Nursing Care of the Newborn

Nursing Care of the Newborn Related

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The nurse is assigned to the room of a 15-year-old person who gave birth to a newborn 72 hours ago. Why is this newborn a perfect candidate for the Brazelton assessment?

  • A. This parent-newborn couplet is at risk for delayed attachment.
  • B. The newborn is likely going home soon.
  • C. The EHR is prompting her to do so.
  • D. The infant is likely withdrawing from a substance.
Correct Answer: A

Rationale: The correct answer is A because the Brazelton assessment is used to evaluate the newborn's neurobehavioral development and ability to interact with the environment. In this case, the 15-year-old parent may be at risk for delayed attachment due to her age and the circumstances of giving birth. The assessment can help identify any issues early on and provide appropriate interventions.

Choice B is incorrect because the timing of when the newborn is going home is not relevant to the Brazelton assessment. Choice C is incorrect as the Electronic Health Record (EHR) prompting is not a valid reason to conduct the assessment. Choice D is incorrect as there is no indication that the infant is withdrawing from a substance.

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A postpartum nurse is giving guidance to a mother whose breast-fed newborn is experiencing hyperbilirubinemia. What are the best instructions for the nurse to give the mother in this case?

  • A. It is best for the infant if she stops breast-feeding and switches to bottle-feeding permanently.
  • B. The mother should switch to bottle-feeding until the baby’s bilirubin returns to normal range.
  • C. The mother should alternate breast-feeding and bottle-feeding to ensure adequate fluid intake, until the baby’s bilirubin returns to normal range.
  • D. The mother should continue to breast-feed the infant every 2 to 3 hours or more frequently as tolerated (every 2 hours if under phototherapy).
Correct Answer: D

Rationale: Continued frequent breastfeeding helps reduce bilirubin levels effectively.

The nurse knows that during the motoric process, the newborn will be rated poorly if they do what?

  • A. They have good reflexes.
  • B. They have hyper- or hypotonic movements.
  • C. They have good head control.
  • D. They have moderate activity levels.
Correct Answer: B

Rationale: Hyper- or hypotonic movements indicate poor motoric development.

The nurse knows that during the organizational process, the newborn won't be rated as exceptionally good if they do what?

  • A. They will remain alert.
  • B. They will be highly irritable and demonstrate mood swings.
  • C. They will demonstrate self-soothing and quieting techniques.
  • D. The newborn will shut down body responses to stimuli when drowsy.
Correct Answer: B

Rationale: The correct answer is B because a newborn being highly irritable and demonstrating mood swings is indicative of poor adaptability and self-regulation skills, which are factors considered in rating newborns. Being irritable and having mood swings can be signs of difficulty in self-soothing and adjusting to the environment, hence not meeting the criteria for being rated exceptionally good.

A: Remaining alert is generally a positive sign of responsiveness, so it wouldn't hinder the newborn from being rated as exceptionally good.
C: Demonstrating self-soothing and quieting techniques is a positive behavior that can contribute to a newborn being rated as exceptionally good.
D: Shutting down body responses to stimuli when drowsy is a normal physiological response and does not necessarily impact the newborn's rating as exceptionally good.

When giving a newborn a bath, what is a concern for the nurse (or caregiver)?

  • A. hyperbilirubinemia
  • B. hypoglycemia
  • C. thermoregulation
  • D. contact dermatitis
Correct Answer: C

Rationale: Maintaining thermoregulation is critical during bathing to prevent hypothermia.

The postpartum nurse notices that a new mother has her neonate unwrapped and undressed 'to check out the baby.' For which reason does the nurse conclude the neonate is at risk for cold stress?

  • A. The neonate has an increased metabolic rate.
  • B. The neonate's respiratory rate has dropped.
  • C. The neonate is moving extremities about.
  • D. The neonate's skin is cool and clammy.
Correct Answer: D

Rationale: The correct answer is D because cool and clammy skin is a sign of cold stress in neonates. When a neonate's skin is cool and clammy, it indicates that the baby is losing body heat and struggling to maintain a stable body temperature. Cold stress can lead to complications such as hypothermia and respiratory distress.

A: Increased metabolic rate would actually help generate heat to combat cold stress.
B: Respiratory rate dropping is not necessarily indicative of cold stress and may be a normal response to being undressed.
C: Moving extremities about is a normal behavior and not necessarily a sign of cold stress.

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