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Questions and Answers
A newborn is assessed to have dry, cracked skin, long nails, and an alert expression. Which condition is MOST likely?
A newborn is assessed to have dry, cracked skin, long nails, and an alert expression. Which condition is MOST likely?
- Post-term birth (correct)
- Preterm birth
- Normal gestational age
- Neonatal infection
Which assessment finding in a preterm infant requires the MOST immediate intervention?
Which assessment finding in a preterm infant requires the MOST immediate intervention?
- Plentiful lanugo
- Translucent skin
- Poorly formed ear pinna
- Absent or few creases on soles/palms (correct)
A newborn presents with tachypnea, nasal flaring, and intercostal retractions. Which condition is MOST consistent with these findings?
A newborn presents with tachypnea, nasal flaring, and intercostal retractions. Which condition is MOST consistent with these findings?
- Respiratory Distress Syndrome (RDS) (correct)
- Neonatal infection.
- Post-term syndrome.
- Neonatal abstinence syndrome
A newborn is suspected of having a neonatal infection. Which laboratory finding would be MOST indicative of this condition?
A newborn is suspected of having a neonatal infection. Which laboratory finding would be MOST indicative of this condition?
An infant is displaying wakefulness, irritability, tremors, and a high-pitched cry. The mother has a history of opioid use. Which condition is the MOST likely cause of these symptoms?
An infant is displaying wakefulness, irritability, tremors, and a high-pitched cry. The mother has a history of opioid use. Which condition is the MOST likely cause of these symptoms?
If the mother of a newborn is Rh negative, which test is performed on the newborn to assess for Rh incompatibility?
If the mother of a newborn is Rh negative, which test is performed on the newborn to assess for Rh incompatibility?
Which sample type is MOST suitable for detecting long-term substance exposure in a newborn?
Which sample type is MOST suitable for detecting long-term substance exposure in a newborn?
A preterm newborn is experiencing increasing respiratory distress. Besides oxygen support, what other intervention should the nurse anticipate?
A preterm newborn is experiencing increasing respiratory distress. Besides oxygen support, what other intervention should the nurse anticipate?
A newborn presents with lethargy, poor feeding, hypothermia, and jitteriness. Which condition is MOST likely indicated by these symptoms?
A newborn presents with lethargy, poor feeding, hypothermia, and jitteriness. Which condition is MOST likely indicated by these symptoms?
An infant's weight is plotted below the 10th percentile on the growth chart. Which condition is MOST likely indicated by this finding?
An infant's weight is plotted below the 10th percentile on the growth chart. Which condition is MOST likely indicated by this finding?
Which factor is LEAST likely to contribute to a newborn being classified as Large for Gestational Age (LGA)?
Which factor is LEAST likely to contribute to a newborn being classified as Large for Gestational Age (LGA)?
A newborn has a collection of fluid on their scalp that crosses the suture lines. This finding is MOST indicative of:
A newborn has a collection of fluid on their scalp that crosses the suture lines. This finding is MOST indicative of:
Which newborn condition is MOST associated with mothers who smoke during pregnancy or have high blood pressure?
Which newborn condition is MOST associated with mothers who smoke during pregnancy or have high blood pressure?
A newborn is exhibiting yellowing of the skin and sclera within the first 24 hours of life. These findings are MOST concerning for:
A newborn is exhibiting yellowing of the skin and sclera within the first 24 hours of life. These findings are MOST concerning for:
Which characteristic is MOST indicative of symmetric Intrauterine Growth Restriction (IUGR)?
Which characteristic is MOST indicative of symmetric Intrauterine Growth Restriction (IUGR)?
A pale and mottled newborn with cool extremities and a temperature below 97.7°F (36.5°C) is MOST likely experiencing:
A pale and mottled newborn with cool extremities and a temperature below 97.7°F (36.5°C) is MOST likely experiencing:
An infant presents with jaundice. What is the initial treatment approach?
An infant presents with jaundice. What is the initial treatment approach?
A newborn is diagnosed with hypoglycemia shortly after birth. After attempting to stabilize glucose levels with feeding, the levels remain low. What is the next appropriate intervention?
A newborn is diagnosed with hypoglycemia shortly after birth. After attempting to stabilize glucose levels with feeding, the levels remain low. What is the next appropriate intervention?
What is the primary distinguishing factor when assessing a newborn's head swelling to differentiate between caput succedaneum and cephalohematoma?
What is the primary distinguishing factor when assessing a newborn's head swelling to differentiate between caput succedaneum and cephalohematoma?
An infant of a diabetic mother (IDM) is being assessed. Besides monitoring blood glucose levels, which of the following assessments is crucial in the immediate newborn period?
An infant of a diabetic mother (IDM) is being assessed. Besides monitoring blood glucose levels, which of the following assessments is crucial in the immediate newborn period?
A large for gestational age (LGA) infant is born. What immediate action should the nurse prioritize after ensuring a clear airway and stable vital signs?
A large for gestational age (LGA) infant is born. What immediate action should the nurse prioritize after ensuring a clear airway and stable vital signs?
A newborn is suspected of having pathological jaundice. Which lab tests are most important to determine the cause and severity?
A newborn is suspected of having pathological jaundice. Which lab tests are most important to determine the cause and severity?
A transcutaneous bilirubin (TcB) measurement is performed on a 3-day-old newborn. What is the primary purpose of this test?
A transcutaneous bilirubin (TcB) measurement is performed on a 3-day-old newborn. What is the primary purpose of this test?
Which set of laboratory tests are typically ordered as common assessments for an infant of a diabetic mother?
Which set of laboratory tests are typically ordered as common assessments for an infant of a diabetic mother?
Flashcards
Hypothermia in Newborns
Hypothermia in Newborns
Newborn's body temperature is below 97.7°F, often with symptoms like lethargy and tachypnea.
Hypoglycemia of the newborn
Hypoglycemia of the newborn
Low blood sugar in newborns, leading to symptoms like jitteriness, poor feeding, and even apnea.
Hyperbilirubinemia
Hyperbilirubinemia
Yellowing of the skin and sclera within the first 24 hours, indicating elevated bilirubin levels.
Small for Gestational Age (SGA)
Small for Gestational Age (SGA)
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Thermoregulation in Newborns
Thermoregulation in Newborns
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Infant of a Diabetic Mother (IDM)
Infant of a Diabetic Mother (IDM)
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Caput
Caput
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Large for Gestational Age (LGA)
Large for Gestational Age (LGA)
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Treatment for Hyperbilirubinemia
Treatment for Hyperbilirubinemia
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Treatment for Newborn Hypoglycemia
Treatment for Newborn Hypoglycemia
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Caput vs. Cephalohematoma: Assessment
Caput vs. Cephalohematoma: Assessment
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Potential Treatments for Preterm Newborn
Potential Treatments for Preterm Newborn
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Assessments: Infant of Diabetic Mother
Assessments: Infant of Diabetic Mother
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Assessments: Large for Gestational Age
Assessments: Large for Gestational Age
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Labs: LGA or SGA Infant
Labs: LGA or SGA Infant
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Transcutaneous Bilirubin Test
Transcutaneous Bilirubin Test
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Signs of a post-term newborn
Signs of a post-term newborn
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Etiologies of preterm birth
Etiologies of preterm birth
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Characteristics of a preterm infant
Characteristics of a preterm infant
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Neonatal asphyxia
Neonatal asphyxia
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Respiratory Distress Syndrome (RDS)
Respiratory Distress Syndrome (RDS)
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Neonatal infections
Neonatal infections
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Signs of newborn withdrawal
Signs of newborn withdrawal
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Signs of fetal alcohol syndrome
Signs of fetal alcohol syndrome
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Study Notes
- Post-term newborns exhibit dry, cracked, wrinkled skin, potential meconium staining, long, thin extremities, long nails, wide-eyed and alert expression, abundant hair on the scalp, and limited vernix and lanugo.
- Etiologies of preterm birth include infections/inflammation, maternal or fetal distress, bleeding, and stretching.
- Common problems in preterm newborns: scrawny appearance, poor muscle tone, minimal subcutaneous fat, plentiful lanugo, poorly formed ear pinna, absent or few creases on soles/palms, translucent skin, and abundant vernix.
- Characteristics of preterm infant assessment include staining of amniotic fluid, nails, skin or umbilical cord; barrel-shaped chest, prolonged tachypnea, increasing respiratory distress, intercostal retractions, end-expiratory grunting, cyanosis, and infiltrates on chest X-ray.
- Neonatal asphyxia is the failure to establish adequate, sustained respiration after birth.
- Manifestations of Respiratory Distress Syndrome: expiratory grunting, nasal flaring, chest wall retractions, tachypnea, generalized cyanosis, tachycardia, and fine inspiratory crackles.
- Signs of neonatal infections: hypothermia, respiratory distress, lethargy, elevated C-Reactive Protein, and a left shift.
- Signs of newborn withdrawal: wakefulness, irritability, temperature variations, tachycardia, tremors, hyperactivity, diarrhea, respiratory distress, apneic attacks, weight loss, alkalosis, and lacrimation.
- Signs of Fetal Alcohol Syndrome: a low nasal bridge, epicanthal folds, and a flat upper lip.
- The COOMBS test, a blood test for incompatibilities between the baby and the mother, is completed after birth if the mother is RH- or Type O blood type.
- An infant drug screen involves sampling urine, meconium, or hair.
- Indicators of hypothermia: being restless, crying possibly, pale or mottled, cool extremities, temperature below 97.7, tachypnea, and possible RDS or transient distress.
- Characteristics of hypoglycemia in newborns include lethargy, sleepiness, poor feeding, hypothermia with temperature instability, apnea, irregular respirations, jitteriness, tremors, a high-pitched cry, and an exaggerated Moro reflex.
- Hyperbilirubinemia for pathological jaundice is indicated by yellowing of the skin and sclera before 24 hours of life and elevated bilirubin levels.
- Small for Gestational Age (SGA) Infant: plotted on the growth chart below the 10th percentile.
- Symmetric Intrauterine Growth Restriction (IUGR) involves prolonged restriction of growth in the size of organs, body weight, body length and especially head circumference. Asymmetric IUGR is when head circumference larger than abdomen. Birth weight below the 10th percentile whereas head &/or length, may plot between 10th and 90th percentiles
- Large for Gestational Age (LGA) Infant: at or above the 90th percentile or over 400 grams; risk factors include being male, diabetic mother, multiparity, congenital defects, or syndromes.
- Thermoregulation is the process of maintaining optimal body temperature in newborns via mechanisms such as convection, radiation, evaporation, or conduction.
- An infant of a diabetic mother may experience excessive growth due to high levels of maternal glucose production and potentially develop hypoglycemia.
- Caput is a collection of fluid, edematous swelling of the scalp, usually from long or difficult labor or vacuum extraction, that crosses suture lines and is present at birth.
- Small for Gestational Age infant is a condition commonly seen in infants of mothers who smoke or have high blood pressure, resulting in increased incidence of perinatal asphyxia and perinatal mortality.
- Treatment for hyperbilirubinemia or jaundice involves frequent feedings and phototherapy.
- For hypoglycemia in the newborn, IV fluid may be a possibility due to size and possible respiratory support such as oxygen if unable to stabilize glucose levels by feeding.
- Caput vs. Cephalohematoma: A determination of whether a swelling crosses suture lines.
- Assessment: Assessments for an Infant of Diabetic Mother include: assess for signs and symptoms of macrosomia; monitor blood glucose levels; monitor vitals; initiate early feedings; maintain a thermal neutral environment; monitor for signs and symptoms of respiratory distress.
- Assessment: Assessments for Large for Gestational Age Infant include: monitor vitals and for signs of respiratory distress, complete a gestational age assessment, screen for hypoglycemia and polycythemia, observe for signs and symptoms of birth trauma, and prevent cold stress.
- Labs: Labs for Large or Small for Gestational Age Infant include include CBC, serum glucose, BMP, chest X-ray, Plot weight, length, and FOC on growth chart.
- Labs for Hyperbilirubinemia for Pathological Jaundice include: Coombs test results, serum bilirubin levels, hemoglobin level, and reticulocyte count.
- A transcutaneous bilirubin test is when age & hour specific bilirubin measurement with bilirubinometer is performed for hyperbilirubinemia.
- Assessments: Common Assessments for an Infant of Diabetic Mother include- serum glucose, serum bilirubin, BMP, CBC, gestational age assessment.
- Treatment for Hyperbilirubinemia for Physiological Jaundice: Frequent feeding is important, bilirubin is eliminated in the feces; if under phototherapy, limit time not under lights and protect eyes.
- Breast milk is abundant in IgA but does not have adequate Vitamin D. It contains protein, fat, and carbs and should not be microwaved.
- Signs: Signs of an adequately breastfed baby include gaining weight, appearing satisfied, having 6 or more wet diapers, and 3 or more bowel movements.
- Warning Signs of Illness: temp greater than 101 or less than 97.9, persistent vomiting, refusal to eat, green watery diarrhea, infrequent wet diapers, excessive sleepiness, inconsolable, abdominal distention, difficulty breathing.
- Safe to Sleep/Back to Sleep Campaign recommendations include: room sharing, avoiding tobacco smoke, breastfeeding, sleeping on a firm surface, using a pacifier, and placing the baby on their back to sleep.
- Safe Newborn Car Seat Management: Must know it's history, rear-facing use up to 2 years, harness at shoulder or below, and at a 45-degree angle.
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