Assessment and Management of Newborn Complications Quizlet

Assessment and Management of Newborn Complications Quizlet Related

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The newborn is having occasional gasping respirations with a heart rate of 90 beats per minute. Skin color is cyanotic with poor muscle tone. Interpreting relevant clinical data in this scenario, what problems are possible? Select all that apply.

  • A. The newborn is hypothermic.
  • B. The newborn is full term.
  • C. The newborn is experiencing respiratory distress.
  • D. The newborn is anemic.
Correct Answer: C

Rationale: The correct answer is C: The newborn is experiencing respiratory distress. Gasping respirations, low heart rate, cyanotic skin, and poor muscle tone are indicative of respiratory distress in a newborn. Gasping is an abnormal breathing pattern seen in severe respiratory distress. A low heart rate is a compensatory response to decreased oxygen levels. Cyanotic skin color indicates poor oxygenation. Poor muscle tone can be a sign of inadequate oxygen delivery to tissues.

Explanation for other choices:
A: The newborn may be hypothermic due to poor temperature regulation, but the primary concern in this scenario is respiratory distress.
B: Being full term does not directly explain the newborn's clinical presentation, so it is not a likely cause.
D: Anemia could contribute to poor oxygen delivery, but the clinical presentation suggests a more acute issue related to respiratory distress.

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Which laboratory value is important to check on a newborn with excessive bruising following delivery?

  • A. White blood cells
  • B. Glucose
  • C. Bilirubin
  • D. Potassium
Correct Answer: C

Rationale: The correct answer is C: Bilirubin. Excessive bruising in a newborn can indicate hemolysis, leading to elevated bilirubin levels and potential jaundice. Checking bilirubin levels is crucial to monitor for hyperbilirubinemia, which can lead to complications like kernicterus. White blood cells (A) are not typically associated with bruising. Glucose (B) levels are important in monitoring for hypoglycemia, not bruising. Potassium (D) levels are not directly related to bruising in a newborn.

The nurse is providing support to a mother whose newborn is diagnosed with a life-threatening defect. The mother states, “I just want to go home and never come back.” Which reaction by the mother does the nurse recognize?

  • A. Guilty feelings by the mother
  • B. Delay of attachment process
  • C. Maternal emotional distancing
  • D. Disruption of family life
Correct Answer: C

Rationale: The correct answer is C: Maternal emotional distancing. The mother's statement of wanting to go home and never come back indicates a desire to emotionally distance herself from the situation. This reaction is a common coping mechanism when faced with overwhelming emotions. Guilty feelings (choice A) typically involve a sense of responsibility or remorse, which is not evident in the mother's statement. Delay of attachment process (choice B) refers to difficulties in forming an emotional bond with the newborn, which is not explicitly mentioned in the scenario. Disruption of family life (choice D) implies changes in family dynamics, which are not directly related to the mother's expressed desire to distance herself emotionally.

Which sign will the newborn experiencing respiratory obstruction often exhibit first?

  • A. Gagging
  • B. Vomiting
  • C. Decreased heart rate
  • D. Increased respiratory rate
Correct Answer: D

Rationale: The correct answer is D: Increased respiratory rate. When a newborn experiences respiratory obstruction, they will initially exhibit an increased respiratory rate as their body tries to compensate for the lack of oxygen. This is a natural response to try to increase oxygen intake. Gagging (choice A) and vomiting (choice B) may occur as secondary symptoms if the obstruction persists. Decreased heart rate (choice C) is unlikely to be the first sign, as the body typically prioritizes ensuring oxygen supply to vital organs such as the brain. Therefore, the increased respiratory rate is the most immediate and crucial sign to indicate respiratory obstruction in a newborn.

The nurses in a NICU are concerned about the appropriate levels of oxygen therapy during the care of premature neonates. The nurses referenced an article by Newman (2014) titled, “Oxygen Saturation Limits and Evidence supporting the Targets.” On which evidence-based conclusion will the nurses develop guidelines?

  • A. Oxygen saturation limits of 85% to 89% are effective.
  • B. Oxygen saturation rates of 91% to 95% are effective.
  • C. Infants are within saturation limits about 75% of the time.
  • D. Oxygen saturation limits need to be between 87% to 94%.
Correct Answer: B

Rationale: The correct answer is B: Oxygen saturation rates of 91% to 95% are effective. This range is supported by the article by Newman (2014) as the optimal oxygen saturation levels for premature neonates. Here's the rationale:
1. The range of 91% to 95% falls within the typical target range for oxygen saturation in premature neonates, ensuring adequate oxygenation without the risk of hyperoxia or hypoxia.
2. Maintaining oxygen saturation within this range has been shown to improve outcomes and reduce the risk of complications in premature neonates.
3. The article by Newman likely provides evidence-based research supporting this specific range as the most effective for neonatal care.
In summary, choices A, C, and D are incorrect because they do not align with the evidence-based optimal oxygen saturation range for premature neonates as supported by the referenced article.

A 3-month-old has pulled out their NG tube at home, and the mother is now speaking with the on-call nurse. What recommendation should the nurse provide her?

  • A. drive the infant to the nearest ER
  • B. Call 911 and wait for EMS to arrive
  • C. attempt to replace the NG tube yourself following discharge training
  • D. feed the infant by mouth as there is not an NG tube to use
Correct Answer: C

Rationale: The correct answer is C because the mother was trained on NG tube replacement. This knowledge ensures proper technique and reduces the risk of injury. Driving to the ER or calling 911 may waste time, and feeding by mouth without the NG tube is not safe. Replacing the NG tube at home is the most efficient and appropriate course of action in this scenario.

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