Exam 37: Nursing Care of the High Risk Newborn

For clinical purposes,preterm and postterm infants are defined as:

Risk factors associated with necrotizing enterocolitis (NEC)include (choose all that apply):

A premature infant with respiratory distress syndrome (RDS)receives artificial surfactant.How does the nurse explain surfactant therapy to the parents?

With regard to eventual discharge of the high risk newborn or transfer to a different facility,nurses and families should be aware that:

On day 3 of life,a newborn continues to require 100% oxygen by nasal cannula.The parents ask if they may hold their infant during his next gavage feeding.Given that this newborn is physiologically stable,what response does the nurse give?

In the continuing assessment of a preterm infant,the nurse notices continued respiratory distress even though oxygen and ventilation have been provided.The nurse should suspect:

A premature infant never seems to sleep longer than an hour at a time.Each time a light is turned on,an incubator closes,or people talk near her crib,she wakes up and cries inconsolably until held.The correct nursing diagnosis is ineffective coping,related to:

Calculate the corrected age of an infant who was born at 25 1/7 weeks and is preparing for discharge 124 days past delivery.

An infant is being discharged from the neonatal intensive care unit (NICU)after 70 days of hospitalization.The infant was born at 30 weeks of gestation with several conditions associated with prematurity,including respiratory distress syndrome,mild bronchopulmonary dysplasia,and retinopathy of prematurity requiring surgical treatment.During discharge teaching the infant's mother asks the nurse if her baby will meet developmental milestones on time,as did her son who was born at term.The nurse's most appropriate response is:

A newborn was admitted to the neonatal intensive care unit (NICU)after being delivered at 29 weeks of gestation to a 28-year-old multiparous,married,Caucasian female whose pregnancy was uncomplicated until premature rupture of membranes and preterm birth.The newborn's parents arrive for their first visit after the birth.The parents walk toward the bedside but remain approximately 5 feet away from the bed.The nurse's most appropriate action is to:

In appraising the growth and development potential of a preterm infant,nurses should:

A pregnant woman was admitted for induction of labor at 43 weeks of gestation with sure dates.A nonstress test (NST)in the obstetrician's office revealed a nonreactive tracing.On artificial rupture of membranes,thick meconium-stained fluid was noted.The nurse caring for the infant after birth anticipates:

Insensible water loss (IWL)is an evaporative loss that occurs largely through the skin.The effects of radiant warmers,incubators,phototherapy,and other factors can augment the IWL.Increased stooling or voiding,increased evaporative losses,inadequate volume or incorrect fluid administration,and problems of malabsorption may cause weight loss.Calculate the weight loss for the following scenario.Is the infant's weight loss in an acceptable range? Day 9 weight: 2340 g Day 10 weight: 2299 g

An infant is to receive gastrostomy feedings.What intervention should the nurse institute to prevent bloating,gastrointestinal reflux into the esophagus,vomiting,and respiratory compromise?

An infant at 36 weeks of gestation has increasing respirations (80 to 100 breaths/min with marked substernal retractions).The infant is given oxygen by continuous nasal positive airway pressure (CPAP).Which arterial oxygen level indicates hypoxia?

There are numerous signs and symptoms of neonatal infection.Interestingly,the most common is ________________,whereas ________________ is rare.

A nurse practicing in the perinatal setting should promote kangaroo care regardless of an infant's gestational age.This intervention:

Which combination of expressing pain could be demonstrated in a neonate?

As a result of large body surface in relation to weight,the preterm infant is at high risk for heat loss and cold stress.In understanding the four mechanisms of heat transfer (convection,conduction,radiation,and evaporation)the nurse can create an environment for the infant that prevents temperature instability.While evaluating the plan that has been implemented,the nurse knows that the infant is experiencing cold stress when he or she exhibits: