Chapter 32 The Newborn at Risk: Birth-Related Stressors

Chapter 32   The Newborn at Risk: Birth-Related Stressors

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse prepares to admit to the nursery a newborn whose mother had meconium-stained amniotic fluid. The nurse knows this newborn might require which of the following?

1. Initial resuscitation
2. Vigorous stimulation at birth
3. Phototherapy immediately
4. An initial feeding of iron-enriched formula

Answer:  1

Explanation:  1. The presence of meconium in the amniotic fluid indicates that the fetus may be suffering from asphyxia. Meconium-stained newborns or newborns who have aspirated particulate meconium often have respiratory depression at birth and require resuscitation to establish adequate respiratory effort.

Page Ref: 826

Cognitive Level:  Applying

Client Need/Sub:  Physiological Integrity: Reduction of Risk Potential

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  2 Differentiate, based on clinical manifestations, among the various types of respiratory distress (respiratory distress syndrome, transient tachypnea of the newborn, meconium aspiration syndrome, and persistent pulmonary hypertension) in the newborn and each type’s related nursing care.

MNL LO:  4.5.3 Correlate high-risk conditions present at birth to their associated nursing care.

 

 

2) A laboring mother has recurrent late decelerations. At birth, the infant has a heart rate of 100, is not breathing, and is limp and bluish in color. What nursing action is best?

1. Begin chest compressions.
2. Begin direct tracheal suctioning.
3. Begin bag-and-mask ventilation.
4. Obtain a blood pressure reading.

Answer:  3

Explanation:  3. Most newborns can be effectively resuscitated by bag-and-mask ventilation.

Page Ref: 814

Cognitive Level:  Applying

Client Need/Sub:  Physiological Integrity: Reduction of Risk Potential

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | NLN Competencies: Quality and Safety: Communicate potential risk factors and actual errors. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  1 Describe how to identify infants in need of resuscitation and the appropriate method of resuscitation based on the prenatal/labor record and observable physiologic indicators.

MNL LO:  4.5.3 Correlate high-risk conditions present at birth to their associated nursing care.

 

3) Which fetal/neonatal risk factors would lead the nurse to anticipate a potential need to resuscitate a newborn?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Nonreassuring fetal heart rate pattern/sustained bradycardia
2. Fetal scalp/capillary blood sample pH greater than 7.25
3. History of meconium in amniotic fluid
4. Prematurity
5. Significant intrapartum bleeding

Answer:  1, 3, 4, 5

Explanation:  1. Nonreassuring fetal heart rate pattern/sustained bradycardia would be considered a potential need to resuscitate a newborn.

3. History of meconium in amniotic fluid would be considered a potential need to resuscitate a newborn.
4. Prematurity would be considered a potential need to resuscitate a newborn.
5. Significant intrapartum bleeding would be considered a potential need to resuscitate a newborn.

Page Ref: 812

Cognitive Level:  Analyzing

Client Need/Sub:  Physiological Integrity: Physiological Adaptation

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Describe how to identify infants in need of resuscitation and the appropriate method of resuscitation based on the prenatal/labor record and observable physiologic indicators.

MNL LO:  4.5.1 Examine characteristics of the high-risk newborn.

 

4) During newborn resuscitation, how does the nurse evaluate the effectiveness of bag-and-mask ventilations?

1. The rise and fall of the chest
2. Sudden wakefulness
3. Urinary output
4. Adequate thermoregulation

Answer:  1

Explanation:  1. With proper resuscitation, chest movement is observed for proper ventilation. Pressure should be adequate to move the chest wall.

Page Ref: 814

Cognitive Level:  Remembering

Client Need/Sub:  Physiological Integrity: Reduction of Risk Potential

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Factors that contribute to or threaten health. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  1 Describe how to identify infants in need of resuscitation and the appropriate method of resuscitation based on the prenatal/labor record and observable physiologic indicators.

MNL LO:  4.5.3 Correlate high-risk conditions present at birth to their associated nursing care.