Assessment and Management of Newborn Complications Quizlet

Assessment and Management of Newborn Complications Quizlet Related

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Edward, a newborn delivered at 41 weeks' gestation, weighs 10 lb 4 oz. Vaginal delivery for this G1P1 mother was assisted with forceps. The nurse is completing her assessment and notes a sharply demarcated swelling over the parietal bones. The occipital and frontal skull bones are not affected. The neck does not appear edematous and is soft to the touch with full mobility. The infant is awake and active and has been breast-feeding well. What is the most probable cause of the swelling?

  • A. cephalohematoma
  • B. subgaleal hemorrhage
  • C. caput succedaneum
  • D. skull fracture
Correct Answer: A

Rationale: The correct answer is A: cephalohematoma. Cephalohematoma is a subperiosteal collection of blood that occurs due to trauma during delivery, such as with forceps assistance. The swelling is sharply demarcated because it is bound by suture lines of the skull bones. In this case, the parietal bones are affected, while the other skull bones are not involved. The absence of edema in the neck and the infant's good activity and feeding suggest no significant underlying issues.

Summary:
B: Subgaleal hemorrhage involves bleeding into the potential space between the periosteum and the skull, resulting in diffuse swelling extending beyond suture lines.
C: Caput succedaneum is soft tissue swelling that crosses suture lines and involves the scalp, not just the parietal bones.
D: Skull fracture would present with additional signs such as crepitus, misshapen skull, or neurological deficits, which are not mentioned

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The postnatal nurse is providing care for a neonate being treated with phototherapy for hyperbilirubinemia. For which side effects of phototherapy will the nurse contact the neonatal care provider? Select all that apply.

  • A. Hyperthermia
  • B. Lethargy
  • C. Hypocalcemia
  • D. Thrombocytopenia
Correct Answer: A

Rationale: The correct answer is A: Hyperthermia. During phototherapy, neonates are at risk for developing hyperthermia due to the heat generated by the lights. The nurse should contact the provider if the neonate shows signs of hyperthermia to prevent complications.

B: Lethargy is not a direct side effect of phototherapy but can be a result of other factors such as inadequate feeding or underlying medical conditions.

C: Hypocalcemia is not a common side effect of phototherapy. It is more often associated with other conditions or treatments.

D: Thrombocytopenia is not a typical side effect of phototherapy. It refers to low platelet levels and is usually not directly related to phototherapy treatment.

A premature infant has been admitted to the NICU for both respiratory and nutritional support. When should the nurse begin discharge teaching to the family?

  • A. after the infant has met goals of a mature breathing pattern and their percentile on the growth chart
  • B. as the infant is extubated and transitioned to nasal cannula
  • C. when the family shows interest in caring for their neonate independently
  • D. as early as possible and throughout the admission
Correct Answer: D

Rationale: The correct answer is D because discharge teaching should start as early as possible and continue throughout the admission to ensure the family receives adequate education and support. Starting early allows for more time to address any concerns, teach necessary skills, and build confidence in caring for the premature infant. This approach promotes better outcomes for both the infant and the family.

Choice A is incorrect because waiting for the infant to meet specific goals may delay essential education and support for the family. Choice B is incorrect as it focuses on a specific medical intervention rather than comprehensive teaching. Choice C is incorrect because interest alone may not indicate readiness or understanding of the care required for a premature infant.

If the neonatal nurse is suspicious of necrotizing enterocolitis in the infant, which intervention should take place first?

  • A. Stop feeds
  • B. Obtain a blood gas
  • C. Call the practitioner
  • D. Check electrolytes
Correct Answer: A

Rationale: The correct answer is A: Stop feeds. This is the first intervention because neonatal necrotizing enterocolitis is a serious condition that requires immediate action to prevent further complications. Stopping feeds helps reduce intestinal inflammation and allows the bowel to rest. This step is crucial in managing NEC and preventing perforation. Obtaining a blood gas or checking electrolytes can provide valuable information but are not as urgent as stopping feeds. Calling the practitioner is important but should come after initiating the immediate intervention of stopping feeds.

Which rationale is true regarding jaundice in newborns?

  • A. Jaundice can result in a newborn when the mother and newborn have the same blood type.
  • B. A mother who breastfeeds her newborn who develops jaundice may have to begin formula temporarily.
  • C. Bilirubin levels will drop in newborns who have jaundice and may cause brain abnormalities.
  • D. Keeping a newborn with jaundice below 98.7°F is essential in lowering bilirubin levels.
Correct Answer: B

Rationale: Step 1: Breast milk jaundice is a common cause of jaundice in newborns due to a substance in breast milk that can increase bilirubin levels.
Step 2: Switching to formula temporarily can help resolve the issue as formula-fed babies have lower incidences of jaundice.
Step 3: This is supported by medical guidelines recommending temporary cessation of breastfeeding in cases of severe jaundice.

Summary:
A: Blood type compatibility does not directly cause jaundice in newborns.
C: Bilirubin levels need to be monitored and managed in newborns with jaundice to prevent brain damage.
D: Maintaining a specific temperature is not the primary method of managing jaundice in newborns.

Which patient should be assessed first?

  • A. Infant with a blood glucose level of 45 mg/dL, maternal history of gestational diabetes
  • B. Infant who is plotted on the growth chart between the 75th and 85th percentile for weight and length and the 50th percentile for head circumference
  • C. Infant born at 42 weeks gestation to 40-year-old mother who was otherwise healthy during pregnancy and at the time of delivery
  • D. Infant born at 38 weeks gestation with a green stain and bruising noted on initial assessment at delivery
Correct Answer: A

Rationale: The correct answer is A. An infant with a blood glucose level of 45 mg/dL and a maternal history of gestational diabetes should be assessed first to rule out hypoglycemia, which can be life-threatening in newborns. Hypoglycemia can lead to seizures, brain damage, or even death if not promptly treated. Infants born to mothers with gestational diabetes are at higher risk for hypoglycemia due to their own insulin production in response to high maternal glucose levels. Therefore, immediate assessment and intervention are crucial.

Choice B is incorrect because growth parameters within normal ranges do not indicate an immediate need for assessment. Choice C is also incorrect as the mother's age and gestational age do not necessarily indicate an urgent need for assessment. Choice D is incorrect as the presence of a green stain and bruising may indicate meconium aspiration syndrome, but hypoglycemia poses a more immediate threat to the infant's health.

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