Prep-u ch 24 - Nursing Management of the Newborn at Risk: Acquired and Congenital Newborn Conditions

The nurse is caring for an infant born to a mother with cocaine use disorder during her pregnancy. The nurse would likely notice that this infant:

cries when touched.

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?

"After this surgery is done tomorrow, my baby will be able to eat and drink."

A nursing instructor is teaching about newborn congenital disorders and realizes that the student needs further instruction after making which statement?

"All congenital disorders can be diagnosed at birth."

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."

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?

"We can probably start feeding him with the bottle about a day after the surgery."

Which nursing actions limit overstimulation of the preterm infant? Select all that apply.

- Speak softly to the infant. - Keep lights low in the nursery. - Coordinate nursing care.

The nurse is caring for a client who is at her due date. The client asks. "How long is the health care provider going to let me go?" The nurse is correct to state that typical a mother should not pass how many weeks gestation?

42 weeks

The nurse is caring for an infant diagnosed with a ventricular septal defect. Which assessment findings does the nurse anticipate?

A harsh murmur

Which health care provider assessment technique does the nurse anticipate being used to determine developmental dysplasia of the hip (DDH) on a newborn?

Barlow sign and Ortolani click

For which potential neonatal infection does the nurse anticipate using ophthalmic erythromycin?

Chlamydia trachomatis

The nurse is assessing the plantar creases on the newborns for documentation on the Ballard Scale. Which documentation is interpreted as evidence of a full-term infant?

Creases covering two-thirds of the anterior foot

Which assessment findings are most prominent in the infant with Tetralogy of Fallot and significant pulmonary stenosis?

Dyspnea on limited exertion, fatigue, cyanosis

A male newborn is born with hypospadias. The nurse doing the newborn physical assessment notes that the penis is also curved downward. What information would the nurse provide the parents for this infant?

His ability to void and have an erection in adulthood may be impaired and surgery is needed.

In completing the newborn assessment checklist, the nurse documents a meconium stool. This documentation rules out which condition?

Imperforate anus

A preterm newborn is noted to have hypotonia, apnea, bradycardia, a bulging fontanelle, cyanosis, and increased head circumference. These signs indicate the newborn has which complication?

Intraventricular hemorrhage (IVH)

A nurse is assigned to care for a newborn with esophageal atresia. What preoperative nursing care is the priority for this newborn?

Prevent aspiration by elevating the head of the bed, and insert an NG tube to low suction.

Which nursing measure is most effective in reducing newborn infections?

Maintain medical asepsis while providing care.

Which types of play are most appropriate for the 3-month-old who is in an orthopedic cast?

Mobiles and rattles

The nurse is caring for a neonate. Which is the most important step the nurse can take to prevent and control infection?

Practice meticulous hand washing.

A ventilated 33 weeks' gestation newborn in the neonatal intensive care unit (NICU) receives surfactant therapy. Which would the nurse expect to assess as a positive response to this therapy?

Oxygen saturation levels are at 98%.

Which intervention is helpful for the neonate experiencing drug withdrawal?

Place the Isolette in a quiet area of the nursery.

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.

An infant is suspected of having persistent pulmonary hypertension of the newborn (PPHN). What intervention implemented by the nurse would be most beneficial in treating this client?

Provide oxygen by oxygen hood or ventilator.

When attempting to interact with a neonate experiencing drug withdrawal, which behavior would indicate that the neonate is willing to interact?

Quiet, alert state

A 6-week gestation client asks the nurse what foods she should eat to help prevent neural tube disorders in her growing baby. The nurse would recommend which foods?

Spinach, oranges, and beans

The nurse is working in the special care nursery caring for a newborn withdrawing from alcohol. Which nursing intervention promotes client comfort?

Swaddle and decrease stimulation

The client brings her infant daughter to the pediatrician's office for her first visit since hospital discharge. At birth, the newborn was at the 8th percentile with a weight of 2,350 g. She was born at 36 weeks' gestation. Which documentation is most accurate?

The infant was a preterm, low birth weight and small for gestational age neonate.

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 probably had diabetes.

Which respiratory disorder in a neonate is usually mild and runs a self-limited course?

Transient tachypnea

A meconium plug is an extremely hard portion of meconium that has completely blocked the intestinal lumen, causing bowel obstruction.

True

A 36-week neonate born weighing 1,800 g has microcephaly and microophthalmia. Based on these findings, which risk factor might be expected in the maternal history?

Use of alcohol

A nurse is caring for a neonate of 25 weeks' gestation who is at risk for intraventricular hemorrhage (IVH). Which assessment finding should be reported immediately?

a sudden drop in hemocrit

The nurse reviews the antenatal history and notes of a term newborn. The mother admits to continual daily use of alcohol throughout her pregnancy. For which should the nurse assess the infant? Select all that apply.

abnormal smallness of the head a flatter groove between the nose and upper lip weight below the 10th percentile for gestational age inadequate sucking

The nurse suspects a preterm newborn receiving enteral feedings of having necrotizing enterocolitis (NEC). What assessment finding best correlates with this diagnosis?

bloody stools

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

While caring for a neonate of a diabetic mother, the nurse should monitor the neonate for which complication?

macrosomia

Which medication would be included in the plan of care for a newborn with acute neonatal abstinence syndrome who is not responding to conservative nursing approaches?

morphine sulphate

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

A 32 weeks' gestation newborn is admitted to the neonatal intensive care unit. The assessment reveals a pale dyspneic newborn with marked tremors, a bulging anterior fontanel, and a high-pitched cry. What diagnosis best correlates with the assessment findings?

periventricular-intraventricular hemorrhage