Nursing Care of the Newborn

Nursing Care of the Newborn Related

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The nurse is receiving shift report on her mother-baby couplet assignment. Which infant should the nurse evaluate first?

  • A. 38-weeks' gestation female newborn with a blood sugar level of 60 mg/dL
  • B. Term male newborn with a noted axillary temperature of 37.2°C (99°F)
  • C. 40-weeks' gestation female newborn with reported poor feed at last attempt
  • D. 39-weeks' gestation male newborn who has been crying prior to initial bath
Correct Answer: C

Rationale: The correct answer is C, to evaluate the 40-weeks' gestation female newborn with reported poor feed at the last attempt first. This choice should be prioritized as poor feeding in a newborn can be a sign of potential serious issues such as inadequate nutrition, dehydration, or underlying medical conditions. Addressing this concern promptly is crucial for the infant's well-being.

Option A can be considered as the blood sugar level of 60 mg/dL in the 38-weeks' gestation female newborn is slightly low, but it is not an immediate priority compared to poor feeding. Option B's axillary temperature of 37.2°C is within the normal range for a newborn, so it can be assessed after addressing the concern of poor feeding. Option D, a 39-weeks' gestation male newborn crying prior to the initial bath, can also be evaluated after addressing the more urgent issue of poor feed.

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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.

The family with a newborn diagnosed with cleft lip and palate is concerned about what will happen in the future. The birthing parent asks if they will be able to breast-feed the infant. What is the best response from the nurse?

  • A. Newborns with cleft lip and palate require a special nipple and setup to receive full nutrition.
  • B. Newborns with cleft lip and palate are unable to breast-feed but can have breast milk.
  • C. Newborns with a cleft lip and palate may be able to breast-feed because latching may fill the gap.
  • D. Newborns with cleft lip and palate are able to breast-feed only after surgical repair of their cleft.
Correct Answer: C

Rationale: Some infants with cleft lip and palate can breastfeed successfully depending on the severity and latching ability.

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.

A breastfeeding patient who was discharged yesterday calls to ask about a tender hard area on her right breast. What should the nurse's first response be?

  • A. This is a normal response in breastfeeding mothers.'
  • B. Notify your doctor so he can start you on antibiotics.'
  • C. Stop breastfeeding because you probably have an infection.'
  • D. Try massaging the area and apply heat; it is probably a plugged duct.'
Correct Answer: D

Rationale: The correct response is D because a tender, hard area on the breast is likely a plugged duct, which can be relieved by massaging the area and applying heat to promote milk flow. This approach helps prevent further complications and encourages continued breastfeeding.

Choice A is incorrect as it dismisses the patient's concern without providing helpful guidance. Choice B is incorrect because antibiotics are not typically necessary for a plugged duct unless it progresses to mastitis. Choice C is incorrect as stopping breastfeeding can worsen the condition and may lead to engorgement or mastitis.

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.

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