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exam2
neonatal
| Question | Answer |
|---|---|
| during what period do you review prenatla record for risk factors (infections, disease, drugs ETOH, GDM, ets) review delivery record, (prolonged ROM, instruments, narcotics, analgesia, presence of meconium)? | admission/first 4 hrs of life nursing assessment |
| for what nursing assessment is the focus to protect and support the neonate as changes occur, maintain resp fx, thermoregulation, cardiac assessment, dec risk for infection, nut and hydration, educate patients? | nursing assessment/admission and first 4 hours of life |
| during the nursing assessment what is most critical and immediate physiolo, change that occurs in transition from fetus to neonate, initiated by compression of thorax, lung expansion, inc in alv o2 conc, vasodilation of pulmonary vessels? can change quick | normal respiratory changes |
| what is excessive heat loss>hypothermia>adaptations in infants body>inc hr, inc rr, inc o2 consumption, hypoxima, no glucose, hypoglycemia, dec in surfactant,>RDS? Risks: premi, SGA, hypoglycimia, prolonged resusc efferts, sepsis, neuro, endo, cardio prob | cold stress |
| what is clinically shown as axillary temp below 97.6 deg f, cool skin, lethargy, pallor, tachypnea, grunting, hypoglycemia, hypotonia, jitteriness, weak suck? | s/s of cold stress |
| what is blood glucose level <40 in the neonate, risks: diabetic mom, >4000g LGA, post term, premi, SGA, hypothermia, neonatal infec, RD, neonatal resuscitation, birth trauma? | hypoglycemia |
| what condition in the neonate is clinically manifested as jitteriness, hypotonia, irritability, apnea, lethargy, temp instability? | hypoglycemia |
| for what condition in the newborn do you monitor for s/s of hypoglycemia, assess BG w/ glucose monitor, assist with breastfeeding, maintain NTE, | hypoglycemia |
| when doing a cardiovascular assesment on the newborn, what connects the pulmonary artery with the decending aorta, usually closes within 15 min post birth, causes murmors. common | patent ductus arteriosus |
| what neonates organ is immature, but is capable of carb metabolism and blood coagulation, billirubin congigation is limited? | liver |
| what is a fat soluble substance produced from the breakdown of RBCs uncojugated? most be converted | indirect bilirubin |
| what is a water soluble substance, conjugated by liver enzymes, can be excreted in the urine and stool congugated? | direct bilirubin |
| what is a condition were there is a high level of unconjugated bilirubin in the neonates blood related to the immediate liver function, high RBC count that is common in neonates, and inc hemolysis caused by shorter RBC life span? | hyperbilirubinemia |
| clotting fators are made in the liver, what influences the activation of these factors? during intrauterine life, fetus gets this from mom, after birth this dec, baby at risk for hemorrhage, is given prophlyaxis to dec bleeding risk? | vitamin k |
| what neonatal system is immature functunally, but rapidaly adapts to demands for growth and development through ingestion, digestion, absorption and elimination, early capacity 40-60ml 90 at day 3-4, eat every 3-4 hr | gastrointestinal changes |
| what kind of stool is yellow and semiformed, later it becomes a golden yellow with a pasty consistency and smells sour? more stools per day 4-8 | breastfeed stool |
| what kind of stool is drier and more formed than breastfed stool it is a paler yellow or brownish yellow has an unpleasent odor? constipation can occur | formula feed stool |
| what type of neonate stool is loose and green? | diarrheal stool |
| what neonatal system protects the nonate from bacteria and virus, include active humoral immunity, passive immunity, lymphocytes, immunoglobulins | immune system |
| because of immature defense mechanisms, decreased exposure to organisms, delayed response to antigens, birth trauma promotes portal of entry, TX: erythromycin to eyes for eye infection, keep dry and warm, skin to skin contact, glucose monitoring if needed | infection |
| initiate feedings of breast or bottle, if baby in resp distress IV fluids, educate parents regarding admission process and expectations? | nutrition/hydration and education |
| what is an evaluation to assess need to remain under observation, includes birth history, airway clearance, vitals, body temp, neuro status, resp status, ability to feed, evidence of complications? | reassessment |
| who is responsible for first checks and confirms newborn's id with mothers id? obtain and record significant information? | nurses |
| when do you maintain a clear airway and stable vitals, maintain NTE, (radient warmer during assessment), administer vitamin k, erythromycin, early assessment of neonatel distress, initiation of first feed, facilitate parent-newborn attachment? | admission |
| when do you assess the neonate per protocol? glucose monitoring, feeding implementation, thermoregulation? | nursing management following newborn transition |
| when do you maintain vitals, maintain cardiopulmonary fx, maintain NTE, promote hydration and nutrition, promote skin integ, lab and diagnostic tests (PKU, immun, hearing) promo of safety, prevent complications, circumcision, enhancement of attachment, IO | after transition |
Created by:
malcolmnursing2
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