Healthy Newborn

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Healthy Newborn

Submitted by Ngassa, Gratino (gngassa) on 5/15/2013 11:14:57 AM

Points Awarded| 1.00|
Points Missed| 22.00|
Percentage| 4.3%|

Infant Care at Birth
The nursery RN places the infant under a radiant warmer and starts to dry her quickly.

1.
What is the rationale for these actions?
A) Heat production is increased through stimulation.
INCORRECT
Drying the infant may increase heat production, but this is not the best method to correct the newborn's body temperature.

B) Convective heat loss from evaporation is reduced.
CORRECT
Drying the infant quickly and placing her under a radiant warmer reduces heat loss through evaporation and radiation. 

C) Newborns in an incubator are more difficult to access than those in a radiant warmer. INCORRECT
Although a radiant warmer allows healthcare personnel easy access to the infant, that is not the reason for its use in this situation.

D) Bonding is promoted by enhancing the infant's appearance. INCORRECT
Drying and warming do not necessarily enhance the infant's appearance or promote bonding.

2.
Which action should the nurse take prior to drying the infant's back? A) Note if the infant has passed any meconium stool.
INCORRECT
Although this observation is important, it is not related to drying the back.

B) Observe the sacral area for possible Mongolian spots.
INCORRECT
Mongolian spots are normal variations in the pigment of the skin, and they do not hinder drying the back.

C) Assess the amount and location of vernix caseosa.
INCORRECT
The amount of vernix caseosa is related to gestation age, but is not related to drying the back.

D) Inspect the back for possible neurological defects.
CORRECT
To prevent harm while drying the newborn, the back should always be inspected for possible neurological defects, like spinal bifida. 

At 1 minute of age, the infant is crying and has a heart rate of 160 and a respiratory rate of 58. Both of the infant's arms and legs are flexed, and her hands and feet are cyanotic.

3.
Which APGAR score should the nurse assign?
A) 10.
INCORRECT
Review the findings again.

B) 9.
CORRECT
One point is deducted for acrocyanosis. 

C) 8.
INCORRECT
Review the findings again.

D) 7.
INCORRECT
Review the findings again.

The nurse conducts a physical assessment of the infant looking for normal as well as abnormal findings.

4.
Upon inspection of the umbilical cord, which finding should the nurse report to the healthcare provider? A) The cord is covered with Wharton's jelly.
INCORRECT
This is a normal finding.

B) Pulsations are felt at the base of the cord.
INCORRECT
This is a normal finding.

C) One artery and one vein are present.
CORRECT
Two arteries and one vein should be present. 

D) The cord is glistening with a pearl-like coloring.
INCORRECT
This is a normal finding.

The Carson baby's head is molded from the vaginal delivery. Upon seeing the baby, Ms. Carson says, "Oh, she is so beautiful, but something is wrong with her head."  

5.
How should the nurse respond?
A) "No nothing is wrong with her head. She really is a beautiful baby." INCORRECT
This response does not fully address the mother's concern.

B) "'Yes, it is misshaped, but we will show you how to change it over time." INCORRECT
Parents can be taught to change an infant's sleeping positions to correct a misshaped head, but this is not the best response.

C) "Her head has been molded from delivery through the birth canal, which is normal." CORRECT
Molding commonly occurs in babies delivered vaginally, and the head will become more symmetrical over time.

D) "I know you are concerned. Would you like to talk further with the midwife?" INCORRECT
Acknowledging Ms. Carson's feelings is a thoughtful response, but referral to the midwife is not necessary.

Ms. Carson is offered the opportunity to breastfeed. After...
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