Chapter 29 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Chapter 29 Contemporary Maternal Newborn Nursing 7th Edition by Patricia W. Ladewig

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

Chapter 29_LO01_Q01

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. Deep suction the airways
3. Begin bag-and-mask ventilation.
4. Obtain a blood pressure reading.

Correct Answer: 3

Rationale:

1. Chest compressions are not initiated until the heart rate is less than 60 and respirations have been established.
2. This would be appropriate if there were meconium-stained fluid. There is no information about the amniotic fluid.
3. When an infant is not breathing, and has poor muscle tone, bag-and-mask ventilation is the appropriate resuscitation measure to undertake.
4. Blood pressure is insignificant during resuscitation efforts. This infant needs respirations established.

Cognitive level: Application

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 29.1 Describe how to identify infants in need of resuscitation and the appropriate method of resuscitation based on the antepartal/labor record and physiologic

indicators seen at birth in the nursing care management of the infant at risk because of asphyxiation.

Chapter 29_LO02 _Q02

The nurse is assessing a 2-hour-old newborn delivered by cesarean at 38 weeks. The amniotic fluid was clear. His mother had pre-eclampsia. His respiratory rate is 80; he is grunting, and has nasal flaring. What is the most likely cause of this infant’s condition?

1. Meconium aspiration syndrome
2. Transient tachypnea of the newborn
3. Respiratory distress syndrome
4. Prematurity of the neonate

Correct Answer: 2

Rationale:

1. There was no meconium in the amniotic fluid, which rules out meconium aspiration syndrome.
2. The infant is term, and born by cesarean. He is most likely experiencing transient tachypnea of the newborn.
3. The infant is not premature, and therefore is not likely to be experiencing respiratory distress syndrome.
4. The infant is not premature. Prematurity alone does not cause respiratory distress; the lack of surfactant causes respiratory distress syndrome.

Cognitive level: Comprehension

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 29.2 Based on clinical manifestations, differentiate among the various types of respiratory distress (respiratory distress syndrome, transient tachypnea of the newborn, and meconium aspiration syndrome) in the newborn, and the nursing care related to each type.

Chapter 29_LO02 _Q03

A nurse is caring for a newborn on a ventilator who has respiratory distress syndrome (RDS). The nurse informs the parents that the newborn is improving. Which of the following data supports the nurse’s assessment?

1. Decreased urine output
2. Pulmonary vascular resistance increases.
3. Increased PCO₂
4. Increased urination

Answer: 4

Rationale:

1. As fluid moves out of the lungs and into the bloodstream, alveoli open, and kidney perfusion increases, thereby increasing urine output.
2. Pulmonary vascular resistance increases with hypoxia.
3. Increased PCO₂ results from alveolar hypoventilation.
4. Increased urination could be an indication that the newborn’s condition is improving.

Cognitive Level: Analysis

Category of Client Need: Physiological Integrity: Physiological Adaptation

Nursing Process: Evaluation

Learning Outcome: 29.2 Based on clinical manifestations, differentiate among the various types of respiratory distress (respiratory distress syndrome, transient tachypnea of the newborn, and meconium aspiration syndrome) in the newborn, and the nursing care related to each type.

Chapter 29_LO03 _Q04

The nurse is caring for an infant who delivered in a car on the way to the hospital and who has developed cold stress. Which finding requires immediate intervention?

1. Vasoconstriction and pallor
2. Blood glucose level of 45
3. Room-temperature IV running
4. Positioned under radiant warmer

Correct Answer: 2

Rationale:

1. Vasoconstriction is the first physiologic response to a lowering temperature, and will cause pallor.
2. This is an adequate blood sugar in a neonate. Less than 40 is hypoglycemic.
3. IV fluids should be warmed prior to administration, and wrapped in a blanket or other insulating material to keep them warm. Room-temperature IV fluids will increase the cold stress.
4. Radiant warmers are used to gradually increase the neonate’s temperature.

Cognitive level: Analysis

Category of Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 29.3 Explain the causes, effects, and the nursing care management of newborns with selected metabolic abnormalities (including cold stress and hypoglycemia).