Chapter 24 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 24 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 24_LO01_Q01

The nurse is assessing a newborn at 1 hour of age. Which finding requires an immediate intervention?

1. Respiratory rate 60, crackles present bilaterally
2. Pulse rate 145, systolic murmur heard
3. Mean blood pressure 55 mm Hg
4. Pauses in respiration lasting 30 seconds

Correct Answer: 4

Rationale:

1. This respiratory rate is normal; crackles are commonly heard in the first few hours after birth as the infant reabsorbs the fluid in the lungs present at birth.
2. This pulse rate is normal. Systolic murmurs are very unlikely to indicate serious pathology, and are usually caused by incomplete closure of the ductus arteriosus or foramen ovale.
3. This is a normal finding in an infant at 1 hour of life.
4. Pauses in respirations greater than 20 seconds are considered episodes of apnea, and require further intervention.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 24.1 Explain the respiratory and cardiovascular changes that occur during the transition to extrauterine life and during stabilization in determining the nursing care of the newborn.

Chapter 24_LO02 _Q02

The newborn at 24 hours of age has a red blood cell count of 5.4 million per ml. Which of the following entries would the nurse expect to find in the newborn’s chart?

1. Cord clamping delayed until pulsation ceased.
2. CBC drawn from the anterior surface of the left hand.
3. Placental abruption noted to be 80% at time of delivery.
4. Infant has breastfed 15–20 minutes every three hours.

Correct Answer: 1

Rationale:

1. Delayed cord clamping can cause an increase of up to 61%, resulting in a slightly higher-than-average red blood cell count.
2. Venous blood has lower red cell counts than do capillary blood samples.
3. Maternal or fetal blood loss cause hypovolemia and low red blood cell counts (less than 5.2 million per ml).
4. Breastfeeding does not impact red cell counts in the first day of life.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 24.2 Compare the factors that modify the newborn’s blood values to the corresponding results.

Chapter 24_LO03 _Q03

The nurse is teaching new parents how to dress their newborn. Which statements indicate that teaching has been effective? Select all that apply.

1. “We should make sure that we keep our home air-conditioned so the baby doesn’t overheat.”
2. “It is important that we dry the baby off as soon as we give him a bath or shampoo his hair.”
3. “When we change the baby’s diaper, we should change any wet clothing or blankets, too.”
4. “If the baby’s body temperature gets too low, he will warm himself up without any shivering.”
5. “Our baby will have a much faster rate of breathing if he is not dressed warmly enough.”

Correct Answers: 2, 3, 4, 5

Rationale:

1. Babies need to be kept warm. Cold ambient temperatures will increase the oxygen consumption of a newborn, and can lead to respiratory distress.
2. Drying a wet baby prevents evaporation, one mechanism of heat loss.
3. Changing wet clothing or blankets immediately prevents evaporation, one mechanism of heat loss.
4. Non-shivering thermogenesis is the mechanism used by newborns to warm themselves.
5. A neonate with a low body temperature will increase oxygen consumption, which can lead to respiratory distress.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Evaluation

Learning Outcome: 24.3 Relate the process of thermogenesis in the newborn and the major mechanisms of heat loss to the challenge of maintaining newborn thermal stability.

Chapter 24_LO03 _Q04

The nurse is planning the care of a 1-day-old infant. Which of the following nursing interventions would protect the newborn from heat loss by convection?

1. Placing the newborn away from air currents
2. Pre-warming the examination table
3. Drying the newborn thoroughly
4. Removing wet linens from the isolette

Answer: 1

Rationale:

1. Placing the newborn away from air currents reduces heat loss by convection.
2. Pre-warming the examination table reduces heat loss by conduction.
3. Drying the newborn thoroughly immediately after birth or after a bath will prevent heat loss by evaporation.
4. Removing wet linens that are not in direct contact with the newborn from the isolette reduces heat loss by radiation.

Cognitive Level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Planning

Learning Outcome: 24.3 Relate the process of thermogenesis in the newborn and the major mechanisms of heat loss to the challenge of maintaining newborn thermal stability.