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78 Cards in this Set
- Front
- Back
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A term newborn is one delivered between ___ and ___ weeks because this is the optimal developmental time for adjustment to the extrauterine environment.
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38 to 42 weeks
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Mary, a 37 week newborn is in the 20th percentile for gestational age. Is she considered SGA?
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No, you have to be below the 10th percentile for gestational age to be considered SGA.
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What is the difference between asymmetrically small and symmetrically small newborns?
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Asymmetrically small newborn have a normal size head and smaller body, while symmetrically small newborns have a small head and small body
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The newborn with symmetrical SGA most likely experienced the deficit which trimester?
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The first trimester.
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The newborn with asymmetrically SGA most likely experienced the deficit in which trimester?
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The second trimester.
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Hypothermia, pain, hypoglycemia, and polycythemia are four common conditions affecting which newborn:
a) LGA b) SGA c) post term infants d) preterm infants |
b) SGA
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SGA infants have (high/low) metabolic rates which result in (high/low) glucose and (high/low) temperature.
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SGA infants have HIGH metabolic rates which result in LOW glucose and LOW temperature.
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Cold stress increases metabolic needs and places the SGA and preterm newborn at further risk for respiratory distress and
a) respiratory acidosis b) respiratory alkalosis c) metabolic acidosis d) metabolic alkalosis |
c) metabolic acidosis
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What is a normal axillary temperature for a newborn?
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97.9-99.5
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You take a rectal temperature of a newborn and find it to be 100.4. What do you do?
a) apply a cooling blanket b) call the doctor c) document the finding d) apply ice packs to the groin and armpits |
c) document the finding: A normal rectal temperature ranges from 97.9-100.4
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Which of the following should the nurse do in preparation for kangaroo care?
a) undress the infant down to the diaper b) have the mother shower or wash with a prewarmed pack c) have the mother apply cream to her chest d) bundle the infant snuggly in a prewarmed blanket |
a) undress the infant down to the diaper to prepare for the skin-to-skin holding of the baby on the mother's chest
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What is the PIPP and what score would indicate severe pain?
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It is the Premature Infant Pain Profile and a score of 12 indicates severe pain and requires immediate attention.
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What glucose level in an infant is considered hypoglycemia?
a) below 110 b) below 80 c) below 60 d) below 40 |
c) below 60
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An infant born with polycythemia is suspected of experiencing ____ in utero.
a) stress b) oxygen deprivation c) meconium aspiration d) increased circulation |
b) oxygen deprivation
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How much must an infant weigh at birth to be considered LGA?
a) 7 lbs 6 oz b) 8 lbs 4 oz c) 9 lbs 6 oz d) 10 lbs 4 oz |
b) 8 lbs 4 oz or 3750 grams
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Infants of diabetic mothers are often LGA and are at risk for: CATA:
a) hyperglycemia b) hypoglycemia c) bradypnea d) tachypnea e) hypocalcemia f) hypercalcemia h) hypomagnesemia i) hypermagnesemia |
b) hypoglycemia
d) tachypnea e) hypocalcemia h) hypomagnesemia |
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What are the risk of blood glucose levels above 150 in the newborn?
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Dehydration and weight loss.
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What is the name of the disorder characterized by a delayed clearance of fetal lung fluid as a result of hyperaeration of the fetal lungs and pulmonary edema from the fetal lung fluid in the alveoli?
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TTN Transient Tachypnea of the Newborn
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Who is at greater risk for TTN? Those undergoing:
a) cesarean births b) vaginal births c) opioid assisted births d) epidural assisted births |
a) cesarean births
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What is the usual treatment for TTN and for how long?
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CPAP for 1-2 days
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Which of the following can result in seizures in the newborn?
a) hypocalcemia b) hypercalcemia c) hypomagnesemia d) hypermagnesemia |
a) hypocalcemia
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What is a normal blood calcium level in a preterm newborn?
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Above 7.5 mg/dL
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What is a normal blood calcium level in a term newborn?
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8 mg/dL
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Which of the following facilities return to a normal calcium level in the infant?
a) urinating b) pooping c) feeding d) chelation therapy |
c) feeding
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Which of the following are signs of low magnesium in the infant
a) decreased reflexes b) increased neuromuscular irritability c) seizures d) vomiting |
b) increased neuromuscular irritability
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What are normal magnesium levels in a newborn?
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1.5-2.8 mg/dL
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Which of the following would you assess for in the patient with low magnesium?
a) low glucose, sweating b) irritability, air hunger, retractions c) hyperactivity, clonus, seizures d) hypotonia,poor feeding, respiratory distress |
d) hypotonia, poor feeding and respiratory distress
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The nurse knows to assess the infant born with shoulder dystocia for:
a) broken long bones b) brachial plexus injuries c) neurological deficits d) meconium aspiration |
b) brachial plexus injuries
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How are brachial plexus injuries usually treated?
a) limb immobilization b) intense physical therapy c) corticosteroid administration d) artificial stimulation via TENS units |
a) limb immobilization
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The newborn with an upper root injury usually holds the affected arm limp and turned inward, terms the "waiter's tip" position. What is the name given to this injury?
a) Erb's palsy b) Klumpk's palsy c) Erb-Klumpke's palsy d) total paralysis |
a) Erb's palsy
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How are long bone fractures in newborns typically treated?
a) surgery b) cast c) soft splint d) external pins |
c) soft splint for 2 weeks since healing is rapid
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How are femoral fractures treated?
a) Halvihurst splint b) Beract splint c) Pavlik harness d) Peruvee closure device(PCD) |
c) Pavlik harness: Which immobilizes the hip and leg and allows the femur to heal
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What would you hear upon auscultation of the lungs of a newborn with RDS?
a) clear sounds b) gurgles c) atelectasis d) diminished LS |
c) atelectasis
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What is the priority intervention for the newborn with RDSin severe respiratory failure.?
a) auscultating LS b) mechanical ventilation c) synthetic surfactant administration d) mechanical stimulation |
b) mechanical ventilation
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After an airway has been established, what is the next priority for a newborn with RDS?
a) auscultating LS b) mechanical ventilation c) synthetic surfactant administration d) mechanical stimulation |
c) synthetic surfactant administration
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What medication is used for RDS for supplementation with synthetic surfactant?
a) dextramethasone b) Betamethasone c) Survanta d) prednisone |
c) Beractant (Survanta)
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How should Beractant (Survanta) be stored?
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Refrigerated in a light protected bottle
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What needs to be done prior to administering beractant (Survanta)?
a) check temperature b) have mother sign consent c) suction mouth & nose d) administer a breathing treatment |
c) suction mouth & nose
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What results when the normal negative feedback loop to hypoxia and hypercapnia does not work?
a) bradypnea b) overstimulation c) apnea d) under stimulation |
c) apnea: Apnea is a common occurrence in preterm newborns. The inspiratory center in the medulla oblongata of the brainstem, the central and peripheral chemoreceptors, and the neuroregulators are immature and do not provide the normal negative feedback loop to hypoxia and hypercapnia.
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Apnea spells are significant if they last more than ___ seconds.
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15-20 seconds
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The nurse teaches the mother of a newborn with a history of apnea spells, that the newborn can be discharged when they are free of apnea and bradycardia for:
a) 1 day b) 2-3 days c) 4-5 days d) 5-7 days |
d) 5-7 days
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What qualified a newborn as having bronchopulmonary dysplasia and what causes this?
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Bronchopulmonary dysplasia is a condition in which the newborn becomes oxygen dependent past 36 weeks; It is a complication produced by long-term oxygen use.
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True or False: Transcutaneous bilirubinometry (TcB) is a noninvasive way of monitoring bilirubin in infants who are on phototherapy.
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False: It is used on infant NOT receiving phototherapy. Once phototherapy is begun, the TcB monitor is no longer a useful screening tool and serum blood specimens must be drawn every 6-12 hours.
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Which of the following bilirubin levels is diagnostic of jaundice in an infant?
a) 12.9 or above b) 15 or above c) 17 or above d) 20 or above |
a) 12.9 or above
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Which of the following bilirubin levels is diagnostic of jaundice in a preterm infant?
a) 12.9 or above b) 15 or above c) 17 or above d) 20 or above |
b) 15 or above
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What is done to prepare the infant for treatment via phototherapy?
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The eyes and genitalia of the newborn are covered to prevent tissue and retinal damage. Also a temperature sensor is placed on their abdomen.
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What causes retinopathy of prematurity?
a) increased ICP b) hypoxia c) overstimulation d) meconium |
b) hypoxia
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What can be done to ease the stress on the newborns eyes with ROP?
a) tape them shut with water-soluble adhesive tape b) maintain bright lights in their environment c) cover the incubator with a blanket during the day d) administer erythromycin via a thin ribbon into the lower conjunctiva sac |
c) cover the incubator with a blanket during the day
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What are the causes of anemia is premature newborns?
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Frequent blood draws, rapid growth rate and immature liver function
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What is r-HuEPO given for, and until what week is it administer until and why?
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It is a medication that stimulates RBC production; It is administered until the 35th week, at which point it can be discontinued because the liver is mature enough to produce the erythropoietin needed for RBC production independently.
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True or False: Encourage the use of pacifiers as they decrease the incidence of SIDS.
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True
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The passage of meconium is believed to be either a maturational occurrence or a response to:
a) intrauterine hypoxia b) maternal malnutrition c) blood vessel proliferation d) increased fetal movement |
a) intrauterine hypoxia
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What is required if an infant with meconium aspiration pneumonia is confirmed to have a pneumothorax?
a) mechanical ventilation b) bronchodilators c) chest tubes d) central line |
c) chest tubes
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Which of the following are signs or symptoms of persistent pulmonary hypertension of the newborn?
a) left to right shunting of blood b) high blood pressure c) cyanosis and tachypnea d) grunting and retractions |
c) cyanosis and tachypnea: There is also RIGHT to LEFT shunting of blood, blood pressure is NOT elevated and grunting and retractions are not usually present
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The nurse knows that PKU test for a disorder _____ in nature.
a) hemolytic b) metabolic c) endocrine d) neurological |
b) metabolic in nature
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Accumulations of phenylalanine in the blood eventually cause: CATA
a) sepsis b) seizures c) developmental delays d) increased ICP e) mental retardation |
b) seizures
c) developmental delay e) mental retardation |
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Which of the following foods would be avoided in the diet planning of a child with PKU? CATA
a) eggs b) nuts c) whole grains d) fruits and vegetables e) legumes f) artificial sweeteners g) breast milk h) regular formula |
All foods high in protein are avoided such as eggs, nuts, legumes, breast milk and regular formula; Artificial sweeteners (especially aspartame) are also avoided since they produce phenylalanine.
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How are infants with cleft lip or cleft palate fed?
a) with an extra long nipple b) tilted back almost to a supine position c) every 1-2 hours to enhance nutritional deficits d) avoiding bottles with reservoirs that regulate formula flow |
a) with an extra long nipple to help prevent aspiration: Also they are fed in an upright position to decrease the incidence of regurgitation;They are also given bottles with a reservoir to help regulate formula flow
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Which of the following may be a clue of maternal alcohol or drug abuse? A history of:
a) low socioeconomic status b) low vitamin B12 c) low vitamin B6 d) inconsistent prenatal care |
d) inconsistent prenatal care
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Which of the following are sign or symptoms of neonatal abstinence syndrome?
a) lethargy, hypotonia, high weight gain b) tremors, loose stools, hiccups c) poor rooting reflex, bradypnea d) sepsis, thrombocytopenia, jaundice |
b) tremors, loose stools and hiccups; Also irritability, wakefulness, uncoordinated feeding pattern, yawning, poor weight gain, hypertonia, seizures, exaggerated rooting reflex, regurgitation, vomiting, tachypnea, apnea, sneezing, stuffy nose, lacrimation.
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Which of the following is the best source for drug testing in the neonate?
a) saliva b) hair c) urine d) stool e) blood |
d) stool: It reflects a longer period of time of intrauterine exposure than urine testing
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What are the following medications indicated for: Paregoric, phenobarbital(Luminal), Clonidine(Catapres), Chlorpromazine(Thorzine) and Diazepam(Valium)?
a) IDAM b) septic infants c) withdrawing mothers d) breast feeding mothers experiencing opioid withdrawl |
a) IDAM: Infant of Drug Abusing Mothers
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True or False: Narcan can be used on the infant of a drug abusing mother in order to reverse the CNS depressant effects of recent drugs in her system.
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False: Narcan use may increase the severity of drug withdrawal in IDAMs. If the mother is a suspected drug abuser, it should NOT be used.
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What would hypertension in the neonate most likely be related to?
a) cardiac issues b) renal issues c) endocrine issues d) respiratory issues |
b) renal issues
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What does the nurse expect when taking the blood pressure of a neonate in the upper and lower extremities?
a) the lower extremities will high a slightly lower pressure b) the upper extremities will have a slightly lower pressure c) the upper and lower extremities will be the same |
b) the upper extremities will have a slightly lower pressure; A difference of more than 20 mm Hg may indicate CoA
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What is contraindicated in newborns with respirations greater than 60?
a) phototherapy b) blood pressure measurement c) PO feeding d) respiratory treatments |
c) PO feeding due to the increased risk of aspiration pneumonia
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How is newborn output best calculated?
a) via insertion of a foley catheter b) via counting the number of wet diapers c) via daily weight d) via weighing the diaper |
d) via weighing the diaper on a gram scale
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How is the infant in the NICU best handled to prevent complications?
a) frequently to promote lung compliance and stimulation b) infrequently to minimize stimulation c) every hour to enhance oxygen consumption d) every 6 hours to prevent rapid increases in blood pressure |
b) infrequently to minimize stimulation: Minimal stimulation is advised to reduce oxygen consumption and prevent rapid increases in blood pressure that may cause cerebral hemorrhage. Nursing care is organized into "cluster care" which is done usually every 3 hours.
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What do you do if a mother has just started her kangaroo care for the day at change of shift, and you need to give report to another nurse?
a) proceed to give report, and do not disturb the mother b) give report, but try to speak in a low voice c) ask the mother to leave the NICU during the change of shift report |
c) ask the mother to leave the NICU during the change of shift report due to HIPAA regulations to protect the privacy of all the newborns
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In planning the discharge of the NICU graduate, the nurse knows that:
a) follow up care will likely be required b) care management may need to be involved to handle insurance reimbursements c) sight and hearing specialist will not be necessary |
a) follow up care will likely be required for sight, hearing, developmental/educational issues, physical therapy and occupational therapy.
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Immediate conditions that pose nursing concerns for the SGA newborn include which of the following:
a) long-term chronic or end of life care b) bronchopulmonary dysplasia and ischemia c) muscle contractures and hyperthermia d) hypothermia and pain management |
d) hypothermia and pain management
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Upon assessing the newborn, the nurse notes shallow rapid respirations, palmar sweating, decreased oxygen saturation, and a high-pitched cry. These clinical assessments are indicative of which of the following:
a) a neurological problem b) hypoglycemia c) pain d) transient tachypnea |
c) pain
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Which of the following is contraindicated during phototherapy with bilirubin lights?
a) applying eye patches to prevent retinal damage and a covering over the genital area b) ensure periodic removal from the incubator for feedings and bonding purposes c) apply a head covering to prevent heat loss d) maintain adequate hydration to promote excretion |
c) apply a head covering to prevent heat loss
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A 42-week newborn is assessed 20 hours after delivery by the nurse. On assessment the nurse auscultates rales and rhonchi, notes the newborn is tachypneic and has meconium stained nails. The nurse suspects:
a) sepsis b) meconium aspiration pneumonia c) transient tachypnea of the newborn (TTN) d) RDS |
b) meconium aspiration pneumonia
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For which of the following is surfactant considered the first line of defense?
a) RDS b) meconium aspiration pneumonia c) sepsis d) transient tachypnea of the newborn |
a) RDS
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If a pregnant woman is Hep B positive, will she be able to breast feed her baby after birth?
a) no, it is not advised, but bottle feeding would be recommended b) no, not until the child is 6 months old c) yes, breast feeding is not a problem d) yes, if the baby receives prophylaxis at birth and remains on scheduled immunizations |
d) yes, if the baby receives prophylaxis at birth and remains on scheduled immunizations
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What would the initial sign of histoplasmosis be?
a) high blood pressure b) headache c) enlarged lymph nodes d) abdominal distension |
c) enlarged lymph nodes: This disorder begins as a respiratory infection and then turns systemic
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For the HIV positive patient undergoing PPD testing, redness and induration of ___ mm indicates exposure to TB.
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6+mm
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