Newborn Assessment and Care Quiz

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Questions and Answers

What is the primary mechanism through which newborns generate heat during thermogenesis?

Increasing heart rate

Increasing respiratory rate

Activation of brown fat metabolism (correct)

Shivering thermogenesis

Which of the following assessments is NOT included as a priority care at birth for newborns?

Temperature regulation

Umbilical cord inspection (correct)

Respiratory rate monitoring

Apgar score evaluation

Which reflex is characterized by the baby's hands extending outward and then retracting in response to a sudden stimulus?

Plantar grasp reflex

Moro reflex (correct)

Sucking reflex

Palmar grasp reflex

In which population is the incidence of neonatal hyperbilirubinemia more significantly increased?

Asian infants Signup and view all the answers

What is the composition of the umbilical cord in terms of blood vessels?

2 arteries and 1 vein Signup and view all the answers

What is the primary intervention for a prolapsed cord during childbirth?

Trendelenburg position and relieving pressure on the cord Signup and view all the answers

In which situation is it especially critical to evaluate for shoulder dystocia?

When a macrosomic baby is being delivered Signup and view all the answers

Which of the following correctly describes a symptom indicating potential infection in a postpartum assessment?

Green meconium staining Signup and view all the answers

What is a potential consequence of shoulder dystocia if not resolved promptly?

Fetal hypoxia or death Signup and view all the answers

Which factors could contribute to a higher risk of cord prolapse during labor?

Excessive amniotic fluid and high fetal station Signup and view all the answers

What is the expected finding in a fundal assessment postpartum?

Descent of the fundus towards pelvic inlet Signup and view all the answers

Which of the following is NOT a risk factor associated with shoulder dystocia?

Maternal high blood pressure Signup and view all the answers

What indicates a normal odor of a postpartum vaginal discharge?

Musty smell indicating normalcy Signup and view all the answers

Which fish is considered safe to consume during pregnancy?

Limit white tuna to 6oz/week Signup and view all the answers

What is the recommended increase in protein intake per day during pregnancy?

10g per day Signup and view all the answers

Which substance should be completely avoided during pregnancy due to no safe consumption level?

Alcohol Signup and view all the answers

What amount of caffeine is considered safe for pregnant individuals?

Up to 300 mg/day Signup and view all the answers

What is an indication that a Non Stress Test (NST) is reactive?

Fetal heart rate accelerates 15 beats/min for 15 seconds Signup and view all the answers

What is the normal range score for a Biophysical Profile indicating fetal well-being?

8-10 Signup and view all the answers

During the first trimester, how much weight should a pregnant individual expect to gain?

2-4 pounds Signup and view all the answers

What is the ideal method to help alleviate morning sickness?

Eating crackers before rising Signup and view all the answers

Which of the following is a common nutrition-related issue during pregnancy?

Heartburn Signup and view all the answers

Which condition is a common risk factor for gestational diabetes?

Family history of diabetes Signup and view all the answers

What is a common characteristic of painless vaginal bleeding during the second or third trimester associated with placenta previa?

Bright red blood Signup and view all the answers

Which condition is diagnosed with ultrasound and requires immediate emergency cesarean section if fetal distress occurs?

Abruption placenta Signup and view all the answers

What is a common risk factor associated with abruption placenta?

Maternal hypertension Signup and view all the answers

Which statement about Rh incompatibility is accurate?

It occurs when an Rh- woman carries an Rh+ fetus. Signup and view all the answers

What physical finding is associated with abruption placenta during examination?

Firm, board-like abdomen and dark red bleeding Signup and view all the answers

Which management step is NOT recommended for placenta previa?

Vaginal examinations Signup and view all the answers

What laboratory test is essential for assessing coagulopathy in a patient with suspected abruption placenta?

Complete blood count (CBC) Signup and view all the answers

What is a major clinical manifestation of Rh incompatibility in the newborn?

Neonatal jaundice due to hyperbilirubinemia Signup and view all the answers

What is an essential intervention for a patient experiencing signs of hypovolemic shock due to abruption placenta?

Infusion of IV fluids and blood products Signup and view all the answers

What primary factor differentiates the management of Rh incompatibility from ABO incompatibility?

Rh incompatibility can lead to severe complications in the fetus. Signup and view all the answers

What is the purpose of administering Rhogam to Rh- women during pregnancy?

To prevent the production of maternal antibodies against Rh+ blood Signup and view all the answers

In the VEAL CHOP mnemonic, what should be done in response to late decelerations?

Administer oxygen and increase IV fluid, stop contractions Signup and view all the answers

Which opioid is known to act on the CNS to decrease pain perception without loss of consciousness during labor?

Fentanyl Signup and view all the answers

What characterizes Braxton Hicks contractions compared to true labor contractions?

They decrease in intensity with walking or changing positions. Signup and view all the answers

What is the significance of fetal station in labor assessment?

It helps to determine the baby's position relative to the ischial spine. Signup and view all the answers

What is the primary focus during the active phase of labor?

Cervical changes leading to full dilation Signup and view all the answers

What potential maternal complication can arise from the administration of an epidural block during labor?

Maternal fever and respiratory depression Signup and view all the answers

During which stage of labor does the expulsion of the placenta occur?

3rd stage of labor Signup and view all the answers

What is the nursing priority immediately following the rupture of membranes?

Check the fetal heart rate (FHR) Signup and view all the answers

What physical change indicates that the fundus is not properly involuting after childbirth?

The fundus feels soft and boggy. Signup and view all the answers

Which of the following statements regarding Lochia is correct?

Lochia alba may last up to 6 weeks postpartum. Signup and view all the answers

What is a normal finding when assessing the postpartum fundus?

The fundus feels like a grapefruit. Signup and view all the answers

What treatment can help manage after-birth pains in postpartum women?

Providing NSAIDs. Signup and view all the answers

What symptom indicates the potential presence of an infection postpartum?

Elevated temperature. Signup and view all the answers

Which assessment finding would most likely indicate a complication in the postpartum period?

Non-palpable fundus after 2 weeks. Signup and view all the answers

What is the primary purpose of uterine contractions after childbirth?

To prevent excessive postpartum bleeding. Signup and view all the answers

Which of the following practices is essential for preventing postpartum infection?

Utilizing proper hand hygiene. Signup and view all the answers

Study Notes

Antepartum Nutrition and Weight Gain

Foods to Avoid:
- Fish (shark, swordfish, king mackerel, tilefish): high mercury content. Limit white tuna to 6 ounces per week.
- Certain soft cheeses and ready-to-eat meats (unless heated until steaming): risk of listeria.
- Unpasteurized milk and juice: risk of listeria monocytogenes.
- Alcohol: no safe amount; it's a teratogen.
- Tobacco: can cause low birth weight and premature births. Limit caffeine to 300 mg/day (one cup of coffee). High caffeine (500-700mg) intake associated with miscarriage.
Nutritional Requirements:
- Increase protein by 10 grams per day.
- Folic acid (15-30 mg/day) crucial for neurological development.
- Iron supplements (15-30 mg/day): increase maternal red blood cell mass. Iron absorption best with Vitamin C.
- Calcium (essential for bone/tooth formation). Drink 2-3 liters of fluids daily, preferably water, milk, and fruit juice
Nutritional Help for Common Problems:
- Morning Sickness: Crackers before rising, protein snacks at bedtime, avoid fatty/spicy foods.
- Constipation: Fiber at 30 grams/hydrate. Take prenatal vitamins at night, ginger tea/cookies.

Heartburn

Avoid: Spicy foods, acidic foods, eat small frequent meals, sit up for 1 hour after meals
Weight Gain: Approximately 2–4 pounds in the first trimester, then 1 pound per week for the remainder of the pregnancy.

Danger Signs of Pregnancy

Pain on urination
Vaginal bleeding
Urinary urgency
Cramping
Blurry vision
Headaches

Fetal Assessment

Non-Stress Test (NST): Commonly used to assess fetal well-being during the third trimester.
Monitors the fetal heart rate (FHR) in response to fetal movement. Using a Doppler transducer to monitor uterine contractions.
NST is considered reactive if the FHR accelerates to 15 beats/min for at least 15 seconds, occuring 2 or more times in a 20 min period.

Assesses Fetal Well-being

Breathing movements
Fetal movements
Fetal tone
Reactive fetal heart rate
Amniotic fluid volume

High Risk Antepartum

PIH (Preeclampsia/Eclampsia): Symptoms include high blood pressure, protein in urine.
Diabetes:
- Pregestational diabetes (Type 1 & 2)
- Gestational diabetes usually occurs in the second half of pregnancy.
- Pre-existing diabetes (Type 1 & 2)
  - Total insulin deficiency
  - Fasting blood glucose of 126 mg/dL or twice a random blood glucose of 200 mg/dL.
  - Insulin resistance with relative insulin deficiency
  - Oral hypoglycemics usually used
Hyperemesis gravidarum: Persistent nausea and vomiting, prolonged beyond 12 weeks of pregnancy, resulting in dehydration, malnutrition, electrolyte imbalances.
Risk Factors (to Mother/Fetus):
- Spontaneous abortion
- Infections
- Polyhydramnios (excessive amniotic fluid)

Risk Factors for Gestational Diabetes

Gestational diabetes in a previous pregnancy
Overweight or obesity (BMI > 30)
Family history of diabetes (primary relative)
Previous delivery of a baby weighing more than 9 pounds
PCOS
Maternal age older than 35 years

Glucose Screening

Glucose screening 1-hour "glucose challenge test" (24–28 weeks)
Fasting is not necessary. 1-hour later, serum glucose should be <140mg/dL. Fasting serum glucose, drawn and tested 1,2, and 3 hours. If glucose tolerance test fails, further investigation is needed.

Diagnosing Pregnancy Complications

Painless, bright red vaginal bleeding during second or third trimester
Uterus: Soft, non tender with normal tone.
Fundal height: Greater than expected for gestational age
Fetal malposition (breech, oblique, transverse): Difficult labor
Previa
Shoulder dystocia: Difficulty delivering the anterior shoulder
Risks include fetal hypoxia and death

Management of Complication

Assessment of frequent vital signs, pain, bleeding, fundal height
Assessment of fetal heart rate and movement
CBC/blood work (HCT, HBG, coagulation profile)
Ultrasound for placenta placement
IV fluids and blood products as needed; avoid vaginal exams
Monitoring for signs of DIC

Risks to Mother/Fetus

Ketosis/DKA: Less common
Spontaneous abortion: Loss of pregnancy before 20 weeks.
Infections, urinary or vaginal
Polyhydramnios: Excessive amniotic fluid

Risks for Pre-existing Pregnancy

Polyhydramnios
Ketoacidosis
Hypoglycemia
Labor complications
Difficulties with pregnancy related to macrosomia (large baby)

Placenta Previa

Placenta previa (completely or partially covers the os) or
Low-lying placenta (less than 2cm from os but does not cover it): often diagnosed by ultrasound before onset of bleeding

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Description

Test your knowledge on essential concepts related to newborn assessment and care. This quiz covers topics from thermogenesis, reflexes, and risks associated with childbirth to postpartum evaluations. Enhance your understanding of newborn health and safety.