OB Ch. 23 PrepU

The nurse is teaching nursing students about the risks that late preterm infants may experience. The nurse feels confident learning has taken place when the students make which statement?

"Late preterm infants may have more clinical problems compared with full-term infants."

A nurse is explaining to the parents the preoperative care for their infant born with bladder exstrophy. The parents ask, "What will happen to the bladder while waiting for the surgery?" What is the nurse's best response?

"The bladder will be covered in a sterile plastic bag to keep it moist."

Which safety precautions should a nurse take to prevent infection in a newborn? Select all that apply.

-Avoid coming to work when ill. -Use sterile gloves for an invasive procedure. -Initiate universal precautions when caring for the infant.

The nurse in the NICU is caring for preterm newborns. Which guidelines are recommended for care of these newborns? Select

-Dress the newborn in ways to preserve warmth. -Take the newborn's temperature often. -Supply oxygen for the newborn, if necessary.

At a preconception counseling class, a client expresses concern and wonders how Healthy People 2030 will improve maternal-infant outcomes. Which response(s) by the nurse is appropriate? Select all that apply.

-Healthy People 2030 aims to reduce the rate of fetal and infant deaths. -Healthy People 2030 aims to decrease the number of all infant deaths (within 1 year). -Healthy People 2030 aims to decrease the number of neonatal deaths (within the first year). -Healthy People 2030 aims to foster early and consistent prenatal care.

A couple has just given birth to a baby who has low Apgar scores due to asphyxia from prolonged cord compression. The neonatologist has given a poor prognosis to the newborn, who is not expected to live. Which interventions are appropriate at this time? Select all that apply.

-Offer to pray with the family if appropriate. Leave the parents to talk through their next steps. -Initiate spiritual comfort by calling the hospital clergy, if appropriate. -Respect variations in the family's spiritual needs and readiness.

A neonate is being admitted to the observational nursery with the diagnosis of postmaturity. What would the nurse expect to find with this gestational age variation? Select all that apply.

-meconium-stained skin and fingernails -thin umbilical cord -peeling, wrinkled skin

The nurse caring for a small-for-gestational-age newborn in the special-care nursery. What characteristics are commonly documented? Select all that apply.

-poor skin turgor -sparse or absent hair -diminished muscle tissue

What percentage of neonates require some type of assistance to transition to extrauterine life?

10%

Hypoglycemia in a mature infant is defined as a blood glucose level below which amount?

45 mg/100 ml whole blood

A nurse is assessing a term newborn and finds the blood glucose level is 23 mg/dl (1.28 mmol/L). The newborn has a weak cry, is irritable, and exhibits bradycardia. Which intervention is most appropriate?

Administer dextrose intravenously.

The nurse is assisting parents who have just experienced the death of their twin infants. What would be the most appropriate action for the nurse?

Allow the parents to be present at medical rounds and the resuscitation.

Immediately after birth, the nurse is caring for a newborn with a myelomeningocele. What intervention should the nurse provide to prevent drying out of the sac to avoid damage?

Apply a sterile dressing moistened in a warm, sterile saline solution.

Which assessment by the nurse will best monitor the nutrition and fluid balance in the postterm newborn?

Assess for decrease in urinary output.

The obstetrics nurse has admitted a large-for-gestational-age infant, 1-hour old, for observation. The initial blood glucose level is 44 mg/dl (2.44 mmol). What is the nurse's priority action?

Begin supervised feedings for the newborn.

The nurse is caring for a small-for-gestational-age infant at 1 hour old, after a difficult birth, with a glucose level of 40 mg/dl (2.22 mmol/L). Which nursing action is the priority?

Initiate early oral feedings.

Approximately 8 hours after surgery, the nurse notes on assessment shrill crying and projective vomiting. Which response should the nurse prioritize at this time?

Notify the primary care provider immediately

A 20-year-old client gave birth to a baby boy at 43 weeks' gestation. What might the nurse observe in the newborn during routine assessment?

The newborn may look wrinkled and old at birth.

When documenting the newborn's weight on a growth chart, the nurse recognizes the newborn is large-for-gestational-size based on which percentile on growth charts?

above 90th percentile

A nurse is reading a journal article about birth defects and finds that some birth defects are preventable. Which risk factor would the nurse expect to find as being cited as the current leading preventable cause of birth defects?

alcohol

A newborn does not breathe spontaneously at birth. The nurse administers oxygen by bag and mask. If oxygen is entering the lungs, the nurse should notice that the:

chest rises with each bag compression.

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is:

expiratory grunting.

A nurse is assessing the fluid status of a preterm newborn. Which parameter would be most appropriate for the nurse to assess?

fontanels (fontanelles)

A client has given birth to a small-for-gestational-age (SGA) newborn. Which finding would the nurse expect to assess?

head larger than body

A 35-year-old client has just given birth to a healthy newborn during her 43rd week of gestation. What should the nurse expect when assessing the condition of the newborn?

meconium aspiration in utero or at birth

A newborn is found to have hemolytic disease. Which combination would be found related to the blood types of this newborn and the parents of the newborn?

newborn who is type A, mother who is type O

It would be best to place an infant with a meningomyelocele in which position prior to surgery?

on the stomach (prone)

A client has just given birth at 42 weeks' gestation. What would the nurse expect to find during her assessment of the neonate?

peeling and wrinkling of the neonate's epidermis

The nurse is assessing a small-for-gestational age (SGA) newborn, 12 hours of age, and notes the newborn is lethargic with cyanosis of the extremities, jittery with handling, and a jaundiced, ruddy skin color. The nurse expects which diagnosis as a result of the findings?

polycythemia

The small-for-gestational-age neonate is at increased risk for which complication during the transitional period?

polycythemia, probably due to chronic fetal hypoxia

A nurse is assisting with the resuscitation of a preterm newborn. Which assessment would help assist the team in determining that the resuscitation efforts have been successful?

pulse rate of 110 beats per minute

Which facial change is characteristic in a neonate with fetal alcohol spectrum disorder?

short, palpebral fissures

Which finding would lead the nurse to suspect that a large-for-gestational-age newborn is developing hyperbilirubinemia? tea-colored urine

tea-colored urine

The nurse determines a newborn is small-for-gestational-age based on which characteristics?

wasted appearance of extremities, thin umbilical cord, and reduced subcutaneous fat stores