Nursing Care for Newborns

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Questions and Answers

What is the most important nursing action to prevent deficient fluid volume in a newborn?

Keep the newborn warm

Monitor Baby's Weight, urine output, specific gravity, serum electrolytes (correct)

Provide Gavage Feeding

Perform Frequent Handwashing

What is another term for an infant large for gestational age?

Midsomia

Microsomia

Macrosomia (correct)

Manosomia

Which of the following is NOT a characteristic appearance of a premature newborn?

Fingernails have grown beyond the end of the fingertips (correct)

Head is disproportionately large

Lanugo is extensive at the back, forearms, forehead, and sides of the face

Unusually ruddy because of little subcutaneous fat

What is the most common cause of small for gestational age (SGA) newborns?

Cigarette Smoking Signup and view all the answers

A small for gestational age newborn has a birthweight of:

Below 10th percentile on an intrauterine growth curve for that age Signup and view all the answers

What is the therapeutic management used to convert excess bilirubin into a soluble, excretable form?

Phototherapy Signup and view all the answers

What is the typical weight of a preterm infant at birth?

Less than 2,500 g (5lb 8 oz) Signup and view all the answers

Which of the following is NOT a risk factor for prematurity?

Normal nutritional status Signup and view all the answers

What is the primary reason why multiple pregnancy is a risk factor for prematurity?

Due to increased risk of developing hypertension Signup and view all the answers

What is the term for a fetus weighing between 1,000 and 1,500 g at birth?

Very Low Birth Weight Signup and view all the answers

Why are closely spaced pregnancies a risk factor for prematurity?

Due to maternal body not fully recovering Signup and view all the answers

What is the primary reason why intrauterine septum is a risk factor for prematurity?

Due to pregnancy not progressing to full term Signup and view all the answers

What is a major factor contributing to hypoglycemia in preterm infants?

Less nutrients available Signup and view all the answers

Why is gavage feeding sometimes delayed in preterm infants?

To establish effective respirations Signup and view all the answers

What is a normal range of urine specific gravity for newborns?

1.005 to 1.030 Signup and view all the answers

What is the main reason for using a softer nipple when feeding preterm infants?

To prevent tiring and exhaustion Signup and view all the answers

What is the recommended daily calorie intake for very preterm infants?

115 to 140 calories/KBW Signup and view all the answers

What can be used to help strengthen a baby's sucking reflex?

Pacifier Signup and view all the answers

What is a complication of inadequate fluid management in preterm infants?

Pulmonary edema and heart failure Signup and view all the answers

Why do babies have a higher risk of ineffective thermoregulation?

They have a large surface area to body weight ratio Signup and view all the answers

What is a benefit of skin-to-skin contact, also known as kangaroo care, for babies?

It helps to promote thermoregulation Signup and view all the answers

What is the purpose of measuring aspirate?

To determine if the baby is absorbing food properly Signup and view all the answers

Why is handwashing and gowning strictly enforced in postmature babies?

To prevent infection Signup and view all the answers

What is the period of reactivity in babies?

A period of alertness and activity, from 1 to 4 or 12 to 18 hours of age Signup and view all the answers

What is a common complication of a post-term baby during birth?

Difficulty establishing respirations Signup and view all the answers

Why may a post-term baby experience hypoglycemia?

The fetus had to use stores of glycogen for nourishment in the last weeks of intrauterine life Signup and view all the answers

What is a potential consequence of polycythemia in a post-term baby?

Thicker blood due to decreased plasma levels Signup and view all the answers

Why is temperature regulation challenging for a post-term baby?

Low levels of subcutaneous fat Signup and view all the answers

What is a necessary part of follow-up care for a post-term baby until school age?

Tracking developmental abilities Signup and view all the answers

What is a potential cause of seizure activity in a post-term baby?

Hypoxia Signup and view all the answers

Study Notes

Newborn Care

Risk for deficient fluid volume in newborns is due to insensible water loss at birth and small stomach.
Monitoring weight, urine output, specific gravity, and serum electrolytes is crucial in newborns.

Premature Newborns

Premature infants are defined as live-born infants born before the end of week 37 of gestation.
Premature infants have physiologic and anatomic immaturity of various organs and systems at the time of birth.
Premature infants have a weight of less than 2,500g (5lb 8 oz) at birth.
Risk factors for premature birth include low socioeconomic level, poor nutritional status, lack of prenatal care, multiple pregnancy, previous early birth, race, cigarette smoking, age of the mother, and abnormalities of the mother's reproductive system.

Characteristics of Premature Newborns

Large body surface area relative to total body weight.
Immature reflexes, poor swallowing and sucking, and small stomach.
Regurgitate readily due to immature cardiac sphincter.
Immature digestion and absorption.
Risk for hypoglycemia due to less nutrients.
Intracranial hemorrhage and respiratory distress syndrome are common complications.

Management of Premature Newborns

IVF administration via continuous infusion pump to prevent hypoglycemia.
Provide glucose and prevent hypoglycemia.
Monitor weight, urine output, specific gravity, and serum electrolytes.
Use total parenteral nutrition (TPN) for very preterm infants.
Monitor for sucking difficulty, and small stomach.
Provide gavage feeding, and use a softer nipple to prevent exhaustion.

Risk for Imbalanced Nutrition

Risk for imbalanced nutrition is due to additional nutrients needed for maintenance of rapid growth and small stomach.
Nutrients may not be supplied, and hypocalcemia and azotemia may develop.
Feeding schedule should be established, and gavage feeding may be used.
Breast milk expression or breast pump can be used.

Ineffective Thermoregulation

Premature newborns have ineffective thermoregulation due to immaturity.
Large surface area to body weight ratio, extended position, rapid cooling from evaporation, little subcutaneous fat, and poor muscular development contribute to heat loss.
Keep the baby warm using heat warmers, skin-to-skin contact, incubators, and plastic wrap.

Macrosomia (Large for Gestational Age)

Macrosomia is also known as large for gestational age.
The birthweight is above the 10th percentile on an intrauterine growth curve for that age.
Characteristics of macrosomia include a head that is disproportionately large, and fingernails that have grown well beyond the end of the fingertips.

Small for Gestational Age (SGA)

SGA is defined as a birthweight below the 10th percentile on an intrauterine growth curve for that age.
The most common cause of SGA is placental anomaly.
Risk factors for SGA include cigarette smoking, use of narcotics, and women with severe diabetes mellitus.

Postmaturity

Postmaturity is defined as a birth after 42 weeks of gestation.
Characteristics of postmaturity include a large body size, less amniotic fluid, and meconium-stained amniotic fluid.
Management of postmaturity includes sonogram, non-stress test, and complete biophysical profile.
Cesarean birth may be necessary if the non-stress test reveals compromised placental functioning.
Postmature babies may have difficulty establishing respirations, hypoglycemia, and polycythemia.

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Description

Test your knowledge of nursing care for newborns, including managing fluid volume and recognizing characteristics of premature babies. This quiz covers important concepts in pediatrics and nursing practice.