Newborn Care and Congenital Anomalies
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Questions and Answers

Which statement best describes the expected behavior of a newborn experiencing neonatal opioid withdrawal syndrome?

  • The newborn will display a decreased heart rate.
  • The newborn will show little to no response when disturbed.
  • The newborn will exhibit a calm demeanor most of the time.
  • The newborn will consistently have a high-pitched cry. (correct)

    • When evaluating a preterm newborn with respiratory distress after surfactant administration, which parameter is most critical to monitor?

  • Body temperature changes.
  • Weight gain patterns.
  • Blood pressure fluctuations.
  • Oxygen saturation levels. (correct)

    • Which of the following characteristics would you expect to find in a preterm newborn born at 32 weeks gestation?

  • Abundant lanugo. (correct)
  • Firm grip reflex.
  • Prominent subcutaneous fat.
  • Thick and well-developed skin.

    • What is a common physical characteristic of a newborn who is considered postmature?

    <p>Leathery, cracked skin appearance.</p> Signup and view all the answers

    Which finding should be prioritized for reporting in a newborn undergoing phototherapy for high bilirubin levels?

    <p>Significant changes in fontanel appearance.</p> Signup and view all the answers

    Which condition is characterized by excessive mucous secretions and choking in newborns?

    <p>Tracheoesophageal atresia</p> Signup and view all the answers

    What major congenital anomaly involves defects in the structure of the heart?

    <p>Congenital heart disease</p> Signup and view all the answers

    Which risk factor is associated with an increased likelihood of congenital anomalies?

    <p>Maternal age greater than 40 years</p> Signup and view all the answers

    What is a common manifestation of hypothyroidism in a newborn if untreated?

    <p>Failure to thrive</p> Signup and view all the answers

    Which congenital anomaly is assessed through symptoms appearing in the first 24 hours of life?

    <p>Tracheoesophageal atresia</p> Signup and view all the answers

    What defect results from a failure of the lip or hard or soft palate to fuse properly?

    <p>Cleft lip/palate</p> Signup and view all the answers

    Which metabolic disorder involves the inability to metabolize galactose?

    <p>Galactosemia</p> Signup and view all the answers

    Which risk factor is least likely associated with congenital anomalies?

    <p>High maternal socioeconomic status</p> Signup and view all the answers

    Which of the following conditions is commonly associated with a protrusion of the meninges and/or spinal cord?

    <p>Spina Bifida</p> Signup and view all the answers

    What is a typical finding in a newborn with hydrocephalus?

    <p>Enlarged head and bulging fontanels</p> Signup and view all the answers

    In the assessment of a newborn, which symptom is associated with respiratory distress lasting over 24 hours?

    <p>Retraction</p> Signup and view all the answers

    What is the primary focus when feeding an infant with cleft lip/palate?

    <p>Determining the most effective nipple or specialized feeding method.</p> Signup and view all the answers

    Which condition is characterized by oblique palpebral fissures and a flat facial profile?

    <p>Down Syndrome</p> Signup and view all the answers

    Peripheral cyanosis is one of the symptoms observed in which condition affecting newborns?

    <p>Tetralogy of Fallot</p> Signup and view all the answers

    Which symptom would indicate dehydration in a newborn?

    <p>Dry mucous membranes.</p> Signup and view all the answers

    What is an important instruction for parents regarding feeding a newborn diagnosed with galactosemia?

    <p>Provide a soy-based formula exclusively.</p> Signup and view all the answers

    Which procedure is utilized to confirm congenital anomalies prenatally?

    <p>Chorionic villi sampling</p> Signup and view all the answers

    Which of the following is NOT a common respiratory symptom in newborn assessments?

    <p>High blood pressure</p> Signup and view all the answers

    What is the recommended position for feeding a newborn with cleft lip/palate?

    <p>Sitting in an upright position.</p> Signup and view all the answers

    In the case of tracheoesophageal atresia, what should be done before initiating feedings?

    <p>Confirm the patency of the esophagus.</p> Signup and view all the answers

    In newborn assessment, a deep crease across the center of the palm is indicative of:

    <p>Down Syndrome</p> Signup and view all the answers

    Which of the following statements about feeding infants with PKU is accurate?

    <p>Synthetic formulas low in phenylalanine should be used.</p> Signup and view all the answers

    What is the most reliable age for performing a Guthrie test for diagnosing PKU?

    <p>After the first week of protein intake</p> Signup and view all the answers

    What is a necessary action when feeding an infant with cleft lip/palate?

    <p>Burp the infant frequently during feedings.</p> Signup and view all the answers

    What is a prevalent maternal factor that may lead to congenital anomalies in newborns?

    <p>Exposure to drugs during the first trimester</p> Signup and view all the answers

    What should be monitored daily for a newborn with cleft lip/palate while hospitalized?

    <p>Weight.</p> Signup and view all the answers

    What is the main dietary restriction for parents of an infant with galactosemia?

    <p>Lactose and galactose.</p> Signup and view all the answers

    Regarding duodenal atresia, when should feedings typically be withheld?

    <p>Until surgical repair and passing stools.</p> Signup and view all the answers

    Study Notes

    Discharge Instructions

    • Adhere to the newborn's individualized care plan.
    • Follow-up care for infants at low to moderate risk of hyperbilirubinemia should happen within two days.
    • Higher-risk infants require follow-up within 24 hours.

    Congenital Anomalies

    • Congenital anomalies affect all body systems and are frequently diagnosed before birth.
    • A nurse should support parents emotionally during corrective procedures for anomalies.
    • Common major congenital anomalies include:
      • Congenital heart disease: Examples include atrial septal defects and tetralogy of Fallot.
      • Neurological defects: Conditions like hydrocephalus and spina bifida.
      • Gastrointestinal issues: Cleft lip/palate and tracheoesophageal fistula.
      • Musculoskeletal deformities: Such as clubfoot and developmental dysplasia of the hip.
      • Genitourinary deformities: Including hypospadias and ambiguous genitalia.
      • Metabolic disorders: Phenylketonuria and hypothyroidism.
      • Chromosomal abnormalities.

    Risk Factors

    • Genetic or environmental factors can increase the risk of congenital anomalies, including:
      • Maternal age over 40 years.
      • Exposure to viral infections or drugs during pregnancy.
      • Maternal obesity and poor nutrition (e.g., folic acid deficiency).
      • Conditions like oligohydramnios or polyhydramnios and newborns who are preterm or SGA.

    Assessment

    • Assess for signs of congenital anomalies, such as:
      • Cleft lip/palate: Visible openings affecting the lip or palate.
      • Tracheoesophageal atresia: Symptoms include excessive drooling and choking episodes.
      • Duodenal atresia: Characterized by bilious vomiting and failure to pass meconium within the first day.
      • Metabolic disorders like PKU and galactosemia can lead to cognitive impairment if untreated.

    Neurological Anomalies

    • Spina bifida: Protrusion of spinal cord or meninges.
    • Hydrocephalus: Enlarged head with prominent fontanels; setting sun sign occurs.
    • Patent ductus arteriosus: Symptoms include abnormal heart sounds and feeding difficulties.
    • Tetralogy of Fallot: Manifests with cyanosis and respiratory distress.
    • Down syndrome: Characterized by distinct physical traits, including slanted eyes and hypotonia.

    Nursing Assessment

    • Evaluate infant's nutritional intake and waste elimination.
    • Monitor vital signs and establish parent-infant bonding.
    • Assess parents’ emotional response to congenital defects, encouraging open communication.

    Diagnostic and Therapeutic Procedures

    • Use prenatal screening methods such as ultrasound for anomaly detection.
    • Diagnostic confirmation through amniocentesis or chorionic villi sampling.
    • Routine metabolic screening includes tests for PKU and galactosemia.

    Patient-Centered Care

    • Focus on supporting parental expression of grief and anxiety about congenital diagnoses.
    • Daily monitoring of newborn's weight and hydration status.
    • Employ techniques to assist with feeding, especially for infants with cleft lip/palate.

    Nutrition

    • For cleft lip/palate: Use specialized feeding techniques to reduce aspiration risk and promote effective nutrition.
    • Tracheoesophageal atresia: Withhold feedings pending surgical intervention.
    • For metabolic disorders such as PKU: Specialized low-phenylalanine formulas are required.
    • For galactosemia: Soy-based formula should be provided, with breastfeeding contraindicated due to galactose.

    Application Exercises

    • Exercise scenarios focus on understanding newborn assessments related to neonatal conditions, such as recognizing signs of neonatal opioid withdrawal syndrome and preterm birth characteristics.
    • Monitoring effectiveness post-surfactant administration and identifying expected findings for preterm infants.
    • Educating parents about the conditions of postmature infants, including physical characteristics.

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    Description

    This quiz covers essential discharge instructions for newborn care, including follow-up for hyperbilirubinemia and understanding congenital anomalies. It emphasizes the importance of timely medical care and emotional support for parents. Test your knowledge on these critical aspects of newborn health!

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