Question 1

The nurse assesses that a newborn's skin has a ruddy appearance, and the peripheral pulses are decreased. The nurse suspects polycythemia. Which of the following lab reports might indicate polycythemia?

Accepted Answer

Polycythemia is an increase in the number of red blood cells, resulting in thicker blood. A venous hemoglobin level higher than 26 g/dL is an indication of polycythemia. Bilirubin level of 6 mg/dL is indicative of hyperbilirubinemia, venous hemoglobin level lower than 12 g/dL is indicative of anemia, and blood glucose level of 44 mg/dL is indicative of hypoglycemia.

Question 2

The nurse is observing a student nurse care for a neonate undergoing intensive phototherapy. Which action by the student nurse indicates that she understands how to provide care for an infant undergoing intensive phototherapy?

Accepted Answer

Assessing urine-specific gravity at each voiding is necessary to monitor the effectiveness of phototherapy and prevent dehydration. Leaving eye coverings off can cause eye damage, temperature should be checked at least every 4 hours, and the infant should not be taken out of the isolette for diaper changes to maintain constant exposure to phototherapy.

Question 3

A laboring mother has recurrent late decelerations. At birth, the infant has a heart rate of 100, is not breathing, and is limp and bluish in color. What nursing action is best?

Accepted Answer

The best nursing action in this scenario is to begin bag-and-mask ventilation. The infant is not breathing and is limp and bluish, indicating respiratory distress or failure. Bag-and-mask ventilation can help to provide the infant with the necessary oxygen to start breathing on their own. Chest compressions are not necessary in this scenario, as the infant has a heart rate of 100. Deep suctioning may be necessary after bag-and-mask ventilation to clear the airways but should not be the first action taken. Blood pressure assessment is not necessary at this immediate moment and is a lower priority than assisting with breathing.

Question 4

The nurse is assessing a 2-hour-old newborn delivered by cesarean at 38 weeks. The amniotic fluid was clear. His mother had preeclampsia. His respiratory rate is 80; he is grunting and has nasal flaring. What is the most likely cause of this infant's condition?

Accepted Answer

The symptoms of grunting and nasal flaring suggest Transient Tachypnea of the Newborn (TTN), which is common in infants born by C-section delivery, especially if the mother had a condition like preeclampsia. TTN occurs when there is an excessive accumulation of lung fluid in the alveoli, causing respiratory distress. It usually resolves on its own within 24-48 hours. Meconium aspiration syndrome can occur when a baby passes stool in utero and inhales it during delivery, leading to respiratory distress. Respiratory distress syndrome is seen more commonly in premature infants, though it can also occur in full-term babies. Prematurity can cause respiratory distress due to immature lungs, but this infant was born at 38 weeks, which is considered full-term.

Question 5

The mother of a severely premature infant is being allowed to see her baby for the first time. The infant has an IV, a feeding tube, and is receiving phototherapy. He is also hooked up to cardiac and respiratory monitors. What information or instructions should the mother NOT receive before seeing her infant?

Accepted Answer

It is not appropriate to tell a mother that she cannot touch her newborn baby. Instead, healthcare providers should educate the mother on how to handle her premature infant safely, such as by supporting the baby's head and neck and avoiding aggressive movements.

Question 6

A mother called the maternity ward four days after the birth of her baby girl. She tells the nurse that she has noticed her infant's skin tone is yellow and asks if she should bring the infant to the hospital. What is the most likely cause of the infant's skin tone?

Accepted Answer

The most likely cause of the infant's yellow skin tone is physiologic jaundice, which is a common and normal occurrence in newborns due to the breakdown of fetal red blood cells and the liver's immaturity in processing bilirubin. It usually resolves on its own within a few weeks. However, if the infant shows signs of severe jaundice or has other complications such as fever, poor feeding, or lethargy, further evaluation and treatment may be necessary.

Question 7

The newborn has been diagnosed with sepsis. What indications would lead the nurse to suspect this condition?

Accepted Answer

The answer of The newborn has been diagnosed with sepsis....

Question 8

A nurse is caring for a newborn on a ventilator who has respiratory distress syndrome (RDS). The nurse informs the parents that the newborn is improving. Which of the following data supports the nurse's assessment?

Accepted Answer

Increased urination is a positive sign in a newborn with RDS because it indicates improved renal perfusion and clearance of excess fluids, which can be a complication of the condition. Decreased urine output would be concerning and could indicate poor renal function or dehydration. Increased PCO2 levels and pulmonary vascular resistance are also negative signs and can indicate worsening respiratory distress.

Question 9

A diabetic mother has just given birth to a baby boy. The baby appears lethargic and has a high-pitched cry. The initial plasma glucose level was 19 mg/dL. What is the proper nursing action for this infant?

Accepted Answer

The infant is experiencing severe hypoglycemia (plasma glucose level of 19 mg/dL). Immediate intervention with an IV of D10W dextrose solution is necessary to rapidly increase blood glucose levels and prevent potential neurological damage.

Question 10

One day after giving birth vaginally, a patient develops painful vesicular lesions on her perineum and vulva. She is diagnosed with a primary herpes simplex II infection. The expected care for her neonate includes:

Accepted Answer

Intravenous acyclovir (Zovirax) and contact precautions are the expected care for a neonate born to a mother with a primary herpes simplex II infection, due to the high risk of neonatal herpes, which can be severe and requires prompt antiviral treatment and measures to prevent spread.

Question 11

The nurse is caring for an infant who delivered in a car on the way to the hospital and who has developed cold stress. Which finding requires immediate intervention?

Accepted Answer

Room temperature IV running can exacerbate cold stress in an infant. It is important to warm IV fluids to prevent further heat loss and stabilize the infant's temperature.

Quiz 28: The Newborn at Risk: Birth-Related Stressors