 breaths per minute. It is not unusual for a newborn to have periodic breathing episodes lasting 5 to 10 seconds. Apnea lasting longer than 20 seconds accompanied by cyanosis, heart rate changes, or other signs of difficult breathing is abnormal.

When assessing the heart rate of a sleeping 1-day-old newborn, the nurse counts a rate of 105 beats/min (bpm). The nurse's next action should be to notify the pediatrician. stimulate the newborn to cry. document this normal finding. reassess in 10 minutes.

document this normal finding. - The heart rate of a newborn should range between 120 and 160 beats per minute (bpm) with normal activity. It may elevate to 180 bpm when infants are crying or drop to as low as 100 bpm when they are in deep sleep.

At birth, which should the nurse do to prevent heat loss in the newborn? Dry the infant. Place the infant on a flat surface. Monitor the temperature. Rub the infant's back.

dry the infant - Evaporation occurs when wet surfaces are exposed to air. As the surfaces dry, heat is lost. At birth the infant loses heat when amniotic fluid on the skin evaporates. Drying the infant helps prevent excessive heat loss.

A small-for-gestational age infant was born. During the initial assessment, a nurse notes that the infant's body is in proportion and appears normally developed for the size. The nurse is aware that this infant's problem probably occurred early in the pregnancy. in the middle of the pregnancy. late in the pregnancy. during labor.

early in the pregnancy. - Symmetric growth restriction involves the entire body. It occurred early in the pregnancy. The infant's body is proportionate and appears normally developed. The total number of cells as well as the cell size decreases. These infants often are small throughout their lives.

The hormones that inhibit breast response to prolactin and prevent milk production are _______________, ________________, and ________________.

estrogen; progesterone; human chorionic somatomammotropin

The nurse helps a breastfeeding mother change the diaper of her 16-hour-old newborn after the first bowel movement. The mother expresses concern because the large amount of thick, sticky stool is dark green, almost black. She asks the nurse if something is wrong. The nurse should respond to this mother's concern by telling her not to worry because all breast-fed babies have this type of stool. explaining that the stool is called meconium and is expected for the first few bowel movements of all newborns. asking the mother what she ate at her last meal. suggesting that the mother ask her pediatrician to explain newborn stool patterns to her.

explaining that the stool is called meconium and is expected for the first few bowel movements of all newborns. - At this early age, this type of stool is typical of bottle- and breast-fed newborns. The mother's nutritional intake is not responsible for the appearance of meconium stool. The nurse is fully capable of and responsible for teaching a new mother about the characteristics of her newborn, including expected stool patterns.

A newborn's blood glucose reading is 38 mg/dL. The nurse should reassess in 30 minutes. feed the infant and reassess in 30 minutes. start an intravenous feeding of 10% glucose. notify the health care provider.

feed the infant and reassess in 30 minutes. - Normal blood glucose for the term infant during the first day of life is 40 to 60 mg/dL and 50 to 90 mg/dL thereafter. If the glucose reading is around 40 to 45 mg/dL, the infant is usually fed and the glucose is reassessed in 30 to 60 minutes.

During the initial assessment of a large-for-gestational age (LGA) infant, it is important that the nurse assess for complications that are common for this infant, such as congenital defects. fractures of the clavicle. thinning of the skin. decreased subcutaneous fat.

fractures of the clavicle. - The LGA infant is more likely to go through a longer labor, have injury during birth, or need a cesarean birth. Fractures of the clavicle or skull, damage to the brachial plexus or facial or phrenic nerves, cephalohematoma, and bruising occur more often in these infants than in those of normal size.

One important and simple measure that can be used to prevent infection in newborns is _____________.

hand washing

One reason that preterm infants are at higher risk for cold stress is the fact that they have a smaller surface area. have a decreased amount of brown fat. cannot nurse as effectively. cannot buffer the acids in the body as well.

have a decreased amount of brown fat. - The primary method of heat production in infants is the metabolism of brown fat to produce heat. Preterm infants may be born before stores of brown fat have accumulated.

Heat loss in a preterm infant is more significant than in a full-term infant. The nurse should assess for heat loss continually in a preterm infant. The first sign that the infant's temperature is low may be hyperglycemia. hypoglycemia. respiratory stability. increased flexion.

hypoglycemia - Hypoglycemia and respiratory distress may be the first signs that the infant's temperature is low. Other signs are poor feeding, lethargy, irritability, poor muscle tone, cool skin temperature, and mottled skin.

If the meatus is located on the underside of the penis, it is called _______________.

hypospadias

An infant of a diabetic mother has a total serum calcium level of 5 mg/dL. There is an order for calcium to be given intravenously. Before administering the calcium, the nurse should assess the respiratory rate. thyroid gland for enlargement. infant with a cardiac monitor. blood pressure.

infant with a cardiac monitor. - A cardiac monitor is necessary when IV calcium is given to a newborn because of the risk of bradycardia during administration.

The hematocrit for a newborn is 72%. The nurse is aware that this newborn is at risk for blood clots. jaundice. anemia. leukocytosis.

jaundice - The hematocrit level in the normal infant is 44% to 70%. A level higher than 65% indicates polycythemia. Polycythemia increases the risk of jaundice and damage to the brain.

If enough unconjugated bilirubin accumulates in the blood, it may cause staining of the tissues in the brain, resulting in __________________.

kernicterus

The nurse is graphing the weight, length, and head circumference of a newborn in relationship to the gestational age. The newborn falls within the sixth percentile for the weight, fifth percentile for the length, and ninth percentile for the head circumference. This newborn would be classified as large-for-gestational age. appropriate-for-gestational age. small-for-gestational age.

large-for-gestational age - Infants who fall above the 90th percentile are considered large-for-gestational age. Infants between the 10th and 90th percentiles are considered appropriate-for-gestational age. Infants who fall below the 10th percentile are considered small-for-gestational age.

Prickly heat develops in infants who are too warmly dressed in any weather. This is called _____________.

miliaria

Most infant abductions in a hospital setting occur in the _____________.

mother's room

A shrill, high-pitched cry in a newborn may indicate hunger. neurologic disorder. cardiac disorder. no significance.

neurologic disorder - Newborn cries that are shrill, high-pitched, hoarse, or catlike are abnormal. These may indicate neurologic disorders or other problems.

The nurse notes a yellow discoloration over the face of a 12-hour-old newborn. The nurse's next actions should be based on prevention of pathologic jaundice. renal damage. skin damage. neurotoxicity.

neurotoxicity. - Jaundice is considered pathologic when it appears in the first 24 hours after birth. Pathologic jaundice is a concern because it may lead to kernicterus or deposits of bilirubin on the brain cells. Kernicterus may cause acute bilirubin encephalopathy, which leads to cerebral palsy, mental retardation, and long-term neurologic and developmental problems and death.

The unit manager of the newborn nursery is orienting a group of nursing students. Infection control is one of the manager's major topics. When comparing infection control in a nursery with that in an adult medical unit, one major difference is that all the patients in the nursery are usually in one room. the medical unit has many different organisms brought onto the unit. newborns have a decreased ability to localize infections. adults have a weaker immune system, which makes them more prone to developing infections.

newborns have a decreased ability to localize infections. - Newborns have a decreased ability to localize infections; therefore, they have a tendency to develop generalized sepsis. This fact makes infection control in a nursery extremely important.

During an initial assessment of a newborn, the nurse notices that the left arm does not move as freely as the right arm. When assessing the clavicle, crepitus is noted. The nurse's next action should be to notify the newborn's health care provider. swaddle the newborn loosely. document this normal finding. check range of motion on the left arm.

notify the newborn's health care provider. - Signs of a fractured clavicle are crepitus over the bone, swelling of the area, and decreased movement of the arm on the affected side. Treatment should start as soon as possible and the fracture should heal in a short time.

A newborn is receiving phototherapy for a high bilirubin level. To maintain fluid balance, the nurse should offer the infant water at least every 2 hours. offer the infant formula or breast milk every 3 to 4 hours and offer water every 2 hours. offer the infant formula or breast milk every 2 to 3 hours and avoid offering water. provide a continuous gavage feeding of formula.

offer the infant formula or breast milk every 2 to 3 hours and avoid offering water. - The infant should receive breast or bottle feedings every 2 to 3 hours; a 25% increase in fluid intake is needed during phototherapy. Frequent feedings prevent hypoglycemia, provide protein to maintain the albumin level in the blood, promote gastrointestinal motility, and prompt emptying of bilirubin from the bowel. Avoid offering water because the infant may take less milk, which is more effective in removing bilirubin from the intestines.

During the labor of a 43-week-gestation gravida 2, the nurse notes meconium staining of the amniotic fluid. After birth, the newborn was diagnosed with meconium aspiration syndrome. The nurse should monitor the newborn for respiratory distress and signs of infection. skin breakdown. persistent pulmonary hypertension of the newborn. hyperbilirubinemia.

persistent pulmonary hypertension of the newborn. - Meconium aspiration syndrome results in obstruction of the airways and may lead to persistent pulmonary hypertension of the newborn. In persistent pulmonary hypertension, the vascular resistance of the lungs does not decrease after birth, and normal changes to neonatal circulation are impaired.

When doing a newborn assessment on a 2-day-old infant, the nurse notices facial jaundice. The bilirubin level was assessed and found to be 6 mg/dL. The nurse understands that this jaundice will be classified as physiologic jaundice. pathologic jaundice. breastfeeding jaundice. true breast mild jaundice.

physiologic jaundice. - With physiologic jaundice, the jaundice is not present during the first 24 hours of life. It appears on the second or third day and is considered a normal phenomenon. When jaundice is noted in the face only, the jaundice level can be estimated to be from 5 to 7 mg/dL.

A new mother with no hospitalization insurance asks to be discharged with her baby at 24 hours after birth. To assist this new mother best after discharge, the nurse can allow the mother time to ask all her questions about newborn care just before discharge. plan for a home visit within 48 hours of discharge. give the mother plenty of pamphlets about newborn care before discharge. inform the mother about the dangers of early discharge.

plan for a home visit within 48 hours of discharge. - Home visits have been found to be a cost-effective way to avoid hospital admissions or emergency department visits. The home visit allows for assessment, intervention, and follow-up teaching. It is important to allow the mother time to ask questions before discharge, but at 24 hours after birth she may not be prepared to do so. Giving the mother pamphlets before discharge is helpful; however, nursing assessments or follow-up teaching will not be done.

The ruddy, reddish color of the newborn skin caused by polycythemia is called _________________.

plethora

When the fingers or toes of a newborn have more than five digits, it is called ____________________.

polydactyly

The infant who has the highest risk for asphyxia during labor and birth is the infant who is __________.

postterm

A newborn who is 12 hours old develops tremors. The nurse has assessed the blood glucose and calcium levels and they are both within normal limits. The next assessment by the nurse should be to assess for hypothermia. prenatal drug exposure. lung sounds. cardiac defects.

prenatal drug exposure. - Infants with neonatal abstinence syndrome may be irritable and have hyperactive muscle tone. Although they have tremors, the blood glucose level is normal.

A newborn develops jaundice at 16 hours of age. The nurse notes that the Coombs test is positive. The nurse orders a total serum bilirubin test and the results are 10 mg/dL. The nurse's next action should be to monitor the respiratory rate every 30 minutes. prepare the newborn for phototherapy. initiate oxygen therapy. assess the bilirubin level in 1 hour.

prepare the newborn for phototherapy. - A positive Coombs test indicates that antibodies from the mother have attached to the infant's red blood cells and are causing damage that results in extra levels of bilirubin. The total serum bilirubin test of 8 mg/dL in the first 24 hours indicates that phototherapy may be indicated.

The most important factor that determines the extent of respiratory problems in a preterm infant is the age of the infant. size of the infant. presence of surfactant in adequate amounts. Silverman-Anderson index grade.

presence of surfactant in adequate amounts. - Problems of the respiratory system are a major concern in a preterm infant. The presence of surfactant in adequate amounts is of primary importance. Infants born before surfactant production is adequate develop respiratory distress syndrome.

When placing a newborn under a radiant heat warmer to stabilize temperature after birth, the nurse should place the probe on the left side of the chest. cover the probe with a nonreflective material. recheck the temperature by periodically taking a rectal temperature. prewarm the radiant heat warmer and place the undressed newborn under it.

prewarm the radiant heat warmer and place the undressed newborn under it. - The probe should be placed on the upper abdomen. It should be covered with reflective material. Rectal temperatures should be avoided because rectal thermometers can perforate the intestine. The radiant heat warmer should be preheated to avoid heat loss by conduction.

The hormone that causes the breasts to produce milk is _______________.

prolactin

The position appropriate for a preterm infant but not a full-term infant is __________________.

prone

During the labor of a mother who is postterm, the membranes rupture spontaneously. The nurse notes that the amniotic fluid has a greenish tint. The nurse should be aware that the infant is at high risk after birth for skin breakdown. renal malfunction. respiratory difficulties. cardiac difficulties.

respiratory difficulties. - A postterm infant is it high risk for hypoxia before or during labor. This increases the risk of meconium passage and possible aspiration at birth. Aspiration of meconium fluid can lead to respiratory difficulties.

A full-term newborn is placed in phototherapy to decrease serum bilirubin levels. A nursing diagnosis appropriate for this infant during phototherapy would be risk for injury. risk for infection. risk for deficient fluid volume. ineffective breastfeeding.

risk for deficient fluid volume. - Side effects of phototherapy include frequent, loose green stools that result from increased bile flow and peristalsis. This causes more rapid excretion of bilirubin but may be damaging to the skin and result in fluid loss. The crib used for phototherapy should have safety mechanisms in place, such as high sides. Breastfeeding can continue during phototherapy. The infant may be wrapped in a phototherapy blanket during feedings. There is no increased risk of infection.

When the mother strokes the side of a newborn's mouth, the newborn will turn the head to the side touched. This reflex is called ______________.

rooting

Chronic inflammation of the scalp or other areas of the skin characterized by yellow, scaly, oily lesions is called _________________.

seborrheic dermatitis (cradle cap)

During the admission history of a mother who is in labor, the nurse ascertains that the mother smoked 1 pack of cigarettes/day during the pregnancy, and appears underweight. Because of this information, the nurse should prepare for the birth of an infant who may be large-for-gestational age. small-for-gestational age. postterm. appropriate-for-gestational age.

small-for-gestational age. - Risk factors that may cause an infant to be small-for-gestational age include poor placental function and restrictions of uteroplacental blood flow. Maternal smoking and malnutrition can produce these problems, as can drug abuse, aging, and illness in the expectant mother.

A pregnant woman complains of inverted nipples. She is planning on breastfeeding and thinks that the nipples may be a problem. The nurse should teach her to stretch the nipples out once a day to convert the inversion. roll the nipples twice a day to pull out the nipple. stimulate the breast. wear a tighter-fitting bra.

stimulate the breast. - A breast cup can be worn in the bra during the last several weeks of pregnancy. The cup will exert slight pressure against the areola and help the nipples protrude. Exercises for inverted nipples, such as stretching and manipulation of the nipple, are not recommended during pregnancy because they are not effective and may cause uterine contractions.

At birth, a newborn has a respiratory rate of 75 breaths per minute. In 1 minute, the newborn stops breathing. The first action by the nurse should be to stimulate the newborn. initiate rescue breathing. administer oxygen. initiate cardiopulmonary resuscitation.

stimulate the newborn. - When asphyxia begins after birth, rapid respirations are followed by cessation of respirations. Stimulation of the newborn may restart respirations and should be the first intervention. If asphyxia continues and the infant loses consciousness, resuscitation may be necessary.

The amount of breast milk produced depends primarily on adequate amounts of estrogen and progesterone. stimulation of the breast. amounts of oxytocin. stimulation of the fundus.

stimulation of the breast. - The amount of milk produced depends primarily on adequate stimulation of the breast and removal of the milk by suckling or a breast pump. The stimulation causes production of prolactin, which produces the milk. Estrogen and progesterone inhibit prolactin. Oxytocin aids in the let-down reflex and contraction of the fundus.

The nurse notices a 4-hour-old newborn developing jitteriness. The next action by the nurse should be to assess for maternal drug use. the calcium level. the blood glucose level.

the blood glucose level. - Jitteriness can be caused by maternal drug use, low calcium levels, and hypoglycemia. Of these three, hypoglycemia is the most common cause and should be assessed first.

A new mother tells the nurse, "I've been told that the milk I have right after the baby is born is not good for the baby." The nurse should base the answer on the fact that only the first secretion of milk should be discarded. the colostrum is low in vitamins and protein. the colostrum is high in immunoglobulin A. the mother secretes just small amounts of colostrum.

the colostrum is high in immunoglobulin A. - Colostrum is high in immunoglobulin A, which helps protect the infant's gastrointestinal tract from infection. Colostrum also helps establish the normal flora in the intestines, and its laxative effect speeds the passage of meconium. Colostrum is high in vitamins and protein.

A new mother expresses concern to the nurse that her 8-hour-old newborn has developed some edema in both eyes. The best response would be based on the fact that birth trauma usually will not develop until a few hours after birth. the edema is a sign of eye infections and will need to be investigated. the eye medication given at birth may cause a mild inflammation and edema. this is a sign of lack of rest for the newborn during the labor process.

the eye medication given at birth may cause a mild inflammation and edema. - Some infants develop a mild inflammation a few hours after prophylactic eye treatment.

A new mother has heard that breast milk may contain as much as 55% of the calories in fat. She is concerned that her infant will be getting a diet too high in fat because the American Heart Association recommends that the diet have less than 30% of its calories from fat. The nurse can best advocate for breastfeeding by stating that newborns need the extra fat. whole cow's milk provides the same amount of fat. the fat in breast milk is important for vision and brain growth. the fat is only found in the hindmilk, so the newborn will not get that much.

the fat in breast milk is important for vision and brain growth. - The fat composition of human milk differs greatly from cow's milk. It provides the type of fat that is important for the newborn's vision and brain growth. It is more easily digested by the newborn than cow's milk and may have antibacterial and antiviral properties. Option a is true, but the mother needs more information to make an informed decision. Hindmilk has two to three times as much fat as the foremilk.

When doing the initial measurements of a newborn, the nurse records the head diameter as 34 cm and the chest diameter as 32 cm. The nurse is aware that these measurements are within normal limits. the chest is too large for the head. the head is too large for the chest.

these measurements are within normal limits - The head diameter should be between 32 and 38 cm; the chest diameter should be 30 to 34 cm. The chest is usually 2 to 3 cm smaller than the head.

A full-term infant of a diabetic mother was born by cesarean birth. The nursery nurse should include in the plan of care for this newborn to monitor for signs of (Select all that apply.) hyperglycemia. hypercalcemia. transient tachypnea of the newborn. cardiac anomalies.

transient tachypnea of the newborn. cardiac anomalies. - Risk factors for transient tachypnea of the newborn include cesarean birth and mothers who are diabetic. Congenital anomalies are three times more likely in infants of diabetic mothers. Cardiac, urinary tract, and gastrointestinal anomalies, neural tube anomalies, and sacral agenesis are most frequent.

A new mother asks the nurse about the red stains in her baby boy's wet diapers. The nurse explains this as being uric acid crystals. pseudomenstruation. meconium stains.

uric acid crystals. - Uric acid crystals may be in a newborn's urine for the first few days of life. They will cause a reddish or pink stain on the diaper. This is known as brick dust staining. Pseudomenstruation occurs only in females. Meconium stains would be greenish.

The thick white substance that resembles cream cheese and provides a protective covering for the fetal skin in utero is called the ______________.

vernix caseosa

A mother was not treated prior to birth for an active case of group B streptococcal infection. The newborn developed an infection. This is considered which type of transmission of infection? Vertical Horizontal

vertical - Vertical infections are acquired before or during birth from the mother. Horizontal infections occur after birth from contact with hospital staff members, contaminated equipment, or family members.

The nurse is taking care of a 30-week gestation preterm infant who is 3 days old. The infant is stable enough for a bath to remove the old blood and vernix, but has areas of cracking on the skin. During the bath, it is best for the nurse to use plain warm water. a soap especially formulated for an infant's skin. warm sterile water. distilled water.

warm sterile water. - Bathing preterm infants is not necessary on a daily basis and should be performed as necessary. Bathing can disrupt the chemistry of the skin and may be stressful. Soap should be avoided during the first week for infants less than 32 weeks' gestational age. If there are areas of skin breakdown, sterile water is safest for cleansing.

Diarrhea stools can be identified by a _____________ in the diaper around the stool.

water ring

A crying infant is a major concern for most new parents. The nurse can teach the parents that answering an infant's cry may spoil the infant and the parents need to be cautious. usually means attending to an unanswered need, but until the infant is about 6 months old it is difficult to determine what that need may be. will help the infant develop trust. may become frustrating for the parents; they may need to close the door and ignore the infant at times.

will help the infant develop trust. - Infants express their needs by crying. These needs must be met in a consistent, warm, and prompt manner for the development of trust to occur. Parents should be taught the importance of consistently and quickly answering infant cries.