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Questions and Answers
Which statement about the first period of reactivity in a newborn is correct?
Which statement about the first period of reactivity in a newborn is correct?
What is the recommended procedure for metabolic screening in newborns?
What is the recommended procedure for metabolic screening in newborns?
Which of the following is NOT included in routine physical assessment of a newborn?
Which of the following is NOT included in routine physical assessment of a newborn?
What is the ideal location for blood sample collection from a newborn?
What is the ideal location for blood sample collection from a newborn?
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What can be an effect of untreated phenylketonuria (PKU) in newborns?
What can be an effect of untreated phenylketonuria (PKU) in newborns?
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Which of the following is a recommended action for cord care in newborns?
Which of the following is a recommended action for cord care in newborns?
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What is the purpose of routine pain assessments in newborns?
What is the purpose of routine pain assessments in newborns?
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What is the primary reason for postponing circumcision immediately after birth?
What is the primary reason for postponing circumcision immediately after birth?
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Which of the following is NOT a health benefit associated with circumcision?
Which of the following is NOT a health benefit associated with circumcision?
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What contraindication is associated with a family history of bleeding disorders?
What contraindication is associated with a family history of bleeding disorders?
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Which anesthetic method involves applying pressure around the base of the penis to minimize bleeding during circumcision?
Which anesthetic method involves applying pressure around the base of the penis to minimize bleeding during circumcision?
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Which nursing action is crucial before performing a circumcision on a newborn?
Which nursing action is crucial before performing a circumcision on a newborn?
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Which statement about the Plastibell technique for circumcision is accurate?
Which statement about the Plastibell technique for circumcision is accurate?
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Which of the following nursing assessments is NOT typically performed prior to a circumcision?
Which of the following nursing assessments is NOT typically performed prior to a circumcision?
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What is a common nonpharmacological method used to enhance pain management during circumcision?
What is a common nonpharmacological method used to enhance pain management during circumcision?
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What is the initial action to take if a newborn shows signs of hemorrhage post-procedure?
What is the initial action to take if a newborn shows signs of hemorrhage post-procedure?
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Which condition is associated with excessive heat loss in newborns?
Which condition is associated with excessive heat loss in newborns?
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Which respiratory condition is indicated by a respiratory rate of less than or equal to 30 breaths per minute?
Which respiratory condition is indicated by a respiratory rate of less than or equal to 30 breaths per minute?
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What should a nurse do if bulb suctioning is unsuccessful in clearing a newborn's airway?
What should a nurse do if bulb suctioning is unsuccessful in clearing a newborn's airway?
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What nursing action is appropriate to help prevent respiratory complications in a newborn after a cesarean delivery?
What nursing action is appropriate to help prevent respiratory complications in a newborn after a cesarean delivery?
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In the event of persistent bleeding after circumcision, which is the appropriate action?
In the event of persistent bleeding after circumcision, which is the appropriate action?
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What is the correct order of aspiration when using a bulb syringe?
What is the correct order of aspiration when using a bulb syringe?
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What is necessary to inform the family about the use of the bulb syringe?
What is necessary to inform the family about the use of the bulb syringe?
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Which sign indicates respiratory distress in a newborn?
Which sign indicates respiratory distress in a newborn?
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Which nursing intervention should be prioritized for a newborn showing signs of hypoglycemia?
Which nursing intervention should be prioritized for a newborn showing signs of hypoglycemia?
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What is the main purpose of using two identification bands for a newborn?
What is the main purpose of using two identification bands for a newborn?
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How should parents check the circumcision site for bleeding after the procedure?
How should parents check the circumcision site for bleeding after the procedure?
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Which temperature range is considered normal for a newborn's core temperature?
Which temperature range is considered normal for a newborn's core temperature?
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What mechanism of heat loss involves moisture loss from the skin?
What mechanism of heat loss involves moisture loss from the skin?
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What action should a staff member take if they are unsure of their identification status?
What action should a staff member take if they are unsure of their identification status?
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Which of the following is NOT a sign of hypothermia in a newborn?
Which of the following is NOT a sign of hypothermia in a newborn?
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What should be placed on the newborn's wrist and ankle for identification?
What should be placed on the newborn's wrist and ankle for identification?
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What can happen if a newborn becomes chilled after circumcision?
What can happen if a newborn becomes chilled after circumcision?
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Which is a common misunderstanding about the identification of newborns?
Which is a common misunderstanding about the identification of newborns?
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What is the role of photo identification badges in the care of newborns?
What is the role of photo identification badges in the care of newborns?
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What is the primary purpose of preheating a radiant warmer in a newborn care setting?
What is the primary purpose of preheating a radiant warmer in a newborn care setting?
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Which of the following practices is NOT recommended when bathing a newborn?
Which of the following practices is NOT recommended when bathing a newborn?
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What should be done to minimize heat loss due to evaporation after the newborn is delivered?
What should be done to minimize heat loss due to evaporation after the newborn is delivered?
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Which heat loss mechanism requires keeping the newborn's head covered during care procedures?
Which heat loss mechanism requires keeping the newborn's head covered during care procedures?
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What is the optimal ambient temperature range for a newborn's nursery?
What is the optimal ambient temperature range for a newborn's nursery?
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Which statement is correct regarding the position of a newborn during sleep to reduce the risk of SUID?
Which statement is correct regarding the position of a newborn during sleep to reduce the risk of SUID?
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How often should a bottle-fed newborn typically be fed?
How often should a bottle-fed newborn typically be fed?
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What is the minimum expected time frame for a newborn to void after birth?
What is the minimum expected time frame for a newborn to void after birth?
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When should formula feeding typically begin for a newborn?
When should formula feeding typically begin for a newborn?
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What is the best method for promoting and maintaining a newborn's temperature?
What is the best method for promoting and maintaining a newborn's temperature?
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Study Notes
Nursing Care of Newborns
- Newborn care is aimed at stabilization or restoration of health, focusing on airway management, oxygenation, thermoregulation, and continuous monitoring.
- Physical assessments occur every 8 hours or as necessary, including monitoring vital signs and umbilical cord care.
Assessment Procedures
- Vital signs are monitored frequently post-birth; weight should be recorded daily, consistently using the same scale.
- The umbilical cord is inspected for bleeding and secure clamping to prevent hemorrhage.
- Observe for three distinct phases of reactivity:
- First period of reactivity (0-30 mins): Newborn is alert, exploring, with rapid heart and respiratory rates (up to 180 bpm).
- Relative inactivity (60-100 mins): Newborn becomes quiet and sleeps; heart and respiratory rates decrease.
- Second period of reactivity (2-8 hours): Newborn regains responsiveness; often gags due to mucus accumulation.
Laboratory Tests
- Capillary heel stick for metabolic screening is mandated within 24 hours post-birth (repeated if discharged early).
- Genetic screening must include testing for phenylketonuria (PKU), galactosemia, cystic fibrosis, and other metabolic disorders.
- Serum bilirubin levels are tested in all newborns before discharge.
Circumcision Considerations
- Circumcision is a family decision influenced by health, hygiene, religion, and cultural factors.
- The procedure is generally performed within the first few days of life but can be postponed for cultural reasons or medical instability.
- Health benefits include easier hygiene and decreased STI risk, while risks include hemorrhage, infection, and urinary complications.
- Contraindications include hypospadias, epispadias, bleeding disorders, and lack of Vitamin K.
Thermoregulation
- Maintaining thermal stability is crucial due to the newborn's large surface-area-to-volume ratio and thin insulating layer.
- A newborn's core temperature should be maintained between 36.5 to 37°C (97.7 to 98.6°F) to prevent cold stress and increased oxygen demand.
- Heat loss mechanisms include conduction, convection, evaporation, and radiation, each requiring specific interventions to maintain warmth.
Feeding and Care
- Breastfeeding is encouraged immediately after birth as part of baby-friendly initiatives, while formula feeding usually starts 2 to 4 hours post-birth.
- Newborns typically sleep 16 to 19 hours a day, requiring safe sleep practices to minimize sudden unexpected infant death (SUID) risk.
Family Involvement and Education
- Family education is integral, encouraging participation in newborn care to foster attachment.
- Clear umbilical cord care instructions are vital for infection prevention; the stump typically falls off within 10 to 14 days.
Medications Administered
- Erythromycin ointment is applied to prevent ophthalmia neonatorum.
- Vitamin K is administered to prevent hemorrhagic disorders, given intramuscularly soon after delivery.
- Hepatitis B vaccination is recommended for all newborns, with specific protocols for infants born to infected mothers.
Cold Stress Management
- Cold stress can lead to serious complications like hypoxia, acidosis, and hypoglycemia.
- Monitoring for signs of hypothermia is essential, and appropriate interventions must be enacted promptly.
Additional Key Nursing Interventions
- Gentle pressure applied and timely documentation is critical in managing post-circumcision care and monitoring for complications such as hemorrhage.
- Techniques for airway clearance include suctioning, proper positioning, and ensuring adequate hydration.### Newborn Identification and Safety
- Matching identification bands of parents and newborns is the most reliable method to ensure correct identification of the infant.
Immediate Postpartum Care
- The highest priority nursing intervention for a newborn immediately after birth is initiating breastfeeding, essential for the health of both mother and baby.
Risks from Incomplete Drying
- If a newborn is not completely dried after birth, they are at risk for heat loss via evaporation. This occurs when moisture on the skin turns into gas, pulling heat away from the body. Newborns are particularly susceptible due to their large surface area relative to body mass.
Prophylactic Eye Treatment
- Erythromycin ointment is administered to newborns to prevent ophthalmia neonatorum, an eye infection that can be caused by Neisseria gonorrhoeae.
Importance of Vitamin K Injection
- Vitamin K (phytonadione) is given to newborns shortly after birth to promote blood clotting. Newborns are born with low vitamin K levels as it does not cross the placenta. Administration helps prevent hemorrhagic disease of the newborn (HDN), a serious bleeding condition.
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Description
Explore the essential nursing care practices for newborns as outlined in Chapter 24. This quiz covers stabilization methods, respiratory care, thermoregulation, and the importance of monitoring. Test your knowledge on nursing interventions and family education related to newborn care.
