Deck 26: The Newborn at Risk: Conditions Present at Birth

Question 1

In the special care nursery, the nurse places an infant with hydrocephalus in the prone position and is careful to thoroughly cleanse the perineum after bowel movements. What was this infant most likely born with?
1) Omphalocele
2) Gastroschisis
3) Myelomeningocele
4) Diaphragmatic hernia

Answer 1

3

Question 2

The nurse is working with a family that just experienced the birth of their first child at 34 weeks. Which statements indicate that additional teaching is needed? Select all that apply.
1) "Our baby will be in an Isolette to keep him warm."
2) "The growth of our baby will be faster than if he were term."
3) "Breathing might be harder for our baby because he is early."
4) "Tube feedings will be required because his stomach is small."
5) "Because he came early, he will not produce urine for 2 days."

Answer 2

2, 4, 5

Question 3

The nurse is preparing teaching for the parents of a premature infant weighing
4)4 lb. How much urine in ounces should the nurse instruct the parents that the infant will produce in 1 day if the rate of production is 2 mL/kg/hr? (Calculate to the nearest whole number.)

Answer 3

3 OZ

Question 4

The nurse is reviewing clients scheduled for prenatal care. Which client should the nurse identify as being most likely to have a newborn at risk for mortality or morbidity?
1) 37-year-old G8 P2323, works in a chemical factory
2) 16-year-old primipara, began prenatal care at 30 weeks
3) 28-year-old G2 P1001, history of gestational diabetes
4) 23-year-old primipara, low socioeconomic status, unmarried

Question 5

A newborn is diagnosed with fetal alcohol syndrome (FAS). Which statement indicates that the parents require additional teaching about this health problem?
1) "He might be a fussy baby because of this."
2) "His face looks like it does due to this problem."
3) "Cuddling and rocking will help him stay calm."
4) "Our baby's heart murmur is from this syndrome."

Question 6

The nurse is caring for an infant with abdominal contents protruding at the location of the umbilicus. What statement differentiates between omphalocele and gastroschisis?
1) With omphalocele, the abdominal contents are not covered with a sac; with gastroschisis, the abdominal contents are covered by a sac.
2) With omphalocele, the abdominal contents are covered with a sac; with gastroschisis, the abdominal contents are not covered by a sac.
3) With omphalocele, the abdominal contents protrude into the base of the umbilical cord; with gastroschisis, the abdominal contents protrude to the right of an intact umbilical cord.
4) With omphalocele, the abdominal contents protrude to the right of an intact umbilical cord; with gastroschisis, the abdominal contents protrude into the base of the umbilical cord.

Question 7

A newborn is diagnosed with tetralogy of Fallot. What findings indicate that this client is experiencing heart failure? Select all that apply.
1) Tachypnea
2) Diaphoresis
3) Tachycardia
4) Hepatomegaly
5) Splenomegaly

Question 8

The nurse is assessing a 36-week gestational age newborn. What assessment findings indicate that a cardiac defect is present? Select all that apply.
1) Cyanosis
2) Abdominal bruit
3) Peripheral pulses
4) Signs of heart failure
5) Presence of a heart murmur

Question 9

A client pregnant at 41 weeks asks if labor induction is necessary. Which response is best for the nurse to make?
1) "The healthcare provider wants to be proactive in preventing any problems with your baby if the baby gets any bigger."
2) "Sometimes the placenta ages excessively, and we want to take care of that problem before it happens."
3) "When infants are born 2 or more weeks after their due date, they have meconium in the amniotic fluid."
4) "Babies can develop postmaturity syndrome, which increases their chances of having complications after birth."

Question 10

A full-term infant weighing
8)8 lb is delivered by a client who is HIV positive. The newborn is prescribed zidovudine (AZT) 2 mg/kg/dose every 6 hours for 6 weeks. Realizing that the newborn's weight is going to increase over the 6-week course of treatment, what is the total minimal amount of medication in milligrams that this infant will receive in 1 week? (Calculate to the nearest whole number.)

Question 11

The newborn of a mother with type 2 diabetes mellitus is experiencing tremors. What nursing action has the highest priority?
1) Obtain a bilirubin level.
2) Obtain a blood calcium level.
3) Measure the newborn's temperature.
4) Place a pulse oximeter on the newborn.

Question 12

A small-for-gestational-age (SGA) newborn weighing 2000 g is prescribed to receive 130 kcal/kg/day of oral feeding to achieve a daily weight gain of 30 g.What should this newborn weigh after 2 weeks of receiving these feedings? (Calculate to the nearest whole number.)

Question 13

What should be considered as potentially infectious when providing care to a newborn of a client who is HIV positive? Select all that apply.
1) Feces
2) Urine
3) Blood
4) Soiled linens
5) Feeding bottle

Question 14

The nurse is caring for a newborn born to a client who abused drugs while pregnant. Which assessment findings would be common for this newborn? Select all that apply.
1) Hyperirritability
2) Transient tachypnea
3) Exaggerated reflexes
4) Decreased muscle tone
5) Depressed respiratory effort

Question 15

An infant of a diabetic mother (IDM) weighing 11 lb is prescribed to receive an infusion of dextrose 10% and water at the rate of 5 mg/kg/min until blood glucose level remains about 45 mg/dL. How many milligrams of dextrose will the infant receive in 30 minutes? (Calculate to the nearest whole number.)

Question 16

A newborn has just been admitted to the special care nursery. What criteria should the nurse use to determine this newborn's classification and neonatal mortality risk? Select all that apply.
1) Length
2) Birth weight
3) Gestational age
4) Amount of lanugo
5) Occipital-frontal head circumference

Question 17

A client has delivered a small-for-gestational-age (SGA) infant. What long-term effect should the nurse recognize that this infant is at risk for experiencing?
1) Permanent disfiguration
2) Paralysis below the hips
3) Poor fine motor coordination
4) Thin and underweight as a child to overweight or obese as an adolescent

Question 18

An infant was born at 31 weeks' gestation and weighed 1430 g. What number of calories should this infant receive each day?
1) 72
2) 143
3) 200
4) 258

Question 19

A client with type 2 diabetes mellitus delivered a fetus weighing 7 lb, 14 oz 2 hours ago. The infant's blood glucose is currently 45 mg/dL. What should the nurse do?
1) Begin an IV of 10% dextrose.
2) Document the findings in the chart.
3) Feed the baby 1 oz of formula.
4) Recheck the blood sugar in 4 hours.

Question 20

A 38-week newborn is small for gestational age (SGA). Which nursing intervention should be included in the care of this newborn?
1) Assess for facial paralysis
2) Maintain a warm environment
3) Monitor for feeding difficulties
4) Monitor for signs of hyperglycemia