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NUR207 Test 3
| Question | Answer |
|---|---|
| Anterior and Posterior fontanelles when do they close, what is their shape. | anterior- diamond chape (closes by 12-18months) posterior- triangular (closes by 2 months) |
| What position should the baby sleep | supine, side |
| Assessment finding of development hip dysplasia | most reliable sign is abduction of the leg on the affected side, asymmetry of skin folds, shortening of the femur |
| What is a Pavlik Harness | soft brace used to treat DDH developmental dysplasia of the hip- where the joint is not properly formed |
| Hypoglycemia level in newborn | <40 -term infant <30- preterm infant |
| Signs of increased intracranial pressure | bulging fontanelles lethargy poor feeding seizures high pitched cry |
| Term baby abnormal findings to be reported | pulse >160 BMP <100 temp >99.8 or <97.1 noisy respirations, nasal flaring, chest retractions |
| Newborn medications to be sure they are administered before discharge | · Vitamin K · Erythromycin eye drop · Hepatitis B Vaccine first injection |
| Newborn reflexes rooting reflexes, tonic neck clonic reflex, a moro Reflex | Moro -Sudden jarring causes extension and abduction, spreading fingers making a C Tonic Neck Reflex- Head is turned to one side and arm and leg to the same side Rooting reflexes- Infant’s head turns in the direction of anything of that touch’s cheeks |
| PKU what is it, what does it mean, when is the test given, | - faulty metabolism of phenylalanine, amino acid that is essential, found in protein. - severe cognitive delay , By the time the urine test is positive, brain damage has already occured -Guthrie blood test - 48-72 hrs after ingestion of proteins. |
| Problems associated with post term delivery | - Asphyxia - Meconium aspiration (hypoxia/distress relax anal sphincter, meconium can be aspirated) - Poor nutritional status - (polycythemia) because of intrauterine hypoxia - Difficult delivery-size of infant - Birth defects - Seizures |
| Findings that would be expected to be found on a post term infant | long and thin, looks as though weight has been lost. loose skin in thighs and buttocks. Little lanugo, skin dry and peeling bc of loss of vernix caseosa. Nails are long and may be stained with meconium. Infant has thick head of hair and looks alert. |
| Priority nursing action for a post term neonate | - Priority includes observing for respiratory distress usually because of aspiration of meconium-stained amniotic fluid |
| Signs to report to HCP with a preterm infant | - Breathing difficulties - Low blood sugar - Jaundice |
| Feeding a pre term newborn how is it done | - Varies with gestational age and health status - May require gavage feedings (feeding tube, replaced every 3-7 days)) - If weigh over 3.3lbs may be able to bottle feed - If too premature or too ill, TPN feeding required |
| Expected findings in a preterm infant | inadequate reparatory problems, apnea, neonatal hypoxia poor body temp control ^ tendency to bleed, hypo-glycemia, calcemia poor nutrition retinopathy (cause by 02 toxicity) increased intracranial pressure hyaline membrane disease |
| characteristics of preterm infant | • Skin is transparent and loose • Lack of SQ fat • Lanugo (Fine Hair) covers forehead, shoulders, and arms • Vernix: Cheese like coating covering skin • Extremities appears short • Sole of feet have few creases • Abdomen protrudes |
| How do you know the surfactant is working | Improved Lung functioning will be seen within 72hrs |
| What are the definitions of LGA, SGA, Term infant, pre term infant, post term infant | LGA- above the 90th percentile for that gestational age SGA- below the 10th percentile for that gestational age Preterm infant-34 -36 weeks and 6 days of gestation Posterm infant-beyond 42 weeks’ gestation |
| Complications of rising bilirubin level | deeper the jaundice, greater the risk for neurological damage. As the bilirubin level increases, the jaundice progresses from the head toward the feet |
| Nutritional problems seen in preterm infant | -Sucking and swallowing reflexes are immature -Need for fat soluble vitamins, glucose, nutrients - May need a tube feeding - Oral gavage |
| Signs of hypoglycemia | tremors, weak cry, lethargy, convulsions |
| Role of Bili light on an infant | reduces the high levels of bilirubin in a newborn's blood which causes the jaundice |
| Care of an infant having phototherapy | Cover and protect eyes (remove at least once per shift to check eyes for conjunctivitis) cover ovaries or testes, reposition every 2 hrs |
| Priority pre operative care with a client having meningomyelocele | neurological assessment and prevention of infection. The status of the fontanelles and any signs of increased ICP, such as irritability or vomiting, are significant. Sometimes a shunt is performed shortly after closure of the spine |
| Examples of natural family planning examples | identify s/s associated with ovulation. abstains from intercourse or uses a barrier method. requires extensive assessment and charting of all the changes in the menstrual cycle increasing the odds of achieving pregnancy if desired |
| When does a diaphragm need to be refitted | • 20% of weight fluctuations • After abdominal or pelvic surgery • After every pregnancy • Must stay in place 6 hours after intercourse • Not recommend for clients who have a history of Toxic Shock Syndrome |
| Head and chest circumference to be reported to HCP | Head circumference should be equal to or no more than 2 cm greater than chest circumference until age 2. |
| Signs of respiratory distress in the newborn | Rate and character of respirations Color (cyanosis) General behavior |
| Complications seen in LGA infants | Injury at birth due to size Hypoglycemia |
| Effects of maternal hormones on male infants | eye contact developmental delay increased muscle mass or growth rate |
| Effects of maternal hormones on female infants | breast enlargement (maternal estrogen could produce witch's milk) genital swelling |
| What are Mongolian spots | bluish/greyish usually found over the sacral and gluteal areas |
| Use of a bulb syringe | Always insert the tip of the bulb syringe into the side of their cheek to keep from causing the gag reflex |
| Non prescription forms of pain relief with a newborn | Swaddling Cuddling Rocking Non-nututrive sucking Quiet environment |
| Signs of complications when gavage feed | If only mucus or air is aspirated, the feeding can be given as planned. If a residual of liquid contents is aspirated, the health care provider should be notified before proceeding to feed the infant. |
| Car Seat Safety | A 5-point harness with straps that go over the hips and shoulders A clear clip A splitter plate behind the seat Labeling with specific weight and height limits |
| Care of an infant in a spica cast | • Keep the cast and skin clean and dry • Check the skin daily for sore areas • Use a flashlight to check under the cast edges for sores or blisters • Don't use lotions, oils, or powder on the skin under the cast |
| Retinopathy of the premature. What is it, what is the cause, what can happen | · Disorder of the developing retina in preterm infants · Caused by oxygen toxicity #1 cause of blindness in preterm infant · Watch oxygen levels closely · Should have the least amount of oxygen that is needed to meet the infants needs |
| Signs of neonatal abstinence syndrome | - Body tremors, hyperirritability, wakefulness, diarrhea, poor feeding, sneezing, and yawning |
| cervical mucus changes of a woman who wishes to use natural family-planning methods | Around the time of ovulation, the slippery, clear cervical mucus enhances the motility of the sperm. |
| what meds decrease effectiveness of oral contraceptives? | Anticonvulsants |
| Dyspareunia | painful sexual intercourse |
| cephalohematoma | a is caused by a collection of blood beneath the periosteum of the cranial bone. It does not cross the suture line |
| sternal retractions in newborn | evidence the newborn is in respiratory distress |
| moro reflex | causes drawing the legs up, fanning the arms, and then bringing the arms to the midline in an embrace position. |
| rooting reflex | causes the infant‘s head to turn in the direction of anything that touches the cheek in anticipation of food. |
| anterior fontanelle | open and diamond shaped should not be raised or sunken |
| color of stool of 2 day old breastfed infant | bright yellow, soft, and pasty. |
| In the first 3 to 4 days of life, a newborn generally loses how much birth weight | 5% to 10% |
| Blood-tinged mucus discharged from infants vagina is caused by | female sex hormones transferred in utero from mother to infant |
| how to clear mucus from newborns nose and mouth | Depress the bulb before inserting the syringe tip into the mout,h. depression is slowly released |
| APGAR score | heart rate, respiration, muscle tone, reflexes, and color. The score is obtained 1 minute after birth and again after 5 minutes. |
| newborns are especially prone to dehydration because | small glomeruli, minimal renal blood flow, immature renal tubes that do not concentrate urine |
| high bilirubin level and deep jaundice can cause neurological damage which can cause | brain damage |
| How will the nurse safely ensure tube placement when preparing to initiate a gavage feeding | Aspirate stomach contents |
| nursing intervention during apneic episode | Gently rubbing the infant‘s back, ankles, or feet may stimulate the infant to breathe |
Created by:
snmartin
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